In this issue we introduce “Close-ups: A Patient's Perspective,” a feature that focuses on the personal side of medicine. The major component of this feature is a patient's story, told in his or her own words. In these stories, patients speak about the challenges they face in illness and recovery, and reflect on the support they have received along the way. Eighty-three-year-old E.S. in this issue, for example, tells of the difficulties he and his wife have encountered since she was paralyzed by a stroke.1
Because family physicians often closely participate in the process of illness and recovery, the feature will include, when possible, a section with the physician's thoughts and comments. A third component of the new feature is an image; this may be a photograph of the patient or of something meaningful to him or her, such as a favorite animal or garden scene. Finally, as practice pointers, the feature lists possible resources such as Web sites or organizations.
Why have such a feature? A recent study of general practitioners in the United Kingdom found that the most satisfying aspect of their work was using their knowledge of individual patients to achieve the most successful outcomes.2 The basis of this knowledge goes beyond the factual to include an understanding of the patients' behavior and psychosocial context. Ultimately, the study showed that satisfaction was most closely related to the perceived quality of the physicians' personal relationships with their patients. The need to connect with patients may be more important than ever in an age that presents so many challenges to meaningful practice.
Another study showed that physician dissatisfaction was associated with the day-today challenges of running a business, keeping up with technologic advances, protecting the scope of practice, and managing precious time.3 In addition to these office-based challenges, physicians live in a health care environment that continually raises difficult issues, many of them of a magnitude that transcends our personal practices: uninsured patients, a fragmented health care system, epidemics of obesity and lung disease, the threat of bioterrorism, contentious issues such as abortion, and rising health care costs. For anyone overwhelmed by contemporary health care developments, going back to our roots—meaningful, healing relationships with the people and communities we care for—might put our daily practice into perspective. Close-ups offers an intimate, personal reminder of this most important task.
Close-ups is a collective enterprise. Our readers are encouraged to speak with their patients and submit their stories and photographs. By adding their own reflections, physicians can share the countless ways in which these patients have inspired them. Patients can provide a recorded or written story, which will have a final length of about 250 words. Photographs can be obtained in the office or patients can select their own, but they must be of sufficient quality for publication (i.e., a resolution of at least 300 dpi).
We look forward to sharing these vignettes with our readers, reminding us that our patients are the heart of what we do.