Background: Unconscious bias within the U.S. health care system has been linked with disparities in the treatment of patients by age, gender, and race (1). While many factors contribute to these disparities, implicit bias may play a significant role. Stigmatizing language often reflects the implicit bias that healthcare providers possess toward patients (2). Recent research [...]

Background: Stigmatizing language in clinical notes can negatively impact physician attitudes, propagate bias, affect prescribing behaviors, and exacerbate healthcare disparities, yet remains prevalent even in the Open Notes era. Prior analyses of stigmatizing terms in clinical notes are limited by the lack of context in which terms are used and multiple meanings of certain words [...]

Background: Use of stigmatizing language in clinical note documentation is a recognized problem, but such notes may be viewed disparately and irregularly. Whether such language is also used in highly visible behavioral alerts (BAs), which are presented forcefully through push notifications and viewed repeatedly whenever a chart is opened, is unknown. Further, whether BAs with [...]

Background: Biases related to people with substance use disorder (SUD) actually increase during time spent in formal medical education, and continue into practice. Leading health professional education groups across medicine, nursing, pharmacy, and social work, including the Association of American Medical Colleges (AAMC), have recognized addressing substance use disorders including stigma and bias as a [...]

Background: Self-directed discharge, also known as Against Medical Advice (AMA) discharges, comprise 1–2% of hospital discharges (1). The AMA process poses safety risks to patients and emotional strain on providers, potentially leading to implicit biases in documentation (2). While stigmatizing language in medical records has gained attention (3), its prevalence in AMA documentation remains underexplored. [...]