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Based on the data of China Household tracking survey（CFPS） in 2014, 2016 and 2018, the provincial macro level data of China Health and family planning statistical yearbook and the Internet search index, the fixed effect model and instrumental variable method are used to empirically test the impact of doctor-patient relationship on the health and medical cost economic burden of patients at the individual level, and analyze the long-term impact of doctor-patient relationship on the health and medical economic burden of patients. The study found that:（1） the deterioration of the doctor-patient relationship will reduce the health level of residents, increase the individual medical economic burden and significantly increase the overall medical expenses. This conclusion is still valid after considering the endogenous problems and replacing the core explanatory variables.（2） The impact of doctor-patient relationship shows significant heterogeneity at the regional level, income level and medical institution level.（3） The impact mechanism of doctor-patient relationship on residents’ health and medical economic burden can be explained from the supply side（doctors） and demand side（patients） of medical services. In the long run, the doctor-patient relationship will also have a significant impact on residents’ health and medical economic burden. Therefore, policy suggestions are put forward from the aspects of clarifying the supply and demand subjects in the doctor-patient relationship, clarifying the standard demands in the doctor-patient subjects, and further coordinating China’s medical security system. [ABSTRACT FROM AUTHOR]

Collusions, interpersonal phenomena with an impact on patients, significant others, clinicians, and care, are mainly described in the psychotherapeutic literature but also occur in the medical setting. Comprehended as an unconscious bond between two or more persons from a psychotherapeutic perspective, definitions and collusive situations described in the medical setting vary. The question arises whether medical collusions, compared to collusions occurring in the psychiatric setting emerge in different clinical situations or are not identified as transference-countertransference experiences, since there is less sensitivity for the unconscious dimensions of care. We systematically reviewed the medical literature on collusions. Even though a read threat, avoidance of unpleasant feelings (mainly anxiety), runs through the described collusions, the unconscious dimensions and associated defensive maneuvers are rarely evoked. Given the expressed desire to act on collusions in medicine, involving third-party psychiatric liaison clinicians, who supervise clinicians, and hereby help to disentangle collusions, could be beneficial. [ABSTRACT FROM AUTHOR]

It has often been argued that words have both the power to heal and the power to destroy. While doctors and patients alike agree on the importance of an efficient communication, the complex environment of health services, the evolution of demographic features, the shortage of medical staff or the patients’ social background can render the process of communication extremely difficult. Communication failures between doctors and their patients on various topics that range from a regular diagnosis, the message on a consent form or discussions on a terminal disease, for instance, can have terrible adverse events and can potentially make room for medical errors. Furthermore, most conflicts or even legal actions between the patients and their caregivers result from an absence of or inefficient communication. All these aspects call for an increasing role of language in medicine which should eventually lead to a genuine “communication culture” that can ensure the required quality and psychological comfort of a such a challenging endeavor.

Background. The Patient-Practitioner Orientation Scale (PPOS) was originally developed to compare doctor's and patient's consensus regarding patient centeredness. Research assumed PPOS measurements to be comparable across different groups of participants, however, without assessing the actual validity of this assumption. In this study, we investigate the psychometric properties and measurement invariance of a short version of the German translation of the PPOS. Methods. Based on a cross-sectional survey of N = 332 medical students, we present a short version of the German Patient-Practitioner-Orientation Scale (PPOS-D6) and examine its psychometric properties as well as measurement invariance across participants with varying levels of medical experience and gender using multigroup confirmatory factor analyses. Results. Results indicate that PPOS-D6 provides valid and reliable measurements of patient-centeredness that are invariant across participants with different medical experience. Preliminary results also suggest invariance across gender. Conclusion. PPOS-D6 is a suitable and efficient measure to compare group-specific attitudes towards the doctor-patient interaction. Additional research on convergent and discriminant validity and divergent study samples is advised. [ABSTRACT FROM AUTHOR]

Background The Patient-Practitioner Orientation Scale (PPOS) was originally developed to compare doctor’s and patient’s consensus regarding patient centeredness. Research assumed PPOS measurements to be comparable across different groups of participants, however, without assessing the actual validity of this assumption. In this study, we investigate the psychometric properties and measurement invariance of a short version of the German translation of the PPOS. Methods Based on a cross-sectional survey of N = 332 medical students, we present a short version of the German Patient-Practitioner-Orientation Scale (PPOS-D6) and examine its psychometric properties as well as measurement invariance across participants with varying levels of medical experience and gender using multigroup confirmatory factor analyses. Results Results indicate that PPOS-D6 provides valid and reliable measurements of patient-centeredness that are invariant across participants with different medical experience. Preliminary results also suggest invariance across gender. Conclusion PPOS-D6 is a suitable and efficient measure to compare group-specific attitudes towards the doctor-patient interaction. Additional research on convergent and discriminant validity and divergent study samples is advised.

