Importance of reflective capacity Donald Nease, Dept. of Family Medicine - University of Michigan 17 August 2010 Excellent in depth work examining the challenges of delivering quality care for depression in primary care. The findings related to reflexive monitoring parallel our own and others' work in the US that has sought to increase reflective capacity to implement and sustain change in care processes.(1) It is worth noting the similarities despite the clear differences in how medical care is funded in our respective countries. The suggestion regarding Balint groups as a means to introduce reflexive monitoring is an interesting one. Within the American Balint Society we are just beginning to examine this potential application, having piloted it once at a Society of Teachers of Family Medicine workshop. We too are intrigued by the possibilities for applying it within our own context of Patient Centered Medical Homes. 1. Nease et al. Inducing sustainable improvement in depression care in primary care practices. Joint Commission journal on quality and patient safety / Joint Commission Resources (2008) vol. 34 (5) pp. 247-55 Competing interests I am Immediate Past President of the American Balint Society and currently serve as a Vice President of the International Balint Federation.