Patient and family stories, particularly if we listen attentively and non-judgmentally, provide us with a window into their lives and experiences. These stories help us to know our patients and families in powerful ways, and that knowledge about the patient, as someone special, provides the context, meaning, and clues about their symptoms and illnesses that can lead to healing. At our best, we serve as witness to their struggles and triumphs, supporter of their efforts to change and grow, and guide through the medical maze of diagnostic and therapeutic options. Sometimes, their stories become our own stories—those patients who we will never forget because their stories have changed our lives and the way we practice medicine (Figures 2-1 and 2-2).
Dr. Jim Legler caring for a young girl in a free clinic within a transitional housing village for homeless families. He is a pediatrician who volunteers every week to care for the families working their way out of homelessness. He had been caring for Kimberly and her family for many months at the time this photograph was taken. Dr. Legler serves as a role model for students interested in primary care of the underserved. He is known for his kindness and compassion to all his patients.
Dr. Camille Sabella examines a child recovering from osteomyelitis of the femur. This child required 6 weeks of antimicrobial therapy, which was accomplished successfully. Because this is a common and “routine” infection for a pediatric infectious diseases physician, it is easy to forget the considerable psychosocial effect that this infection had on this boy and his mother. Close follow-up, careful listening, education regarding the expectations and prognosis, and engaging the child in his own care all are important for a successful outcome.
What Families Want From Their Pediatric Providers
In a study of families of pediatric patients under 13 years of age in a large outpatient clinic, three elements were shown to be essential for effective physician-parent-child communication from a parent perspective.1 These included:
Informativeness—Parents place considerable importance on the quality and quantity of information provided by the physician regarding their child’s health.
Interpersonal sensitivity—Parents highly value physicians who were supportive and sensitive to the child’s and parent’s feelings and concerns.
Partnership building—The extent to which the physician involves the parent and child in the care of the child.
Yet, traditionally, there has been little emphasis placed on building interpersonal skills in pediatric practice and training. This led to an American Academy of Pediatrics (AAP) report in 2001, which stated that “there is a need to better learn how to elicit information, including a narrative interview approach, allowing the child, adolescent, and parents to tell their stories” and that “there is a need ...