We agree with Dr. Wintersteen regarding the importance of universal depression screening in the community setting, consistent with the U.S. Preventive Services Task Force (USPSTF) guidelines, when appropriate systems are in place to provide accurate diagnosis, effective treatment, and follow-up. Given the lack of incentives for provision of mental health screenings (1), the intent of our research effort was not to discourage depression screening but rather to document and highlight the additional time demands of important, recommended screening practices and raise awareness among key stakeholders. Our findings also highlight the need for more definitive screening intervals in the USPSTF guidelines to assist with the interpretation of the observed occurrence of depression screening at 3.4% of patient visits. Although we attempted to reduce potential bias by excluding visits in which the patient saw a mid-level practitioner (that is, a physician assistant or nurse practitioner), the study data did not allow for exclusion of cases in which a nurse administered the screening instrument before physician evaluation. As noted in our article, the effect of screening by nurses may have resulted in a slight underestimate in the overall probability of depression screening.