Background: Rapid changes in healthcare delivery system & socio-political climate have resulted in considerable strain on Doctor-patient relationship. Doctors' role is to install positive energy within the patient, through which sick people find relief from suffering. Without it, there continues to be more confusion, fear, and doubt. Future doctor should show compassion, be open, honest, & admits when he is unsure. Objective: This study aims to understand the social dimensions of Iraqi Doctor misbehavior & mal-communication with patients. Subjects & Methods: A cross sectional study, with a tool consisting of two sketch Drawings representing an agonizing misbehavior scenario for a female gynecologist encountering a pregnant patient, & a male orthopeditian encountering a disabled male patient. Scenarios were presented to a convenient sample of 155 Iraqi Doctors, pooled during (2012-2014) in Baghdad, striking their feelings, to generate rich comments. Results: About two thirds of Doctors were females, and the majority was non specialists. Only 7.1% of Doctors (with significant gender difference), offered an excuse for the misbehavior. Around 80% of Doctors expressed patient sympathy. Scenario understanding showed significant Doctors' gender difference. Two thirds of Doctors stated reasons & suggested solutions for the misbehavior. Main reasons stated were: commercialization of medicine (23.8%), loss of today's Doctor humanity (18.1%), and profession power & ability to threat (15.2%). Conclusion: Although Doctor-patient misbehavior is not un-prevalent, most Iraqi Doctors disagree with it. The majority express professional sympathy. Less than tenth of Doctors stand by misbehavior, trying to give excuses. Commercialization of medicine, loss of Doctor's humanity, professional power, & mal-communication are emerging challenges for future Iraqi Doctor-patient relation. [ABSTRACT FROM AUTHOR]

Abstract Background Emotional Intelligence is the ability of a person to understand and respond to one’s own and others’ emotions and use this understanding to guide one’s thoughts and actions. To assess the level of emotional intelligence of medical students in a medical college in Chennai and to explore their understanding of the role of emotions in medical practice. Methods A quantitative, cross sectional, questionnaire based, survey was conducted among 207 medical students in a college in Chennai, India using the Quick Emotional Intelligence Self Assessment Test and some hypothetical emotional clinical vignettes. This was followed by a qualitative moderated fish-bowl discussion to elicit the opinion of medical students on role of emotions in the practice of medicine. Results The mean score of Emotional Intelligence was 107.58 (SD 16.44) out of a maximum possible score of 160. Students who went to government schools for high school education had greater emotional intelligence than students from private schools (p = 0.044) and women were more emotionally intelligent in their response to emotional vignettes than men (p = 0.056). The fish bowl discussion highlighted several positive and negative impacts of emotions in clinical care. The students concluded at the end of the discussion that emotions are inevitable in the practice of medicine and a good physician should know how to handle them. Conclusions Medical students, both men and women, had good level of emotional intelligence in the college that was studied. Students from collectivist social settings like government high schools have better emotional intelligence, which may indicate that a collectivist, community oriented medical education can serve the same purpose. Though students have diverse opinions on the role of emotions in clinical care, cognitive reflection exercises can help them understand its importance.

Existential concerns manifest themselves emotionally in patients. Emotions tend to be transferred between patient and doctor but the underlying existential concerns may remain hidden and obscure for both. If doctors understand that there are always existential concerns behind patients' inquiries it becomes easier to relate to the patient's feelings in an interested and curious way. Ultimately this benefits both doctors and patients. We have observed five existential human concerns leads to strong emotions (1. death, 2. thrown-ness, 3. aloneness, 4. choosing (the imperative of choice) and 5. meaninglessness (the absence of objective meaning). [ABSTRACT FROM AUTHOR]

