How to Get Your Doctor to Respond Online

Telehealth appointments have become a standard part of medical care, with patient portals seeing a sharp increase in use during the COVID-19 pandemic. While these digital tools offer a convenient way to seek medical advice, getting a timely response from a physician requires more than just a clear description of symptoms. Research suggests that the writing style of a message often determines whether it gets passed along to the doctor or gets stuck in the queue.

Staffers Decide Who Gets Seen

Many patients assume their messages go directly to their doctor’s inbox, but a care team member typically reviews these messages first. A nurse or similar staff member must quickly assess the level of urgency and decide which messages should be forwarded to the physician for a response. Because these staff members must make rapid decisions, they often rely on cues in the text itself rather than just the medical facts presented.

The findings could help health systems identify potential sources of bias in portal messaging. When staff members have limited time to review messages, they may unconsciously prioritize messages that match their own communication patterns. This means that a patient’s ability to get a doctor’s attention is often less about the medical condition being described and more about how the message is constructed.

Words and Tone Matter

Researchers at Columbia University’s Mailman School of Public Health analyzed over 3.6 million messages sent by more than 510,000 patients during a two-year period. They found that writing style accounted for a significant portion of the difference in response rates between various demographic groups. For instance, writing style explained 48 percent of the disparity in response rates between Black patients and white patients, and 35 percent of the gap between Hispanic and white patients.

The study also highlighted how education levels and insurance status affected response times. Writing style accounted for 60.5 percent of the difference in response rates between patients with a high school diploma and those with a college degree, and 43 percent of the gap between patients on Medicaid and those with commercial insurance. These statistical correlations suggest that patients from marginalized groups, such as those with less education or limited English proficiency, were less likely to receive a response, not necessarily because their medical needs were less urgent, but because their writing style was perceived differently by the staff reviewing the messages.

Patients from each of these groups can write messages quite differently, according to Mitchell Tang, the first author on the study and an assistant professor of health policy and management at Columbia University Mailman School of Public Health. Those differences in language use can make it less likely that a doctor will respond, even when the clinical need is high. The findings are a reminder about how communication style can influence how we perceive and respond to people, not only in healthcare but in everyday life.

Mitchell Tang notes that communication style plays a significant role in how messages are perceived.

The researchers used natural language processing to analyze the messages, which allowed them to identify patterns and characteristics of writing styles that were associated with different response rates. This approach enabled them to quantify the impact of writing style on response rates and identify areas where biases may exist.

How to Get a Faster Reply

Patients hoping to get a response from their care team can take a few steps to improve their chances. Using the doctor’s name in the opening of the message, starting with “Dear Dr. Jones” rather than jumping into the details, makes it more likely that Dr. Jones is the one who will end up responding. Expressive punctuation, such as exclamation points and question marks, also helps convey a friendly and positive tone.

Being specific with questions and providing clear details about symptoms can further assist the care team. Patients should describe when symptoms occur, how often they happen, what they feel like, and how intense they are. Keeping the word count reasonable—while ensuring the message is long enough to be meaningful—also tends to help. Checking for spelling errors before sending ensures the message looks professional and is easier to read.

They should also keep their messages concise.

Researchers like Mitchell Tang are working to understand how communication styles affect healthcare outcomes.

The study’s results have implications for healthcare providers and policymakers, highlighting the need to address potential biases in portal messaging and ensure that all patients have an equal opportunity to receive timely and effective care. By promoting awareness and understanding of the importance of writing style in telehealth communication, healthcare systems can work to reduce disparities and improve patient outcomes.