Physician Awareness of Their State of Well-Being

August 29, 2016

Tom Janisse, MD

Northwest Permanente


Editor and Publisher

The Permanente Journal

The Permanente Press


What do physicians do to most satisfy their patients? And how do they maintain a state of well-being in their clinical practice? The answers to these questions, and others, have unfolded over several years in a series of confidential interviews in the context of communication and relationship research with physicians who rate highest by patients on the post-visit patient satisfaction survey.

The area of physician well-being was an important component of my research interest, and some of the following has been previously published in The Permanente Journal (1) I believe these verbatims speak for themselves.


The Second of a Series

This article continues a series of five articles detailing, through verbatim Northwest Permanente physician voices, how physicians value and experience patient interactions as part of their medical practice.

This second note presents the second of five realms of well-being that these high-satisfying Northwest Permanente physicians identified in the confidential research interviews:

  1. What physicians derive from patient interactions
  2. Physician awareness of their state of well-being
  3. Physician personal and professional sense of self
  4. The effect of physician well-being on patient interactions
  5. Physician self-care practices.


The actual question posed to the physicians was:

Do you feel that your sense of well-being as a doctor is related to how you practice medicine with your patients?

All physicians agreed that how they practice medicine with their patients is related to, and improves, their own sense of well-being.


Physicians Awareness of Their State of Well-Being

* “The times I feel I’m at my best are the times when I’m working the hardest, but I feel most rewarded, and my own well-being or mood is at its highest because I feel like I am doing the things that I was trained to do, that I’m making a difference, and that I’m connecting with people.” (Psychiatrist)

* “To me the biggest reward of my practice is the shopping bag full of patient thank-you cards and Christmas cards that I get. To me, that’s basically almost worth more than money to have that kind of recognition. And I have a sense of connection. To be fairly highly rated in the patient satisfaction scores, I think that’s all about connection and that’s all about a two-way interaction with the patients, and I think that’s what’s rewarding for both them and me in these kinds of interactions.” (General Surgeon)

* “I don’t consider myself necessarily a very emotional person. But, when I see patients, and can feel, like wow, they’re really struggling here, it does trigger an emotional response, which I think I sometimes choose to ignore because it’s painful for me to feel that. We weren’t trained to connect that way. But, as I think back over my experience with the patients I’ve cared for, so many are not necessarily looking for medications and treatments, they’re really looking for relationships and the connection with someone who can at least empathize with their situation or their plights or the circumstances in their lives. To at least acknowledge that: “Yeah, it’s hard. It’s a difficult situation for you.” And to be, I don’t know if reassured is the right word, but to say, “I wish things were different,” or “I wish I could do something differently here to help you.” I think, for patients, empathy is something that connects the relationship with their physician.” (General Internist)

* “I know that at times when I am distracted, disturbed, I find it very difficult to be present, very difficult to invest. If you just let go of your own problems when you walk into that room, you actually recognize that you feel better. Done right, the process is good for you—learning to let go of stuff we choose to hold on to, and we don’t have to, is often the first step to being well. (Oncologist)

* “My sense of well-being is absolutely supported by the interactions that I have with patients. If I have unhappy patients it makes for an uncomfortable and unhappy time in the office. The difference between Surgery and Primary Care is that the people who come to see us are often afraid, but it’s something that I have a fairly simple solution for and when they leave they are going to be well. I wouldn’t enjoy what I do nearly so much if I only had ten minutes to see someone. I have a lot more respect for the medical people that are in this group, than I do looking at my own situation, because I feel I have an unfair advantage, and our ability tends to be a sort of bond that forms from the operation.” (General Surgeon)


Janisse, T. Relationship of a physician’s well-being to interactions with patients: practices of the highest performing physicians on the Art of Medicine patient survey, 
Perm J 2008 Fall:12(4):70-6. DOI:

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