The majority of cases of clinical depression go unrecognized and untreated, despite the fact that depression is an eminently treatable disorder. The Agency for Health Care Policy and Research (AHCPR) recently published a set of clinical practice guidelines focused on depression in primary care settings. The review of the literature on which the guidelines are based is thorough and appropriate and should enhance the detection of depression and the quality of pharmacotherapy for depression. However, the guidelines encourage primary care physicians to provide pharmacotherapy to their depressed patients as the first line of treatment. The wisdom of this recommendation is questioned and revisions to the guidelines are suggested. Specifically, patients should be informed of the broad array of treatment options available and provided with a more balanced presentation of the potential benefits of psychotherapy for depression. Patients should decide which treatment alternative they wish to undergo.

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Using data from the Bern Sex-role Inventory, this study examined the hypothesis that male and female physicians are perceived differently both by their patients and by other physicians and medical students. This hypothesis was confirmed. Not only were significant differences in profiles of male and female physicians noted, but differences were also found among the three groups surveyed. Further, some of the differences in perception of male and female physicians were related to the sex rather than the group identity of respondents. Female patients, and to some extent female medical students, tended to view women physicians most often as androgynous and feminine. Male medical students tended to view women physicians in reverse pattern, i.e., most often feminine and then androgynous. Male physicians viewed the woman physician most often as feminine, like medical students, and then as undifferentiated. Both male and female patients and medical students tended to view the male physician most often as undifferentiated and masculine. Male physicians viewed their male colleagues most often as clearly masculine. Implications of these differences for residents' training and quality of patients' care are discussed.

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