Judgmental language in care linked to lower patient trust

Clinical takeaway: Use neutral, person-centered language in notes and conversations. Describe behaviors and treatment barriers rather than labeling patients, and invite feedback about wording they find disrespectful.

Clinical notes communicate more than diagnoses and treatment plans. As patients increasingly read their records, wording that conveys disbelief or disapproval may affect their relationship with the clinicians who write them.

A nationally weighted survey of 500 US adults found that disrespectful or judgmental language was associated with substantially lower trust in clinicians to document care accurately and respectfully.

Among patient portal users, 17.1% reported encountering such language in their own or a loved one’s medical records. Among nonusers, 15.6% reported it in health care encounters.

Diminished trust in clinicians’ documentation was reported by 39.6% of respondents who experienced disrespectful language, compared with 13.0% of those who did not. The association persisted after adjustment for demographic and health characteristics. Younger adults, people with lower incomes, and those with chronic pain were more likely to report these experiences.

Respondents also anticipated consequences for future care. Approximately three-quarters believed disrespectful language could influence a new clinician’s treatment decisions or contribute to worse health outcomes. About 86% said they would be less likely to return to a clinician who used it. These responses reflected expectations, rather than observed errors or care discontinuation.

The findings support reviewing documentation habits alongside communication during visits. Describing why a patient has difficulty following a treatment plan, for example, provides more useful clinical information than labeling the patient “noncompliant.”

“Realizing the promise of health information transparency will require concurrent reform in respectful language in clinical documentation and health care encounters,” the study authors concluded.

Source: Steele N, et al. (2026 Oct 13) JAMA Netw Open. Patient experiences of disrespectful or judgmental language in medical records