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.
Berger JT. Demographic Characteristics and Opioid Prescribing. JAMA. 2008;299(15):1773-1774. doi:10.1001/jama.299.15.1773-b