Does portal writing style contribute to disparities in clinician response? - Report - MDSpire
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Does portal writing style contribute to disparities in clinician response?

Message length, punctuation, and clinician greetings were associated with intended clinician response.

  • By

  • Andrea Surnit

  • August 27, 2026

  • 4 min

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Does portal writing style contribute to disparities in clinician response?

Overview

This study analyzes 3.6 million patient-initiated messages to assess disparities in clinician responses based on writing style and content.

Background

Understanding disparities in clinician response to patient messages is crucial. The rise of digital communication through patient portals has transformed patient-clinician interactions, yet disparities persist.

Data Highlights

Demographic GroupResponse Rate DifferenceWriting Style Contribution
Black Patients3.7 percentage points lower48%
Hispanic PatientsNot specified35%
High School EducationNot specified61%
Medicaid BeneficiariesNot specified43%

Key Findings

  • Black patients had a 3.7 percentage point lower response rate from target clinicians compared to White patients.
  • Message content accounted for only 6% of the response gap for Black patients compared to White patients.
  • Writing style explained 48% of the response gap for Black patients and 35% for Hispanic patients.
  • Messages that included the clinician's name in the opening had a higher response rate (39%).
  • Shorter messages and lack of expressive punctuation were more common among historically marginalized groups.
  • Message length and sentiment were significant contributors to response rates among Medicaid beneficiaries and patients with a high school education.

Clinical Implications

Clinicians should be aware of the impact of writing style on response rates to patient messages.

Conclusion

The study highlights the significant role of writing style in clinician response disparities.

Related Resources & Content

  1. JAMA Network Open, 2026 -- Response of Healthcare Teams to the Content and Style of Messages in Patient Portals
  2. JAMA Network Open, 2026 -- Patient Perspectives on AI-Drafted Electronic Portal Messages
  3. ASCO AI in Oncology, 2026 -- Patients Back AI-Drafted Portal Messages
  4. Journal of Medical Internet Research, 2026 -- Disparities in Patient Portal Activation Among Neurology Patients
  5. JAMA Network Open, 2026 -- Care Team Response to Patient Portal Message Content and Writing Style
  6. JAMA Network Open, 2026 -- Patient-Physician Messaging by Race, Ethnicity, Insurance Type, and Preferred Language
  7. ACOG, 2025 -- Effective Patient-Physician Communication
  8. Care Team Response to Patient Portal Message Content and Writing Style | Emergency Medicine | JAMA Network Open | JAMA Network
  9. Patient-Physician Messaging by Race, Ethnicity, Insurance Type, and Preferred Language | Health Policy | JAMA Network Open | JAMA Network
  10. Effective Patient-Physician Communication | ACOG
  11. Language Access and Interpreter Services – Understanding The Requirements | Joint Commission
  12. Information Blocking - ONC - Office of the National Coordinator for Health Information Technology
  13. Coding Quarterly: E-visits in health care - American Academy of Sleep Medicine – Association for Sleep Clinicians and Researchers
  14. Joint Commission and Coalition for Health AI (CHAI) Release Initial Guidance to Support Responsible AI Adoption Across U.S. Health Systems | Joint Commission

Original Source(s)

Does portal writing style contribute to disparities in clinician response?

  • by Andrea Surnit

  • August 27, 2026

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