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James Raymond Bell, MD
Des Moines, Ia

JAMA. 1997;277(18):1433.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Germane to the issue of "underdiagnosis" of depression¹ is the essential role of the primary care physician as patient advocate. The physician incentive is not to make a diagnosis of depression, but rather to make a symptom diagnosis and to treat depression. While the authors may question the logic and ethics of this statement, consider that both health and life insurance companies currently request copies of patient office charts, not summaries prepared by the primary care physician. I have had a significant number of patients either rated (ie, charged a higher insurance premium) or refused insurance coverage when the diagnosis of depression was noted on the chart by the insurance company.

Most depressed patients treated by this primary care physician are not suicidal, but I certainly agree that they are much happier and more productive with rather than without treatment. But reporting the diagnosis of depression . . . [Full Text PDF of this Article]

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