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read with great interest and astonishment the commentary in the November issue of Texas Medicine titled “Epidural Use Disparities by Spanish-Speaking Patients in Labor” by Estevan Apodaca, MD, and Swati Avashia, MD. They asserted the disparity in epidural use they witnessed was part of health care’s long history of providing inferior care to minority and marginalized patients. They concluded that this concerning trend was due to a lack of effort to educate the patient and that not doing so was an acceptable practice. They concluded the Spanish-speaking patient should have the same opportunity as the English-speaking patient to make an informed decision concerning labor pain management. I am a maternal-fetal medicine physician in private practice. I have practiced obstetrics for 34 years, and I am on staff at several hospitals in the Dallas-Fort Worth area and in East Texas. I have never observed the deliberate mistreatment of Spanish- speaking obstetrical patients as described by the physician authors.


Their deliberately disparaging re-


marks about the state of obstetrical care concerning epidural placement is an insult to the many nurses, mid- wives, physicians, and nurse anesthe- tists who care for such Texas patients. If Drs. Apodaca and Avashia have direct knowledge of care violations based on race or language, they have a duty to report it to the appropriate state agencies and boards. I hope they have the courage to


name names. Otherwise, they dem- onstrate another acceptable practice: making an accusation without cor- recting the wrong they are so con- cerned about.


JACK M. GRAHAM, MD GRAPEVINE


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To submit a letter, email it to Texas Medicine Editor Crystal Zuzek, crystal.zuzek@texmed.org. Please limit letters to 250 words.


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March 2017 TEXAS MEDICINE 7


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