Objective: In medicine, numerous commentaries implore clinicians (e.g., physicians, physician assistants, nurse practitioners) to display more humility. However, given the complex power dynamics between patients and clinicians, one should not presume that patients desire and appreciate humble clinicians. This paper examines the relationship between clinician humility and patient outcomes, and aims to provide empirical evidence for the significance of clinician humility.Methods: In two studies, patients (N = 497) recalled their most recent visit to a clinician through an online survey platform (Qualtrics). Patients rated their clinician's humility, satisfaction and trust with their clinician, and health status. They also provided demographic information (e.g., gender, race, subjective SES), details about their clinician (e.g., gender, race, professional status) and information about their last medical visit with this clinician (e.g., purpose of visit, wait time during visit).Results: Through hierarchical multiple regression, we demonstrated that clinician humility positively predicted patient satisfaction, trust, and self-report health (only in Study 2) above and beyond patient, clinician, and visit characteristics.Conclusion: The results demonstrated that clinician humility can predict important patient outcomes above and beyond objective characteristics of the medical interaction.Practice Implications: These findings may shape clinician-patient interactions by validating the pursuit of humility during medical encounters. [ABSTRACT FROM AUTHOR]

Background: Rapid changes in healthcare delivery system & socio-political climate have resulted in considerable strain on Doctor-patient relationship. Doctors' role is to install positive energy within the patient, through which sick people find relief from suffering. Without it, there continues to be more confusion, fear, and doubt. Future doctor should show compassion, be open, honest, & admits when he is unsure. Objective: This study aims to understand the social dimensions of Iraqi Doctor misbehavior & mal-communication with patients. Subjects & Methods: A cross sectional study, with a tool consisting of two sketch Drawings representing an agonizing misbehavior scenario for a female gynecologist encountering a pregnant patient, & a male orthopeditian encountering a disabled male patient. Scenarios were presented to a convenient sample of 155 Iraqi Doctors, pooled during (2012-2014) in Baghdad, striking their feelings, to generate rich comments. Results: About two thirds of Doctors were females, and the majority were non specialists. Only 7.1% of Doctors (with significant gender difference), offered an excuse for the misbehavior. Around 80% of Doctors expressed patient sympathy. Scenario understanding showed significant Doctors' gender difference. Two thirds of Doctors stated reasons & suggested solutions for the misbehavior. Main reasons stated were: commercialization of medicine (23.8%), loss of today's Doctor humanity (18.1%), and profession power & ability to threat (15.2%). Conclusion: Although Doctor-patient misbehavior is not un-prevalent, most Iraqi Doctors disagree with it. The majority express professional sympathy. Less than tenth of Doctors stand by misbehavior, trying to give excuses. Commercialization of medicine, loss of Doctor's humanity, professional power, & mal-communication are emerging challenges for future Iraqi Doctor-patient relation. [ABSTRACT FROM AUTHOR]

God has chosen special persons to take care of the physical pains and sufferings of man and such persons are known as doctors. But recently countrywide dissatisfaction on the major pillar of the medical services raises number of questions. In this present article authors have tried to find out the related factors with the changing scenario of doctor- patients relationship from India’s prospective. In the ancient India, doctors were enjoying the highest level of respect in the society because of the attitude and activity towards the patient. In the last decade of the 20th century and beginning of 21st century, a chronic dissatisfaction began to settle over the relationships between doctors and patients. High level of corruption in the health care industry, inequity in health care delivery, technological development in medical science, growth of health insurance, patient’s desire in share decision making, information technology development are few factors behind changing doctor- patient relationship. If physicians take a little more time in reassuring patients in the old fashioned way, this will restore the deteriorating relationship.

Introduction Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor–patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor–patient relationship. Methods A descriptive, cross-sectional study design with convenience (non-probability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or “HOs” (recent graduates doing their 1 year long internship) and post-graduate trainees or “PGRs” (residents for 4–5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor–patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P > 0.05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson’s burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor–patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced.

Introduction. Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor-patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor-patient relationship. Methods. A descriptive, cross-sectional study design with convenience (nonprobability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or "HOs'' (recent graduates doing their 1 year long internship) and postgraduate trainees or "PGRs'' (residents for 4-5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor-patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results. A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P >0:05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson's burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion. Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor-patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced. [ABSTRACT FROM AUTHOR]

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Family medicine fosters holistic approach to patient-centered practice. Current medical curriculum in Croatia does not have well-structured courses or tools to prepare medicals students for successful communication with the patient and for building lasting and beneficial doctor-patient relationship. We explored the value of students’ practice in writing letters to patients about their illness as a way of building personal and compassionate relationship with patients. Sixth year students at the School of Medicine in Split wrote letters to the patients from consultations under the supervision of the supervisor in a family medicine practice. Structured teaching of communication with the patient brings family medicine back to what has actually always been its main part – communication and doctor-patient relationship. Our future aim is to develop students’ letters to patients as a new tool in the family medicine course examination. Moreover, we will investigate how they can be used in everyday practice of family medicine.

