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In Reply: As petroleum prices near record highs, peak petroleum seems increasingly salient for clinicians of all specialties. Dr Monroe correctly notes that transportation options may influence a woman's choice of breast cancer treatment. It seems reasonable that other specialties and services requiring repeated visits—from dermatology to physical therapy, from renal dialysis to drug addiction treatment, from prenatal care to psychiatry—could be similarly affected. Rural health care, requiring patients to drive long distances, raises similar concerns. Clinicians across the spectrum should plan proactively for peak petroleum to help soften the impact that patients may otherwise sustain.

Financial Disclosures: None reported.

Howard Frumkin, MD, DrPH
hfrumkin@cdc.gov

Jeremy Hess, MD, MPH; Stephen Vindigni, MPH
National Center for Environmental Health/Agency for Toxic Substances and Disease Registry
Centers for Disease Control and Prevention
Atlanta, Georgia

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

JAMA. 2008;299(4):408.

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RELATED LETTER

Gasoline Costs and Treatment Choices
Alan T. Monroe
JAMA. 2008;299(4):407-408.
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