Inclusion Criteria:  Within 6 months of diagnosis of metastatic (or stage IV) solid malignancies Age 18 or greater English speaking Follow-up clinic visit (Supportive Care and Medical Oncology Outpatient Clinics at MD Anderson Cancer Center) Medical oncologist listed as the attending physician COHORT A (Oncology team only cohort): Patients should not have been referred to palliative care services at MD Anderson Cancer Center COHORT B (Oncology team and specialist palliative care cohort): Patients should have an upcoming specialist palliative care follow-up visit within 1 week of a medical oncology visit  Exclusion Criteria:  Delirium (Memorial Delirium Assessment Scale [MDAS] >= 13/30) Significant hearing impairment requiring multiple repetitions during the screening process (that may prolong clinic time)