Columbia University study finds message style affects doctor response rates

A study published in JAMA Network Open reveals that the writing style of patient messages in online portals significantly influences whether a physician responds. Analyzing over 3 million message threads from the Mass General Brigham electronic health record system, researchers found that writing characteristics account for approximately half of the disparities in response rates observed among historically marginalized groups, including non-White patients, individuals without a college education, and Medicaid recipients.

Key factors affecting response rates include the use of formal greetings, such as ‘Dear Dr.’, and the use of the physician’s first name, which was associated with nearly twice the likelihood of a response compared to messages without a greeting. Additionally, expressive punctuation, such as multiple question marks or exclamation points, and positive sentiment were linked to higher response rates, whereas messages expressing frustration or sadness saw lower rates.

Dr. Mitchell Tang of Columbia University’s Mailman School of Public Health, who led the study, emphasized that the goal is not to place the burden of communication on patients. Instead, he suggested that the findings highlight a need to improve the healthcare system’s back-end processes and standardization to mitigate these biases.