One last question: opening Pandora's box?

Family physicians are oriented and trained to inquire about the meaning of patients' symptoms and to recognize when major concerns or worry are present. Yet, in the context of busy practices and the many interruptions of our workday, we may concentrate too much on efficiency in conducting visits and completing tasks for patients, with a resulting narrow focus on the medical or biological aspects of the patient's complaint. This essay tells the story of 2 patient encounters in which I, an experienced family physician, almost missed noticing deep fears experienced by each patient. These experiences led me to reflect on the contextual, patient, and personal factors that can get in the way of recognizing and reaching a deeper understanding of patients' worries, and on the power we have to assuage fears when we address them directly instead of hesitating to open Pandora's box.