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Journal of General Internal Medicine

, Volume 16, Issue 4, pp 211–217 | Cite as

Do gender and race affect decisions about pain management?

  • Carol S. WeisseEmail author
  • Paul C. Sorum
  • Kafi N. Sanders
  • Beth L. Syat
Original Articles

Abstract

OBJECTIVE: To determine if patient gender and race affect decisions about pain management.

DESIGN, SETTING, AND PARTICIPANTS: Experimental design using medical vignettes to evaluate treatment decisions. A convenience sample of 111 primary care physicians (61 men, 50 women) in the Northeast was asked to treat 3 hypothetical patients with pain (kidney stone, back pain) or a control condition (sinusitis). Symptom presentation and severity were held constant, but patient gender and race were varied.

MEASUREMENTS AND MAIN RESULTS: The maximum permitted doses of narcotic analgesics (hydrocodone) prescribed at initial and return visits were calculated by multiplying mg per pill × number of pills per day × number of days × number of refills. No overall differences with respect to patient gender or race were found in decisions to treat or in the maximum permitted doses. However, for renal colic, male physicians prescribed higher doses of hydrocodone to white versus black patients (426 mg vs 238 mg), while female physicians prescribed higher doses to blacks (335 mg vs 161 mg; F1,85=9.65, P=.003). This pattern was repeated for persistent kidney stone pain. For persistent back pain, male physicians prescribed higher doses of hydrocodone to males versus females (406 mg vs 201 mg), but female physicians prescribed higher doses to females (327 mg vs 163 mg; F1,28=5.50, P=.03).

CONCLUSION: When treating pain, gender and racial differences were evident only when the role of physician gender was examined, suggesting that male and female physicians may react differently to gender and/or racial cues.

Key Words

gender race pain treatment 

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Copyright information

© Blackwell Science Inc 2001

Authors and Affiliations

  • Carol S. Weisse
    • 4
    Email author
  • Paul C. Sorum
    • 1
  • Kafi N. Sanders
    • 2
  • Beth L. Syat
    • 3
  1. 1.Departments of Medicine and PediatricsAlbany Medical CenterAlbany
  2. 2.Department of Public HealthYale UniversityNew Haven
  3. 3.Center for Educational OutcomesDartmouth CollegeDurham
  4. 4.Department of PsychologyUnion CollegeSchenectady

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