I have been a physician assistant for more than 22 years, with the last 9 years focused in pain management. I work with some of our poorer patients on the south side of San Antonio. Even though I have only so much time for each patient and am very busy, I make certain that I sit down, face the patients eye-to-eye, and listen to them. There is a great difference between hearing a patient and listening to what he or she is saying.

The eye contact helps me make a personal connection with my patients. I make each one feel that he or she is the only patient whom I am seeing that particular day. Also, I never stand over a patient. And, finally, I try to instill some humor when I see patients. It might be the only time that they will smile that day.—Howard Kagan, PA-C, San Antonio


These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.