, Volume 27, Issue 10, pp 1231-1232

All in a Day’s Work: Establishing Rapport, Making Decisions, Reducing Disparities

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Sandy (not his real name) cuts my hair. He and I usually talk about politics and sports. Last week, something else was on his mind—his disappointment with his recent visit to new primary care doctor. As a small business owner, Sandy had finally decided he could afford to pay for health insurance that would cover preventive care and allow him to go for a check-up for the first time in about 10 years. Sandy smokes, and has done so on and off since he was 17 years old. He is 35 years old now and otherwise in pretty good health. He has quit for varying lengths of time in the past, but always goes back to smoking when he confronts another stressful period in his life. He had not made this appointment because he wanted to quit smoking; in fact, he had made it for the same reason that prompts many men to schedule a check up with their doctor. His girlfriend convinced him to do so.

It seems that his well-intentioned internist had an agenda for the appointment. She correctly advised Sandy that t