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Cited by 126Opioid Use Disorder TreatmentPain Management and Opioid UseDiversity and Career in Medicine

The Effect of Race/Ethnicity and Desirable Social Characteristics on Physicians' Decisions to Prescribe Opioid Analgesics

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Tamayo-Sarver, Joshua H., Dawson, Neal V., Hinze, Susan W., Cydulka, Rita K., Wigton, Robert S., Albert, Jeffrey M., Ibrahim, Said A., Baker, David W.·2003·Academic Emergency Medicine
DOI 10.1111/j.1553-2712.2003.tb00608.x
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Abstract

OBJECTIVE: Racial/ethnic disparities in physician treatment have been documented in multiple areas, including emergency department (ED) analgesia. The purpose of this study was to determine if physicians were predisposed to different treatment decisions based on patient race/ethnicity and if physicians' treatment predispositions changed when socially desirable information about the patient (occupation, socioeconomic status, and relationship with a primary care physician) was made explicit. METHODS: The authors developed three clinical vignettes designed to engage physicians' decision-making processes. The patient's race/ethnicity was included. Each vignette randomly included or omitted explicit socially desirable information. The authors mailed 5,750 practicing emergency physicians three clinical vignettes and a one-page questionnaire about demographic and practice characteristics. Chi-square tests of significance for bivariate analyses and multiple logistic regression were used for multivariate analyses. RESULTS: A total of 2,872 (53%) of the 5,398 potential physician subjects participated. Patient race/ethnicity had no effect on physician prescription of opioids at discharge for African Americans, Hispanics, and whites: absolute differences in rates of prescribing opioids at discharge were less than 2% for all three conditions presented. Making socially desirable information explicit increased the prescribing rates by 4% (95% CI = 0.1% to 8%) for the migraine vignette and 6% (95% CI = 3% to 8%) for the back pain vignette. CONCLUSIONS: Patient race/ethnicity did not influence physicians' predispositions to treatment plans in clinical vignettes. Even knowing that the patient had a high-prestige occupation and a primary care provider only minimally increased prescribing of opioid analgesics for conditions with few objective findings.

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  • Presenting each participant with three vignettes depicting patients of three different ethnicities probably alerted them to the objective of the study.

    “thus probably alerting them to the objective of the study [40].”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [40]

    The Assignment section says each physician received three vignettes, one for each patient race/ethnicity. The Limitations section acknowledges that physicians might guess the study hypotheses, but describes efforts to blind them and does not say the vignettes probably alerted them. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • One study that found no evidence of racial bias in prescription of opioid analgesics presented each participant with three vignettes depicting patients of three different ethnicities.

    “one study that found no evidence of racial bias in prescription of opioid analgesics presented each participant with three vignettes depicting patients of three different ethnicities”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [40]

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Authors
Tamayo-Sarver, J. H., Dawson, N. V., Hinze, S. W., Cydulka, R. K., Wigton, R. S., Albert, J. M., Ibrahim, S. A., & Baker, D. W.
Affiliations
  • MetroHealth Medical Center (US)
  • Case Western Reserve University (US)
  • University of Nebraska Medical Center (US)
  • University of Pittsburgh (US)
ORCID
Venue
Academic Emergency Medicine
Publisher
Wiley
Published
2003-11
Volume
10
Issue
11
Pages
1239-1248
ISSN
  • 1069-6563 (ISSN-L)
  • 1553-2712
DOI
10.1111/j.1553-2712.2003.tb00608.x
OpenAlex
W2090581395
Cited by
126
References
4
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 7 · 2022: 6 · 2021: 7 · 2020: 1 · 2019: 9 · 2018: 4 · 2017: 4 · 2016: 5 · 2015: 7 · 2014: 10 · 2013: 8 · 2012: 2
FWCI
5.55
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1 (tdm, 4322 d)
Locations
  • Academic Emergency Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Case Western Reserve University
  • School of Medicine, Case Western Reserve University
  • Agency for Healthcare Research and Quality
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
Keywords
racial and ethnic disparities, opioid prescribing, emergency department analgesia, physician decision-making, socioeconomic status, occupation, clinical vignettes, African Americans, Hispanic Americans, migraine, back pain
MeSH terms
Analgesics, Opioid, Attitude of Health Personnel, Emergency Service, Hospital, Ethnicity, Female, Humans, Male, Pain, Practice Patterns, Physicians', Social Desirability, Logistic Models, Racial Groups

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