While the appropriateness of giving medical advice on the telephone could be debated, this discussion is based on the assumption that few physicians can avoid providing this service to their patients. In fact, most physicians must respond often to telephone requests for advice. A large portion of these "emergency" calls result from the caller's psychological experience of powerlessness and helplessness in a situation that he or she perceives as health-related. An understanding of the dynamics of helplessness is essential for the physician to respond therapeutically. A five-step interviewing strategy--including listening, clarification, exploration of self-help, support, and advice--can then be followed in sequence. These steps are applicable not only to medical situations but to any telephone situation in which crisis and helplessness are major components.