Negative attitudes toward patients can adversely impact health care quality and contribute to health disparities. Stigmatizing language written in a patient’s medical record can perpetuate negative attitudes and influence decision-making of clinicians subsequently caring for that patient. This qualitative study of 600 encounter notes from 138 physicians found 6 ways that physicians express positive feelings toward patients in medical records, including compliments, approval, and personalization. This study also found 5 ways that physicians express negative feelings toward patients, including disapproval, discrediting, and stereotyping.