I have chosen this reading for comment as I could instantly relate this approach to the medical encounter scenrio in India and how tough it would be for the medical personnel to adopt this in their daily exeriences. In a country like India with the kind of diversity in culture and populations of the people, where there is minimal efficient medical infrastructure available (cant get more optimistic than this), I do not hope that this approach would be relevant. More specifically if we ponder over the rural health and medical settings it becomes almost impossible for the physcians and other medical practitioners to employ such a method considering the meager faclities that are available in the government administered health centres. Even with the available facilities there would be very few practitioners who would at least lend an ear for such an approach (the kind of impressions people have towards the medical personal). I donot aim to generalise these statements for all the people and places throughout the country but I am confident that these are the existing conditions for a major part of the medical settings not only in India but also in many other low resoure countries. Many a times I have observed during all my field visits to some of the villages and towns that the doctors either do not have the time and resources to spend a decent amount of time with their patients or is least interested giving a thought about the patient-physician interaction . I can recollect the hospitals and health centres with a highly disorganised medical staff structure and scores of impatient patients eagerly waiting for their turn to contact the physian whi inturn is waiting to get done with his work and get away for his/her other activities. In such a neck- to -neck setting how do we expect to have a patient centered approach with cultuarally competent communication skills to have relevance where there is a constant struggle for basic infrastucture involving a normal medical encounter. Hence, approaches like these dont hold water in contexts like these where there is no agency for the people (patients) against the power (and structure) of the modern or western hegemonic medical settings.