How long does it take to know someone? How long does it take to be more than 'a doctor' and become 'my doctor'? I have a patient who I've seen for the past 7 years who tries his best to never see me. I have a patient who saw me one time 3 years ago, and he thinks the world of me.

I don't know what it is that I am doing. I don't actually know the recipe for good rapport. Is it listening? Is it patience? Is it time? Is it empathy? I do what I think is right, and is that it?

I know another doctor in town. She is a piece of shit. I have nothing but contempt for her. She is not incompetent. She is not fraudulent. She is lazy. She doesn't follow up on tests in a timely fashion. She doesn't educate her patients. She doesn't start meds when it's appropriate. She is careless and reckless because she cannot be bothered to do her job.

Being an internist requires a certain level of anal retentive behavior. It requires diligence and conscientiousness. It requires that you are, at least some sense, authentic. And maybe that's what people want from their doctor. That at the end of the day, they know that I gave a damn.