Primary Mental Health-Care Clinic (PMHC)—"Waitless environment is good for mental health"—was of particular interest to me. I am a clinical health psychologist who recently began working closely in this clinic with Brady Cole and Andy Pomerantz (who, with their colleague Debra Scott, just hosted a two-day regional conference on the "White River" PMHC model).

I have worked in a variety of settings over the years and have never seen mental-health assessment and treatment planning offered in such a timely, efficient, and effective manner. Integration models work best in a single-payer system like the VA, which does not separate mental and physical health-care benefits. For integrated models to work outside a VA-style, singlepayer system, the business side of medicine will need to think outside the box and develop new financial strategies.

Mark J. Detzer, Ph.D.
Wilder, Vt.

Detzer is an adjunct assistant professor of psychiatry at DMS and a visiting assistant professor of psychology and brain sciences at Dartmouth College, where he teaches two undergraduate courses.

Memorable image
I amlooking for a picture I saw in Dartmouth Medicine—I believe in the Spring 2004 issue; it showed a knee replacement in progress. [The page with this image is reproduced above.]

I read the article in my doctor's waiting room and since then had knee replacement surgery myself. Then this

The top image—a photomontage by Dr. Alfred Feingold, DC '62—stuck in a reader's mind for over three years.

year I had the earlier replacements taken out and new ones put in at DHMC. My surgeon said any removed joints are saved. I would be interested to know why mine lasted only two years. I have had 16 knee surgeries, including four replacements, and I like to stay informed so I can make better choices in the future.

Tiffany DeGraff
Charlestown, N.H.

Dartmouth has the world's largest collection of "explanted" orthopaedic devices; many advances in the design of artificial joints have come about from analyzing patterns in their failure.

RICE is nice
I read your article about improving health

care in Vietnam and am very interested in the project. I've been to Vietnam a few times and have seen how unprepared the local hospital facilities are. I would like to be involved in the improvement of the country's health care. Who should I contact about RICE?

Hungyen Le Nguyen, DC '09
Hanover, N.H.

The DMS project Nguyen refers to—RICE, for Remote Interaction, Consultation, and Epidemiology—is using smartphone technology to link rural clinics in Vietnam with regional hospitals. See "Who would import RICE to Vietnam?.

People are super-nice
My son is doing a fellowship in oncology at DHMC, and I recently had a chance to visit him there. It was my first time in New Hampshire, and I don't think I've ever met as many super-nice people. While I was there, my son let me read his copy of Dartmouth Medicine, which I truly enjoyed. Would you put me on your mailing list?

Linda Hitzelberger
Fraser, Mich.

The reading is good, too
I just had a visitor from California who read your magazine while he was here. He was extremely interested in several of the articles and was very happy to hear he could get on your mailing list. Would you please add him? I have received Dartmouth Medicine for many years and find it excellent reading.

JoAnne Corette
White River Junction, Vt.

We're glad to add interested readers to our mailing list.