Humor is one way through which patients and physicians relate to each other on a human level. Even politics is not off-limits in the doctor-patient relationship.
Patient stories, particularly if we listen attentively and nonjudgmentally, provide us with a window into their lives and experiences. These stories help us to know our patients in powerful ways, and that knowledge about the patient, as someone special, provides the context, meaning, and clues about their symptoms and illnesses that can lead to healing. At our best, we serve as witness to their struggles and triumphs, supporter of their efforts to change and grow, and guide through the medical maze of diagnostic and therapeutic options. Sometimes, their stories become our own stories—those patients who we will never forget because their stories have changed our lives and the way we practice medicine (Figure 2-1).
Dr. Jim Legler caring for a young girl in a free clinic within a transitional housing village for homeless families. He is a family physician who volunteers every week to care for the 40 families working their way out of homelessness. He had been caring for Kimberly and her family for many months at the time this photograph was taken. Dr. Legler serves as a role model for students interested in primary care of the underserved. He is known for his kindness and compassion to all his patients.
As part of the future of family medicine (FFM) initiative, telephone interviews of the general public (N = 1031) were conducted in 2002.1 Most patients strongly agreed that they wanted to take an active role in their healthcare (82% and 91%, patients with family physicians and patients with general internists, respectively), they wanted their physicians to treat a wide variety of medical problems but refer to a specialist when necessary (88% and 84%), and they wanted a physician who looks at the whole person—emotional, psychological, and physical (73% and 74%). In addition, of 39 possible attributes of physicians, most patients (68% to 97% stated extremely or very important) viewed the following as the most important attributes/services that drive overall satisfaction with their physician:
- Does not judge; understands and supports.
- Always honest, direct.
- Acts as partner in maintaining health.
- Treats both serious and nonserious conditions.
- Attends to emotional and physical health.
- Listens to me.
- Encourages healthier lifestyle.
- Tries to get to know me.
- Can help with any problem.
- Someone I can stay with as I get older.
Although the types and intensity of relationships with patients differ, our positive and negative experiences with patients shape us as clinicians, influence us in our personal relationships, and shape the character of our practices. Arthur Kleinman, in his prologue to Patients and Doctors: Life-Changing Stories from Primary Care, wrote, “We all seem to want (or demand) experiences that matter, but ...