The use of patient portal messaging has become increasingly common, yet a recent study indicates that there are disparities in response rates based on the writing style of messages sent by patients. Research led by Dr. Mitchell Tang from Columbia University examined over 3 million patient message threads and revealed that messages using formal greetings and positive expressions are more likely to prompt a response from doctors, reports BritPanorama.
In analysing 1 million messages within the Mass General Brigham electronic health record system, Tang and his colleagues found that the writing characteristics, such as the presence of a greeting and use of punctuation, explain approximately half of the response rate disparities observed among historically marginalised groups, including non-White patients and those enrolled in Medicaid.
Notably, messages initiating with “Dear Dr. [Last Name]” were correlated with increased responses. Messages that included the doctor’s first name saw an even greater likelihood of receiving a reply, up to double that of those without a greeting. Additionally, the study noted that expressive punctuation, by way of multiple question marks or exclamation points, improved response rates significantly.
Tang highlighted the importance of these findings as a step towards addressing potential biases in healthcare communications. He emphasized that rather than attributing the issue to patients, healthcare providers should be encouraged to refine their systems. “The best way of dealing with this is actually to try to improve the system working on the back end,” he asserted.
Current initiatives aim to standardize messaging within patient portals, which could enhance communication efficiency. Tang suggested that artificial intelligence tools may be useful in helping patients construct their messages to better navigate the system. “Could we have AI tools that help patients draft their messages so that we can level the playing field to some degree?” he posited.
When to message, when to call
Since 2020, there has been a marked increase in the use of patient portal messaging, while phone calls to healthcare providers have declined. This surge in electronic messages has implications for physician workload, potentially contributing to burnout. In light of this, doctors recommend that patients opt for direct phone calls when inquiries require more elaboration than a single message can convey.
Tang communicated to CNN that patients should not rely on portal messages for urgent needs, advising them to anticipate a response within two business days for non-urgent inquiries. “If the need is more urgent than that, then they should probably call,” he advised.
The messages more likely to get a response
The study further identified specific writing style traits associated with higher response rates that may not apply universally across all health systems or languages. For instance, a clearer correlation was established with longer messages, which often contained more specifics, suggesting a greater likelihood of the message being escalated to the intended clinician.
What’s in a greeting
The initial sentence of a message is critical; messages addressing doctors with proper salutations tend to elicit prompt responses. Tang remarked, “If you start your message with ‘Dear Dr. Tang,’ we find that it’s much more likely that Dr. Tang is ultimately the one who responds to you.”
Punctuation matters
Moreover, messages featuring expressive punctuation garnered favourable responses. The study suggested that emotional resonance in messaging can significantly influence the doctor’s engagement with the patient.
Positive vs. negative
Interestingly, messages that incorporated positive sentiments, even when addressing health concerns, were found to achieve higher response rates compared to those expressing negativity.
Longer messages
Contrary to traditional advice that patients should strive for brevity in communications, the findings indicated that lengthier messages are more likely to be processed successfully by medical staff. Tang noted that this complexity corresponds with a greater probability of the inquiry being escalated for physician attention.
These insights into patient-doctor communications underscore the evolving nature of healthcare interactions, as both patients and providers adapt to the growing integration of digital platforms in medical practice.
