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To The Editor: The study by Dr Pletcher and colleagues¹ that described trends in opioid prescribing in emergency departments demonstrated continued race/ethnicity–based differentials in treatment. Despite literature showing that physicians' practice patterns are influenced by their own demographic characteristics as well as the clinically irrelevant demographic characteristics of their patients,² physician race/ethnicity was not a covariate examined by the researchers. In addition, a number of studies find that both subjective and objective aspects of medical care are better in patient-doctor dyads that are demographically concordant; in particular, sex concordance may favorably influence pain management.³ Further study of these persistent discrepancies in opioid prescribing should include greater attention to the prescriber characteristics as a relevant variable.

Financial Disclosures: None reported.

Jeffrey T. Berger, MD
jberger@winthrop.org
Winthrop University Hospital
Mineola, New York

1. Pletcher MJ, Kertesz SG, Kohn MA, Gonzales R. Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA. 2008;299(1):70-78. FREE FULL TEXT 2. Berger JT. The influence of physicians' demographic characteristics and their patients' demographic characteristics on physician practice: implications for education and research. Acad Med. 2008;83(1):100-105. PUBMED 3. Weisse CS, Sorum PC, Sanders KN, Syat BL. Do gender and race affect decisions about pain management? J Gen Intern Med. 2001;16(4):211-217. FULL TEXT | ISI | PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2008;299(15):1773-1774.

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Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments
Mark J. Pletcher, Stefan G. Kertesz, Michael A. Kohn, and Ralph Gonzales
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