 Covariates: Patients pain and provider assessment of patients pain are determinants of treatment and thus have the potential of confounding the relationship between raceethnicity and treatment if they vary systematically by raceethnicity.10 Pain was measured in several ways: Patients were asked to rate their pain intensity on a validated and reproducible 11-point numerical rating scale NRS ranging from 0 no pain, to 10 worst imaginable pain.18 They were also asked to describe pain categorically as: no pain, mild pain, moderate pain, or severe pain. Change in pain was measured by response to the question: How does your pain feel now compared to when you entered the Emergency Room? It was also measured by the difference between the patients rating of pain at entry and pain at discharge. At time of discharge the treating physicians were asked to recall and rate the patients initial pain using the same verbal descriptors used by the patients We reasoned that asking doctors to rate patients pain before they made treatment decisions might bias treatment. 