bias among physicians toward minority patients overtly as well as heavily -- as well as supplely -- subtley. this really catapulted the issue of minority health from a public health issue to a civil rights one. as i said, with the different types of remedies implied, sensitivity training for doctors, affirmative action, and even potential tidal six legal challenges. the main problem with the institute of medicine report is that it sought to prove bias or discrimination, and i just speak from the standpoint solely of methodology. this is almost impossible to prove using retrospective approaches, and using large databases. in a sense, charging bias is a diagnosis of exclusion. it is the kind of thing that you arrive at, which is not to say it does not exist, it could well, but it is one of the things that you arrived at after ruling on variables that we can measure and identify, other kinds that would lead to differences, and with large databases, this is very hard. one problem with the report, i have chronicled most of them in this health disparities handout that will give you afterwards, on