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'Windows of Opportunity' to Address Patients' Concerns: Too Small and Too Few?

Avery Hart, MD
JAMA. 1993;270(10):1195. doi:10.1001/jama.1993.03510100045016.
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To the Editor.  —The recent article by Drs Branch and Malik1 describes a valuable interview technique, the "window of opportunity." This type of interaction is reminiscent of the "flash" that Michael and Enid Balint recognized and cultivated in their work with experienced primary care physicians at University College Hospital in London. The flash was described as "a brief, intense, and close contact" that serves "to provide the patient with an opportunity to communicate whatever it is he wants."2Analyzing a sample interaction, Michael Balint3 described the physician's role as chiefly "tuning into the patient, understanding her communications, and responding to them so that she would feel that she was understood." Enid Balint4 pointed out that, while the flash allowed considerable freedom for both physician and patient, it also called for the discipline of close observation by the physician, both of the patient and of the physician's own


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