Over the past few months, I’ve had to see various primary care and specialist physicians as a patient. (I’m basically fine.) However, this required that I interact with multiple physicians and their staff via their “medical portals” to ask questions, make appointments, and receive test results.

Most medical offices are extremely busy, and they receive numerous patient messages throughout the day. Most questions are screened by the office staff before they are relayed to the physician.

Dr. Mitchell Tang and colleagues recently studied the factors that determined how quickly medical offices responded to patient questions submitted through their portals. They reviewed more than 3.6 million messages sent by 500,000 patients in the years 2021-2023. Their conclusion: “Seemingly minor differences among messages, such as whether the opening included the target clinician’s name, were associated with significantly different response rates. In many message triage systems, nurses and medical assistants must quickly assess messages—often with little context—and make snap judgments on their urgency, complexity, and need for escalation.”

If you are a patient who wants to improve your chances of getting a timely and helpful answer from your doctor, here are a few tips:

1. Start your message by greeting your doctor by name.

For instance, “Dear Doctor [last name], I hope you are doing well. I am writing because I am worried about a bad cough”, rather than “I have a bad cough.”

Interestingly enough, including the doctor’s first name as well as the last name seemed to help response rate even more.

2. Express a positive sentiment, as opposed to a neutral or negative tone.

For example, expressing appreciation for past help or thanking the doctor for their time was more helpful than emphasizing sadness or frustration.

3. Write longer, more detailed descriptions of one’s concerns.

Messages of greater than 100 words were more likely to receive a quick reply than short messages of 4-25 words.

Dr. Tang and colleagues provided an example of two messages illustrating these points . Rightly or wrongly, they observe that, “Although both share the same underlying request, differences in writing style may lead a busy nurse to perceive and prioritize them differently.” In this case, Message 2 would be more likely to receive a response than Message 1. (See image below.)

Interestingly enough, some factors made very little difference in response rate. For example, the education level of the patient had little effect : “Notes written at a third- to sixth-grade level were as likely as those at a college level to receive a doctor’s response.”

Nor did using excess punctuation (multiple question marks or multiple exclamation marks) seemed to make a difference in response rate.

If a patient is not quite sure how to best apply these tips, Dr. Tang suggests they could consider using AI to help draft their messages: “We talk about AI tools to help doctors draft their messages. Could we have AI tools that help patients draft their messages so that we can kind of level the playing field to some deg(ee?”

Dr. Tang also notes , “I want to be cautious not to victim-blame here.” He also notes that this research gives physicians and medical offices an opportunity to examine their own potential biases in how they respond to patients, based on the patient’s communication style. I agree with him. The quality of a patient’s care should not depend on the exact word choices they utilize in sending portal messages.

But the more that patients understand how to effectively receive the attention of their physician through writing choices, the more likely they are to receive the answers they need.