Contributors: Linda Roszak Burton, ACC, BBC, BS and Betsy Chapin Taylor, FAHP
To learn more about Linda and Betsy, click here.
 |
This is the first in a series of articles offering a continuum for supporting physician well-being, improving patient relationships through shared core values of trust, respect, and commitment, and resulting in satisfaction, loyalty, and continuity of care.
At Accordant, we call this continuum Ethos (taken from the Greek meaning "for distinguishing character and guiding values and beliefs of a person, group, or institution"). We define Ethos as a holistic approach that calls upon the importance of distinguishing values and virtues in guiding the work of physicians, caregivers, and allies to improve physician well-being and patient trust and engagement to support the success and progress of the health organization in fulfilling its mission and vision of potential.
The catalyst along this continuum is the transformational, evidence-based power of gratitude and the associated psychology and neuroscience evidence-based practices.
It's no secret physicians are in crisis. In fact, a recent Medscape study found physician burnout, depression, suicide, and departure from the profession are at an all-time high. Many physicians speak to the burden of their work in terms of long hours and overwhelming administrative tasks. In this environment, there is no room to ask physicians to take on one more role that can further drain resilience and resolve. Instead, engaging physicians must first safeguard and strengthen their well-being by illuminating pathways to joyful, purpose-filled connectedness and engaging them with meaningful, repeatable, and edifying practices that result in positive and sustainable emotional and social benefits for physicians and patients.
Further, these practices respond to what studies show, and physicians say they want and need - reconnecting to the values and virtues that brought them to a healing profession in the first place. Engaging in discussion with physicians about how to build and expand on their well-being must go well beyond the support of mindfulness and yoga classes and the overly simplified gratitude platitudes. Physician well-being cannot be achieved in isolation. Leadership must prioritize environmental factors standing in the way of their physicians' well-being and actively address barriers such as heavy workloads and the extreme burden of EMRs. Additionally, creating a compassionate, kind and values-based environment (for all staff) can begin by conducting a culture assessment with benchmarking, design, implementation, measurement, and refinement. What we refer to as Conscious Culture.TM
For this article we will focus on well-being and posit "Virtuous Well-Being" informed by research and evidence-based practices in psychology, neuroscience, and gratitude.
What is Virtuous Well-Being? It is the start of the continuum which identifies mindset, actions, and behaviors that allow physicians to achieve elevated health, including physical, emotional, mental, spiritual, and social well-being. It engages self-reflection, a sense of purpose, meaning, and the commitment to personal growth. It requires the cultivation and sustainability of well-being associated with the virtues of gratitude, compassion, and kindness. In turn, these virtues are brought into practice in the physician-patient relationship.
Further, since the physician-patient relationship provides meaning and purpose, it can significantly protect against burnout. Physicians often describe their relationship with their patients as giving a sense of purpose by making a difference in their lives and through a strong sense of connection. Reconnecting to meaning and purpose calls on the physician to bring their "best self" to each patient relationship.
For example: Take 5 to 10 minutes to recount or write (the best approach) a brief account of a past physician-patient relationship you found fulfilling and which reaffirmed your commitment to medicine. Consider:
- Did this physician-patient relationship change your perception in some way, and how?
- How did this physician-patient relationship reinforce your commitment to medicine?
- At its core, what values and virtues were present in this physician-patient relationship?
Virtuous Well-Being is subjective and may vary across cultures, philosophical traditions, and personal belief systems. And, as previously stated, creating a compassionate, kind, and values-based culture requiring full investment in and implementation by every member of the C Suite.
Living a values and virtues-based life is integral to experiencing a sense of purpose, meaning and well-being. Virtuous Well-Being builds stronger relationships, enhances social connections and contributes to overall human flourishing and happiness of self, others, and society as a whole.
Combating the Sense of Overwhelm and Exhaustion – one small step at a time
A comment we often hear is the lack of time for "self-care," especially when overwhelm and exhaustion have become 24/7 companions. As Adam Grant suggests in his book Give and Take, there's never going to be more time in the future, "You won't be less busy—you'll just be busy with new priorities."
With the time desert we all face, start small with a Virtuous Well-Being, self-reflection activity using this three-step approach.
Step One: Decide on a small, simple activity that is good for your well-being (eating a healthy meal, listening to music or a sermon, taking a walk or run, doing a deep breathing exercise, a mindfulness activity, playing with children, or playing an instrument.......)
Step Two: Describe what purpose(s) your well-being serves.
Use this activity for self-reflection and write a simple purpose statement using these four questions:
- How do you benefit from your well-being?
- Why is it meaningful?
- Who else benefits and how?
- What are the embedded virtues in your striving for well-being?
Step Three: Describe why you are grateful for any area of your physical, mental, emotional, spiritual, or social well-being. Next, select one area – commit to a date and time - and describe, preferably in writing:
- Why you are grateful?
- How do you benefit?
- Why is it meaningful?
- Who else benefits and why?
- What embedded virtues are showing up?
"The quality of your action depends on the quality of your being." ~ Thich Nhat Hanh
Once again, looking at the definition of Ethos as a holistic approach calling upon the importance of distinguishing values and virtues is vital in guiding the well-being of physicians, caregivers, and allies.
In future articles, we'll expand on Ethos and build upon Virtuous Well-Being along the continuum to Virtuous Practice. Virtuous Practice yields greater patient satisfaction, trust, and commitment. It is the intentional and consistent cultivation and application of virtues such as gratitude, compassion, and kindness.
We'll recognize how psychology and neuroscience-informed programs and coaching build on knowledge, engagement, and ownership of the core values and virtues that guide physician well-being and patient trust.
And we'll close out this series on Virtuous Medicine to complete the continuum. While not a widely recognized term in medicine, yet symbolic of the Hippocratic Oath, it engages in the qualities and principles that lead to benevolence (to do good), patient-centered care (respecting the autonomy and dignity of the patient), and equitable access to healthcare.
Contact Linda at: [email protected]
Contact Betsy at: [email protected]