On health, happiness, homework, and a trusting patient-physician relationship


Depending on who you ask, health and happiness can have various meanings and implications. Philosophical, societal, religious, scientific, and economic influences try to define and inform these concepts. As a physician, however, I need to understand my patient’s idea of health and happiness. This understanding is gained through a trusting relationship that allows patients to feel comfortable sharing their unique joys, hopes, fears, and anxieties.

An empathic approach allows me to best see the health and happiness of this individual at this moment in time. I can deliver care to support the patient’s good (more on the good of the patient in an upcoming article) by aiming to understand wellness and illness through the patient’s lens. Entering this relationship with my patients yields the privilege, responsibility, and reward of being a physician.

Trust is something that is earned over time and begins with the question, “How may I help you?” In proclaiming this question, I am implying that I am competent to help this person through my medical education and experience and will use this in an intellectually honest way to serve my patient’s best interest. Trust is developed in response to the relationship and the practical prescriptions offered to help the patient achieve health and happiness as defined by that individual. While prescriptions are often equated with medication, many of my prescriptions involve counseling, education, and monitoring of lifestyle habits.

Preventive screening, laboratory, imaging, and medication are all essential components of the evaluation and management of health. However, ignoring the foundational pillars of one’s well-being can impede the benefit of the modalities mentioned above. I often give my patients ‘homework assignments that I believe are foundational to achieving one’s goals as they relate to health and happiness. The homework assignments become a desired instrument to empower one to participate in one’s care.  These assignments usually focus on the following four areas: good sleep, good nutrition, good exercise or physical activity, and good work-life balance.

‘Good’ is defined and redefined over time as I get to know the patients and their goals and I start with what is most important to the patient. I use concepts validated by medical science and the personal experience of helping patients with the aforementioned foundational aspects of well-being. In time, these homework assignments turn into personal habits and these habits turn into the basis of health and happiness all suspended by a trusting relationship of care and empowerment.

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The ‘Good’ of the Patient: Whose good is it? How can we approach it? Why does it matter?