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Context: The value and desirability of a positive doctor-patient relationship has traditionally been described using case histories and narratives, and less often with formal literature, art, movies, and theatre. To the detriment of this relationship some family physicians are facing pressure to engage in volume medicine, at the possible expense of personalized care. What patients appreciate in their care is at risk of being ignored. Objective: To understand what adult patients value in the clinical encounters with their family physicians. Design: In this research, still in progress, we have adopted an interpretive hermeneutics approach to examine a collection of over 140 cards and letters received by an academic family doctor in practice for 39 years. Participants: The patients or their family members who sent the aforementioned notes. Findings: Preliminary analysis suggests that correspondence is not spontaneous, but initiated at holidays (Christmas, New Years, Chanukah); life cycle events (birth, recovery from illness, death); and transitions (leaving the practice because of geographical re-location). Notes are commonly personalized through hand-written text written on behalf of oneself and/or ones family. Showing a wide variety of word selection they expresses appreciation for family physician care of oneself or a family member that was perceived as knowledgeable bio-medically, and experienced as available, authentic, supportive, professional, compassionate, offering hope, and sensitive to suffering. Conclusions: The writing of notes to ones doctors may serve many functions: catharsis, closure, and bearing witness to patients’ appreciation of care in which Hippocratic and Asclepian traditions overlap and complement each other.

A novel source of patients' and families' written words to identify what they value in the doctor-patient encounter