We appreciate Dr. Doroghazi's comments. We feel, however, that he has misunderstood our basic point. Our intent was to shed some light on a subject in medical history taking and case presentation about which little has been written.

He describes our position as advocating dropping race from case presentations. In fact, we have tried to show that skin color is a poor indicator of a person's ethnic background. What is commonly perceived as race, often on the basis of skin color, has little scientific meaning. Ethnicity, because it includes both a person's genetic constitution (and probably something about their belief systems), is a better indicator of the diseases to which they may be inherently prone and the ways in which they may react to both illness and treatment.

Rather than attempt to broadly categorize individuals into groups that often have little relevance or biological meaning, we suggest that a brief ethnic history be obtained if the physician suspects that this factor may be germane to the case. Given the broad variety of persons included in the terms "black" or "white," the clinical utility of these terms is limited. Ethnicity should be explored in some cases and could be appropriately presented either in the history of present illness or the social history. Skin color could be noted with other physical findings.

Rather than propose that "thought police" be used to bother our already harried profession, we suggest that clinicians recognize the limited scientific meaning of the terms "black" or "white." Often of much greater relevance is a person's type of work. Perhaps a universally more relevant "opening line" is one's occupation; that is, "a 36-year-old male truck driver ..." or "a 56-year-old former furniture refinisher ... ." Ethnicity can then be introduced in relevant cases.