Major depression disorder (MDD) causes psychosocial morbidity and complicates clinical outcomes of co-morbid medical conditions.1,–,5 Many depressed individuals rely on primary care, and evidence suggests more needs to be done to improve case-finding errors in primary care settings.6,–,12 Efforts to improve depression screening have shown mixed results, highlighting the need for focused interventions aimed at improving physician management of depression.13 Mitchell and colleagues’ meta-analysis14 of unassisted diagnoses of depression may be the only comprehensive meta-analysis on the subject published and presents a clinical practice review that is subject to controversial interpretation. We expect their findings to stir debate regarding the quality of depression diagnosis in primary care. It is comforting that their …