The elderly patient represents a challenge for the dentist due to his physical and pathological features, elements that must be taken into consideration along with the associated diseases and the possible emotional fragility mainly caused by retirement and the eventual marginalization within the family. The transfer of the elderly person to a retirement home generates even more serious problems because of the risk that he might feel marginalized and abandoned or because of the adjustment problems that might arise. Our study was performed in November 2010 at the Retirement Home Copou and it aimed to establish the profile of such a patient, presenting the psychological factors that influence the reasons for which an elderly person might ask for dental treatment, as well as the general and the oral-dental morbidity in this age group. All these elements are necessary for adjusting the way in which a dentist works with the elderly or within a retirement home.

Background: Patients may be accompanied to the pain clinic consultation and these accompanying persons are relevant in the communication process. Aims: We sought to characterize if patients were accompanied and by whom to the pain clinic. We also wished to determine the accompanying persons influence on the doctor-patient interaction. This has not been studied previously in this clinical setting. Methods: Local ethics committee approval followed by written informed consent was obtained. Patients attending the pain clinic for the first time and review patients were included ( n = 219). Results: Twenty-one percent of patients ( n = 46) were accompanied. Adult accompanied by spouse 19 (41.3 %) and adult child accompanied by parent 18 (39.1 %) were the most common dyads. The accompanying person's role was most frequently described by doctors as an advocate for the patient 30/46 (65.2 %) [for an adult accompanied by spouse (63.1 %)]. The influence of the main accompanying person on the patient doctor encounter was described as positive [adult accompanied by spouse (78.9 %)] [(adult accompanied by parent (94.4 %)]. Conclusions: Patients are accompanied to the pain clinic with a typically positive influence on doctor patient relationship and communication. Awareness of these issues is important in good communication in the pain clinic. [ABSTRACT FROM AUTHOR]

God has chosen special persons to take care of the physical pains and sufferings of man and such persons are known as doctors. But recently countrywide dissatisfaction on the major pillar of the medical services raises number of questions. In this present article authors have tried to find out the related factors with the changing scenario of doctor-patients relationship from India's prospective. In the ancient India, doctors were enjoying the highest level of respect in the society because of the attitude and activity towards the patient. In the last decade of the 20th century and beginning of 21st century, a chronic dissatisfaction began to settle over the relationships between doctors and patients. High level of corruption in the health care industry, inequity in health care delivery, technological development in medical science, growth of health insurance, patient's desire in share decision making, information technology development are few factors behind changing doctor-patient relationship. If physicians take a little more time in reassuring patients in the old fashioned way, this will restore the deteriorating relationship. [ABSTRACT FROM AUTHOR]

Opioids are drugs of reference for the treatment of moderate to severe pain. Their proper use and a periodic assessment of the patient are crucial to prevent misuse. A multidisciplinary group suggests strategies for all stakeholders involved in the management of pain and suggests the importance of the doctorpatient relationship. [ABSTRACT FROM AUTHOR]

The character of medicine has changed over the last 100 years such that medicine is more interested in diseases than the people who suffer from them. Despite notable efforts to address this, the medical humanities do not challenge doctors' fundamental view of the world. Students adopt a metaphysic of physicalism during basic science training that gets carried into medical training. While necessary for medical science, physicalism is insufficient for clinical care. Physicalism offers no foundation for the sine qua non of medicine, the doctor-patient relationship. The character of medicine will not see a renewed interest in humanity until educators address the insufficiency of physicalism for clinical care, and clinicians partner with experts in the humanities to build a sui generis philosophy of medicine. [ABSTRACT FROM AUTHOR]

Introduction: Medically unexplained symptoms (MUS) is an umbrella term used for chronic and often disabling health symptoms and conditions that remain unexplained after standard medical examinations, testing, and/or appropriate workup. Patients with MUS tend to receive little to no treatment but remain distressed, stigmatized, and disabled by symptoms and iatrogenic factors., Methods: A qualitative phenomenological study was conducted to explore daily challenges and psychosocial and iatrogenic factors affecting the management of MUS., Results: The analysis of the interviews revealed that MUS could cause significant distress to patients, impairing their functioning and leading to permanent disability. Conventional healthcare cannot meet the medical needs of these patients and might be a potential source of harm to them. It should be noted that confirmation of conditions associated with clinically significant psychiatric premorbidity was not provided., Conclusion: Inconsistent diagnostic criteria, lack of proper training and research, diagnostic overshadowing, and implicit bias in healthcare professionals can lead to negative patient outcomes and the overuse of alternative or non-evidence-based services. Guidance, practice-based improvement ideas, and suggestions specific to improving patient-provider relationships can be applied to generate positive health effects., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Bellman et al.)

