Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Keeping The Readers in Mind


When documenting in the medical record, we must use respectful language. Both our patients and colleagues will appreciate and benefit from our thoughtfulness. 

“Did you read what the doctor wrote?” my patient asked me in tears. My patient’s consultant’s notes gave an extensive description of how she wasn’t “cooperative” because she didn’t want a medical student present during her physical exam.



In medical school, we’re trained in the structure of the medical note, with an emphasis on writing concise and accurate assessments and plans. We’re rarely taught to use unbiased language. We’re not taught that negative adjectives like “disheveled,” “difficult,” and “alcoholic,”  stigmatize patients.  



As clinicians, we’re privileged to write narratives about our patients. We’re responsible for being mindful about the language we use in our notes. Neutral and respectful words should be used. We must also be aware that our notes can cause harm to patients if they’re not carefully written. 








This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.