Emotional problems are an important component of general morbidity in primary care settings. Research on the sensitivity of primary care physicians to such problems is, however, scanty. This study examines the prevalence of emotional problems among 776 patients in primary care clinics in Israel using the GHQ-28 and as detected by their physcians. Hypotheses were tested relating to physician and practice characteristics and the extent to which they affect the matching of the two methods of problem identification. Using the GHQ, 69% of the patients were classified as ‘cases’ physicians identified 31% of the patients as ‘cases’. Specialist status in family medicine, interest and belief in the importance of emotional health, good communication, a low patient load and familiarity with the patient all predicted a better match of physician classification to GHQ-defined ‘caseness’. The implications of these findings for ongoing medical education are briefly discussed.