A relação médico-paciente é parte integrante do cotidiano de milhares de profissionais. Para evitar uma abordagem idealista ou meramente afetiva desta questão, é necessário investigar como ela está relacionada ao conhecimento médico e à relação mais geral entre medicina e sociedade. Na verdade, longe de ser aleatória, esta relação, da forma como foi estabelecida, pode ser vista como um instrumento de difusão e manutenção do poder do Estado e da instituição médica sobre a sociedade. Para modificar esta prática, o autor propõe duas abordagens, relativas a campos distintos da prática médica: os campos hospitalar e extra-hospitalar. Na área extra-hospitalar, a humanização da prática médica dependeria, basicamente, de uma formação profissional abrangente, de modo a adaptar o médico às demandas inerentes a esta área, onde o raciocínio fisio-patológico mostra-se freqüentemente limitado. No campo hospitalar, a humanização do ato médico dependeria mais diretamente da atuação integrada de uma equipe multi-profissional.The relationship between doctors and their patients is part of everyday life for thousands of professionals. In order to avoid an idealistic or merely emotional approach to this question, it is necessary to investigate how it is related to medical science and to the overall relationship between medicine and society. Indeed, far from being aleatory, the doctor-patient relationship as it has been practiced can be understood as a tool for maintaining the power of both the medical establishment and the state over society. To change this practice, the author proposes two different approaches to specific fields of medical practice: the hospital and non-hospital fields. In the field outside hospitals, the humanization of medical practice depends basically on broadened training for professionals in order to prepare them to deal with this work's inherent demands, where a physiopathological approach is often insufficient. Inside hospitals, a more humanistic relationship depends more directly on the action of a multiprofessional health team.

Online social networking is an immature, but rapidly evolving industry of web-based technologies that allow individuals to develop online relationships. News stories populate the headlines about various websites which can facilitate patient and doctor interaction. There remain questions about protecting patient confidentiality and defining etiquette in order to preserve the doctor/patient relationship and protect physicians. How much social networking-based communication or other forms of E-communication is effective? What are the potential benefits and pitfalls of this form of communication? Physicians are exploring how social networking might provide a forum for interacting with their patients, and advance collaborative patient care. Several organizations and institutions have set forth policies to address these questions and more. Though still in its infancy, this form of media has the power to revolutionize the way physicians interact with their patients and fellow health care workers. In the end, physicians must ask what value is added by engaging patients or other health care providers in a social networking format. Social networks may flourish in health care as a means of distributing information to patients or serve mainly as support groups among patients. Physicians must tread a narrow path to bring value to interactions in these networks while limiting their exposure to unwanted liability. [ABSTRACT FROM AUTHOR]

The lack of adherence to treatment of chronic cardiovascular disease is a clinical problem. Goes beyond doctor-patient relationship to what's new in social and public health worldwide. There is no one solution, but the potential for broad collaboration to resolve it with doctors, patients and facilities that provide organized community action. The Mexican Society of Cardiology aware of its leading role in the affair has taken the initiative to master the problem. This article is the initial report containing a review of the literature and a qualitative research study. Has focused on the interpretation of statements organized discussion "on purpose" at the recent Congress of Cardiology. Stresses the need to organize, promote the culture of health, acting in the rehabilitation of the doctor patient relationship according to the new demands of modernity and radical changes. [ABSTRACT FROM AUTHOR]

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Being a physician is rewarding but also challenging in the complex health care system. As physicians, we are continually trying to deliver more effective and higher quality care to our patients. With improvement in mind, a list of precepts has been generated as a tool to remind all of us in clinical medicine about the exemplary characteristics, behaviors, and attitudes that are expected as the norm in this profession. The list is organized into four categories: promotion of relationships with patients, principles of the effective clinician, growth and improvement, and values to guide one’s career in medicine. The list is envisioned as an instrument that may be helpful to medical learners and physicians by promoting reflection about ways to consistently perform at a high level while more fully appreciating the joy of practicing medicine. The list of precepts may also be useful to medical educators who wish to successfully mold the physicians of tomorrow. [Copyright &y& Elsevier]