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September 8, 1993

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

Author Affiliations

Brigham and Women's Hospital Boston, Mass
State University of New York at Stony Brook School of Medicine

JAMA. 1993;270(10):1196. doi:10.1001/jama.1993.03510100045019

In Reply.  —We observed ordinary encounters, not those concerned with special psychotherapeutic interventions. In fact, much happened between the open questions and empathic closures that we observed. This has been termed active listening. It entails hearing about the background, affect, and handling of patients' concerns. Much more is possible, however, in encounters between physicians and patients than we could observe in our brief study, and we recommend that physicians read The Fifteen Minute Hour, as cited by Dr Nutter.We are flattered that Dr Hart compares our observation with Enid and Michael Balint's "flash." Hart is correct in pointing out that brief interactions that are intensity dependent but not time dependent can be immensely effective, at least according to our observations.Drs Brock and Hammar perceive our observation as fostering the separation of psychosocial from medical interviewing. We meant no such thing. We were rather pleased to see that practicing