Clinical Report: Patients’ Perspectives on Judgmental and Disrespectful Language in Medical Records

Overview

This nationally weighted cross-sectional online survey was designed to assess US adults’ reports of disrespectful or judgmental language (DJL) in medical records, anticipated consequences, and related sociodemographic, clinical, and trust factors. The supplied article excerpt describes the study rationale and methods but does not provide survey results, so the frequency of reported DJL and its reported consequences cannot be summarized.

Background

The 21st Century Cures Act’s information-blocking rule enabled patients to access clinical notes through electronic health record portals, making documentation language visible to patients. Prior research cited in the article found that some patients felt judged or offended by notes and that negative descriptors appeared in clinical records, with disparities reported by race. Existing research has often relied on investigators’ assessments or analyses of notes rather than patients’ direct accounts. The study therefore sought population-weighted estimates of patient-reported DJL and its perceived consequences among US adults.

Data Highlights

Key Findings

• The study was designed to measure patient-reported exposure to disrespectful or judgmental language in medical records across a nationally weighted sample of US adults.
• The survey was administered online by YouGov from November 21 through December 4, 2025, with a prespecified analytic sample of 500 individuals.
• Survey weighting used poststratification by age, gender, race and ethnicity, education, and geographic region, with benchmarks from the US Census Bureau’s American Community Survey.
• The primary outcome included reports of DJL in respondents’ own records or in the records of a loved one.
• Prior studies cited in the article reported that 10% of patients accessing notes at three outpatient sites felt judged or offended by documentation, and that negative descriptors appeared in 8.2% of patients in an analysis of more than 40,000 notes.
• The supplied excerpt does not report the survey’s findings on DJL frequency, anticipated consequences, associated factors, or trust in clinicians’ documentation.

Clinical Implications

The article’s rationale identifies patient access to clinical notes as a context in which documentation language is directly visible to patients. The supplied excerpt does not provide the survey results or specific author recommendations, so it does not support further practice conclusions.

Conclusion

This study was designed to address the limited availability of population-level evidence based on patients’ own perspectives on judgmental and disrespectful language in medical records. Its results are not present in the supplied material.

Related Resources & Content

1. Article title and authors not provided, Source not provided, Year not provided — Patients’ Perspectives on Judgmental and Disrespectful Language in Medical Records
2. Journal of General Internal Medicine, 2026 — Multicenter Survey of Hospital Clinicians’ Awareness and Use of Stigmatizing Language in Clinical Notes
3. ASCO Publications, 2026 — Characterizing patient decisions: Disparities in stigmatizing language use in cancer care electronic health records
4. ASCO Publications — “It sounds very negative”: Patient perspectives on de-escalation of treatment concept and language.
5. ASCO Publications — Words matter: How clinical encounters can be unknowingly stigmatizing to some patient communities.
6. Information Blocking - ONC - Office of the National Coordinator for Health Information Technology
7. Person-first and Destigmatizing Language - National Institutes of Health
8. Information Blocking - ONC - Office of the National Coordinator for Health Information Technology
9. Enforcement Alert - ONC - Office of the National Coordinator for Health Information Technology
10. Information Blocking | Office of Inspector General | Government Oversight | U.S. Department of Health and Human Services
11. FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule –- CMS-1808-F | CMS
12. Finally, CMS has finalized disincentives that are designed to deter information blocking; they are not impermissibly punitive. As discussed in section III.C.2. of this final rule, a reduction of three quarters of the annual market basket update deters eligible hospitals from engaging in information blocking because it would reduce the inpatient prospective payment system (IPPS) payment that an eligible hospital could have earned had it met other requirements under the Medicare Promoting Interoperability Program. For CAHs, receiving 100 percent of reasonable costs instead of the 101 percent of reasonable costs that a CAH may have earned for successful participation in the Medicare Promoting Interoperability Program deters information blocking by CAHs because it reduces the reimbursement a CAH could have received had it met other requirements under the Medicare Promoting Interoperability Program. For MIPS eligible clinicians, the disincentive under the MIPS Promoting Interoperability performance category deters information blocking by other MIPS eligible clinicians because a MIPS eligible clinician who receives a score of zero in the MIPS Promoting Interoperability performance category under the disincentive cannot earn a positive MIPS payment adjustment factor that they otherwise could have earned for their performance in MIPS (88 FR 74960). Finally, the disincentive CMS has finalized under the Shared Savings Program deters information blocking by potentially withholding revenue which an ACO or participant in an ACO might otherwise have earned through participation in the Shared Savings Program.
13. Communicating With and About People with Disabilities | Disability and Health | CDC
14. Person-first and Destigmatizing Language | National Institutes of Health (NIH)
15. Effective Patient-Physician Communication | ACOG
16. Sharing Clinical Notes With Patients: A New Era of Transparency in Medicine | Shared Decision Making and Communication | AMA STEPS Forward | AMA Ed Hub
17. Reference Committee F
18. How words discredit: A taxonomy of stigmatizing language in the electronic health record - PMC
19. Journal of Medical Internet Research - Stigmatizing Language in Gender-Expansive Patient Records: Corpus Development, Disparity Analysis, and Natural Language Processing–Based Detection Study
20. Hospital-Based Clinicians' Knowledge and Practices Regarding Stigmatizing Language in Clinical Documentation: A Multicenter Survey.