Avoiding Racist and Judgmental Clinical Documentation: Helping to Achieve Health Equity

• Published in: American family physician Vol. 109; no. 6; pp. 575 - 577
• Main Authors: Roth, Alan R., DO, FAAFP, FAAHPM, Lazris, Andy, MD, CMD
• Format: Journal Article
• Language: English
• Published: United States American Academy of Family Physicians 01.06.2024
• Subjects: COVID-19; Cultural differences; Decision making; Documentation - standards; Family Medicine/General Medicine; Health Equity; Health insurance; Humans; Insurance coverage; Internal Medicine; Medical records; Minority & ethnic groups; Racial discrimination; Racism - prevention & control; United States; United States; United States > US
• ISSN: 0002-838X; 1532-0650; 1532-0650

A patient files a complaint with hospital administration after reviewing his electronic health record through the patient portal. His new primary care physician began his documentation by describing the patient as a “55-year-old African-American male with uncontrolled blood pressure due to noncompliance with medical care.” The patient had recently started a new job and could not pay for his prescriptions because his health insurance coverage had not taken effect yet. The patient did not attend follow-up visits and a recommended cardiology consultation because he could not afford the copayments for the visits. The patient identifies as Dominican Hispanic, not African American, and feels he was being stigmatized for his race and socioeconomic status and was a victim of stereotyping and racial bias.