What Physicians Derive from Patient Interactions

July 25, 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 an article with the title of this note. (1) I believe these verbatims speak for themselves.


The First of a Series

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

This first note presents the first 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 physicians’ well-being on patient interactions
  5. Physician’s 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.


What Physicians Derive from Patient Interactions

* “I have much more of a sense of well-being from interactions with my patients than I used to. I was trained since I was in medical school that all this connection is just draining your energy—right? It’s burning me out. And so I assumed that was happening, and was why I had energy issues—and thought I’m not going to have the energy to deal with my kids tonight. So, once a mentor definitively changed my frame of mind about that—that it could be satisfying—then I was able to notice, yeah, there is something that’s draining about connection with patients—it does require energy—but there’s also something that’s nourishing about it, and now I have so much more satisfaction. I love seeing patients now. I did before, but now it’s just something special. It really is. It is nourishing.” (Cardiologist)

* “When I think back, there was a period in my career when my Art of Medicine satisfaction scores weren’t where I wanted them to be. They were really good and then they dipped and I said, wow, what’s going on for there? I realized I wasn’t very happy with what I was doing. I was feeling harried and rushed. I wasn’t giving the kind of attention that I wanted to give to my patients. When I changed what I was doing, I found that my experience with my patients was far more rewarding, and I really enjoyed spending time with them. It didn’t necessarily change my workload at all; I was spending the same time, but I sure felt better about what I was doing. I do think my well-being or sense of well-being as a physician is greatly tied to the interaction I have with my patients. What I realized is that those interactions, the ones that are meaningful, and when you really are connected to another person, gives you energy. I found that my days were less frustrating worrying about why people were coming in and just acknowledging that they had problems, and trying to do the best that I could do for them given the circumstances we were both in at the time. So that was really rewarding for me to make that connection.” (General Internist)

  • “Yes, I certainly do and that’s a big part of my life. I think also how I interact with my coworkers and how I interact with my friends outside of medicine, all of that is part of the same thing. I just basically like interacting with people. I like getting into people’s heads. I like getting into what their goals are, what their expectations are out of life. To me that’s very rewarding in general.” (General Surgeon)

* “If I’m not happy doing what I do then patients won’t be completely comfortable with it either. When I get rushed, that’s a problem, though that doesn’t happen much as I am happy with what I’m doing. And when I get positive feedback from parents that makes it a lot easier. I’d much rather get that than more money, so I don’t complain too much about salary or things like that because it’s not about getting more money, it’s about enjoying what I do. I’d much rather hang out at home with my wife but since I’m working it should be fun. I feel I’m very lucky being in the right place at the right time—I’m doing what I like to do.” (Pediatrician)

* “I’m perfectly happy and professionally fulfilled sitting down with a patient and having this interaction. It’s a source of satisfaction for me that, in my efforts to help in their situations, I’ve made a difference and that they are receptive to that, appreciated that, and we’re working together on it, that sense of ‘you’re doing good today; you’re helping out.’ That’s professionally all I’ve ever looked for or needed out of medicine.” (Obstetrics/Gynecologist)


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, 
Permanente Journal 2008 Nov:12(4): 70-76.

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