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VANCOUVER, B.C. -- It's generally a mistake to write a prescription during a refugee's first visit for symptoms of posttraumatic stress disorder; state the diagnosis too soon, and you've already got two strikes against you, Dr. Wahan Wanis said at a meeting on PTSD sponsored by Vancouver General Hospital.

Dr. Wanis urged colleagues not to "cop out" when faced with cross-cultural patients by trying to refer them to a physician who speaks their language or hails from their culture.

Unless such a referral is easy to carry out, it will only delay treatment for what may be a serious problem. And if your patient does finally hunt down a practitioner who speaks Hmong or …