Receiving a letter of appreciation or a card from a patient expressing gratitude after a doctor's treatment is a rare and generous gesture. The benefits of expressing your gratitude in turn for this kind of acknowledgement are many a study from the National Communication Association points out that the emotional act of saying thanks can even reduce job stress and burnout.

Still, for some doctors, it can be tricky to know exactly how to respond to such a message they may feel a bit awkward, and unsure of what to say.

There is no reason to be deterred here are the most professionally appropriate and kind ways to acknowledge how much you value the time and sentiment your patient has expressed, depending on the specific situation in which the thank you was offered.

First of all, it's important to realize that your patient took time out of his or her busy day to put such kind appreciation down on paper.

This speaks volumes about the great impression you've made as a doctor, and the trust that patient has in you. Allow yourself to really feel proud of the fact that your work has made a great impact, and let these positive feelings infuse the response you'll deliver.

If your patient sends you written thanks after treatment for an illness or surgery, verbal thanks are the way to go. Avoid saying, "Thank you, but I was just doing my job."

Remember again, to a grateful patient, the work you do has made an extraordinary difference in his physical and emotional comfort, and you want to validate that. All you need to do is say, "Your note made my day!" at the very top of their next follow-up appointment.

If, sadly, a family sends you a letter of appreciation following the death of one of your patients, a handwritten letter is the proper way to respond.

Research shows that this type of communication from a doctor gives closure to the relationship between the physician and family, and can powerfully aid the family during bereavement when they feel that the physician truly cared about their relatives. Write about your sadness at hearing of the loss, offer a personal remembrance of the patient, and offer your support if the family would like it.

Here are some very helpful guidelines given to doctors in training at Stanford University School of Medicine outlining precisely how to do this.

If a patient hands you a note at your office that includes appreciation for your office staff, you may be tempted to post it for others to read. This, however, could be a HIPAA violation if the note contains identifying health information about that patient, or a patient's relative (ask your provider's compliance office about specific protocol within your organization).

One possible solution? Ask your patient to sign an authorization approving a posting. If that's not feasible, post the note in an employees-only area with the patient(s) name redacted.

Expert discussion of this issue can be found here. And again, verbally communicate your thanks to that patient right back — never let such a meaningful opportunity go to waste.