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Dennis H. Novack, MD
MCP-Hahnemann School of Medicine Philadelphia, Pa

William Clark, MD
Addiction Resource Center, Midcoast Hospital Bath, Me

Richard Frankel, PhD
Primary Care Institute Rochester, NY

JAMA. 1997;278(20):1658.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply

—We derived our statement about Indian and Pakistani residents' training from a qualitative study of international medical graduates, coauthored by a member of our working group.¹ The study illustrated how cultural differences may act as barriers to patient care and reflected the opinions of Indian and Pakistani residents in a single program. We apologize for what may have been an overgeneralization. We certainly meant no offense to our Indian and Pakistani colleagues.

We made no claims to scientific proof that particular physician personal qualities "caused" certain behaviors. We cited studies to substantiate our assertion that physician personal factors affect patient care. Nightingale and Grant² reported strong associations between physicians' attitudes toward risk and their use of certain health care resources, preferences for intubation, and the duration of resuscitation efforts. Physician gender affects clinical decisions. The presence of a cautionary statement in 1 of our 12 citations on gender . . . [Full Text PDF of this Article]

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