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Dr Paulson is a second-year resident in internal medicine at Good Samaritan Regional Medical Center, in Phoenix, AZ. Dr Aguilar-Gaxiola is professor and chair of the Section on Reducing Health Disparities at the University of California—Davis.

Address correspondence to Anthony H.Dekker, DO, Administration, Phoenix Indian Medical Center; 4212 N 16th Street, Phoenix, AZ 85016–5319. E-mail: Anthony.Dekker{at}ihs.gov

Not all patients are treated equally for their pain with some therefore being undertreated. Discrepancies still exist in the way physicians treat special populations of patients such as racial minorities, women, and substance abusers. All healthcare providers need to be aware of the not so readily apparent disparities resulting from stereotyping, bias, ageism, and socioeconomic considerations. Physicians can best provide appropriate and equal care by following pain management guidelines; however, they may receive contradictory information and be apprehensive about prescribing opioids, especially to substance abusers. In this "refreshed" article, the authors describe patient encounters with patients of color and offer some goals for removing inequality and inequity from clinical settings.