In today’s healthcare culture of consistent noise about Physician burnout, Physician shortages, Physician bullying and moral injury, we see one treatment rarely used to combat these ailments. The handwritten note.

By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today
I’ll start this story today with a question. I’ll even provide you with my answer.
Question: If your Doctor had personal stationary, would you consider it pretentious or personal?
Option 1 Answer: In today’s era of greeting cards, gift cards, email and text, yeah, a handwritten letter on personal stationary might signal for me as the receiver definitely a little pretentious. To the casual observer, this topic might sound pretentious. I get it.
Option 2 Answer: I think personal stationary on letterhead size paper is a little to braggadocious. (Yeah, I used that word — it’s a big one!) However, option 2 in the form and smaller size (eg. 4″x 4″) embossed postcard with an envelope communicates something different. It communicates personal engagement, personality and elegant class.
But, that’s just my opinion.
I do understand however that there are those in healthcare (because they email us routinely their rants) that believe the handwritten note should be reserved for family, close friends and if you are a Physician, sometimes your colleagues.
So here’s another question. When did kindness go out of style? Was it the same month the typewriter got retired from our offices? How did I miss that memo?
I think if we really want the real answers to these questions, we need to all look less at ourselves and more to the receiver. Just ask the receiver of your handwritten note how they feel first before you come to your final conclusion.
And by the way, a greeting card with your signature doesn’t count as a handwritten note people! Come on. There’s nothing personal about that.
So, have you ever written a handwritten note to a colleague and slipped dropped it on their chair?
How did it make them feel?
There’s actually some real evidence, studies and some science behind this idea of gratitude and even handwritten notes. I have observed working with Physician’s, Nurses and healthcare executives for the past twenty years that it’s such an undervalued, under utilized tool that changes everything for the receiver.

Articles About Gratitude
- Sansone RA, Sansone LA. Gratitude and well being: the benefits of appreciation. Psychiatry (Edgmont). 2010 Nov;7(11):18-22. PMID: 21191529; PMCID: PMC3010965; Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010965/
- Your brain on gratitude: How a neuroscientist used his research to heal from grief; Gratitude journaling, it turns out, transformed the neuroscientist’s grief — and likely his brain; By Liz Tung; November 21, 2019; Source: https://whyy.org/segments/your-brain-on-gratitude-how-a-neuroscientist-used-his-research-to-heal-from-grief/
- The Impact of Gratitude on Mental Health; NAMI California; Source: https://namica.org/blog/the-impact-of-gratitude-on-mental-health/
- How Gratitude Changes You and Your Brain: New research is starting to explore how gratitude works to improve our mental health. By Joshua Brown, Joel Wong June 6, 2017; Source: https://greatergood.berkeley.edu/article/item/how_gratitude_changes_you_and_your_brain
- Giving thanks can make you happier; By Harvard Health Publishing; August 14, 2021; Source: https://www.health.harvard.edu/healthbeat/giving-thanks-can-make-you-happier
- The Science of Gratitude: Research shows gratitude isn’t just a pleasant feeling—being grateful can also support greater health, happiness, and wisdom in ourselves and our communities; By Misty Pratt February 17, 2022 https://www.mindful.org/the-science-of-gratitude/
- 35 Scientific Benefits of Gratitude: Mental Health Research Findings; By Imed Bouchrika, Phd Chief Data Scientist & Head of Content; Source: https://research.com/education/scientific-benefits-of-gratitude
- Practicing gratitude can have profound health benefits, USC experts say Thanksgiving is a great time to count your blessings, but evidence shows that being grateful throughout the year can lead to better health and well-being; By Eric Lindberg; November 25, 2019 Source: https://news.usc.edu/163123/gratitude-health-research-thanksgiving-usc-experts/
In today’s healthcare culture of consistent noise about Physician burnout, Physician shortages, Physician bullying and moral injury, I see one treatment rarely used to combat these ailments.
The handwritten note.
Here’s a recent story to further illustrate the importance of this concept. Last month I interviewed a Registered Nurse. We had a wonderful interview and conversation about her long career working in hospitals and with Patients. At the end of our time together I asked her if she had ever received a thank you note from a colleague, an Administrator or a co-worker.
She got a big laugh out of that. And then she said the strangest thing.
“No. I never did. But if I had it would have changed everything for me.
~Nurse, 2023, Concierge Medicine Today’s DocPreneur Leadership Podcast
I’m a fan of personal, handwritten notes. There’s really no secret to that anymore.
If I am known at the end of my long career in healthcare as ‘the thank you note guy’, I’m perfectly fine being remembered in that way.
~Michael Tetreault, Editor, Concierge Medicine Today
Personal stationary may seem outdated. I get it. So is the typewriter.
But, I still think they’re cool. And, so do other people!
However, a handwritten note never goes out of style. If you want to leave a lasting impression on someone (eg. a Patient, a colleague, a co-worker), order a set of embossed or monogrammed card stock note cards that isn’t too flashy or communicates inherent wealth — and then handwrite a few sentiments on it. Put it in an envelope, handwrite their name or name and address and either leave it on their desk or drop it in the mail.
We recently polled Physicians online at Concierge Medicine Today and asked Doctors, how many handwritten notes or thank you notes do you write to Patients per month?
You may be oddly curious to review the results. I think you’ll even be surprised to learn that yes, there are Physicians in this world that despite the hectic schedule, find the time to get small and personal with Patients that allows the Patient-Physician relationship to grow deep and wide outside the questions that are discussed in the exam room.
Doctors, how many handwritten notes or thank you notes do you write to Patients per month?
- 29.17% – 1-2 per month
- 20.83% – 3-6 per month
- 16.67% – 7-10 per month
- 8.33% – 10-20 per month
- 20.83% – Other (eg. Birthday’s; Thanksgiving Cards; Holiday Cards; Etc.)
I’ve been encouraging Doctors to write handwritten notes to their Patients, colleagues, a nurse, a co-worker and even their spouse for years. I’m pleased to inform you in this section of the course that there are Doctors who are doing this repeatedly. Moreover, we see it really having a lasting impact and staying power in Concierge Medicine.
In fact, if Concierge Medicine becomes known for something, it’s eventually going to be for how well these Doctors treated others. That’s amazing and these small notes are truly deepening the relationship Physicians have with their teams, their spouse, their colleagues and even their Patients.
There’s always a best way of doing everything, if it be to boil an egg. Manners are the happy ways of doing things.
~Ralph Waldo Emerson