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

Charles S. Berlin, MD
JAMA. 1993;270(10):1196. doi:10.1001/jama.1993.03510100045018.
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To the Editor.  —Drs Branch and Malik1 are to be congratulated for reminding us that patients' psychosocial needs can and should be addressed within the context of an office medical interview. It seems, however, to be a telling commentary that such skills as trust, empathy, asking open-ended questions, and waiting for a response are regarded as newsworthy by the editors. One presumes, perhaps naively, that every medical student is taught these basic skills early in training, hoping that they are reinforced at each further experiential step. A more interesting line of inquiry might have been to delineate why such empathic questioning did not occur in the majority of the taped interviews. Branch and Malik note that "in an era when cost-effectiveness receives high priority," these several-minute sound bites may suffice "to meet patients' psychological and social as well as medical needs." While this may be a reality of the


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