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Your writing style may determine whether your doctor responds. A new study found that Black and Hispanic patients receive lower response rates to patient portal messages than White patients — and writing style alone accounts for up to 60% of that gap. Researchers say health systems need to rethink how messages are triaged to ensure equitable digital care.
A large study published in JAMA Network Open reveals that patients from historically marginalized racial and ethnic groups are less likely to receive responses from their care teams when they send messages through patient portals — and the way they write their messages is a major factor behind the gap.
Researchers from Harvard University analyzed over 3.6 million patient message threads from more than 511,000 patients using natural language processing. They found that Black patients had a 3.7 percentage point lower response rate from their target clinician compared with White patients — an 11.6% relative reduction. Writing style (not just message content) was identified as the biggest explainable driver of these disparities.
Why it matters: Patient portals are increasingly central to healthcare communication, but this study suggests they may be quietly amplifying existing inequities. If triage systems — whether human or AI-assisted — are responding differently based on writing style, health systems could be inadvertently disadvantaging already-marginalized patients. The findings call for urgent redesign of digital communication tools to ensure equitable care for all.