Being a Champion of Culture Change

How is this an Act of Self-Care?

Promoting a culture of well-being often feels like I am fighting against the system which is changing so rapidly around me, as though I have to change the wheels of the bus when it’s going 200+ miles an hour.

And yet Tenet #5 of the Oath to Self-Care and Well-Being says:

We WILL CHAMPION for a healthcare system that values the well-being of its personnel, uses best evidence for an institutional culture of wellness, and recognizes that in so promoting, the patients we care for are ultimately best served.

The terms exhaustion and burnout have become commonplace in leadership meetings or department and organizational conversations. In too many discussions, the implied or perceived message is that to be well is the responsibility of the individual person, as if our personal circumstances are the only reason, that there is something wrong with us. 

While some of the issues I face as a physician myself and that my colleagues and other healthcare professionals face may be due to personal consequences, the majority are due to or influenced by the environment around us. Ample literature supports this. In my own journey towards well-being, I take a few steps forward but many steps backward.

Changing this narrative, drawing attention to the complex environment we work in, requires patience, perseverance, and an international pursuit of knowledge. With the continued surges in disruptive issues—whether COVID-19, political disarray, or the wrath of the hurricanes—it feels more like we have to learn how to build the bus while learning how to change its wheels. We have to make grassroots fundamental change that aligns with the basic values of respect and care for each and every human being.

Oftentimes it takes a drastic event to make a change. One profound example is Uncomfortable Conversations, the student-led virtual learning series aimed at pursuing anti-racism education in general and in the context of healthcare. The series began last summer when a member of GHHS, Radha Patel, MD UTHSC-COM Class of 2021, was inspired by the words of a student who spoke at the White Coats For Black Lives protest. Elizabeth O. Clayton, UTHSC-COM Class of 2023 said:

“This is a call to action. With everything going on, people are looking for change and we all can start in the medical community… especially with medical education. We have to break down the institutional racism that exists through prejudicial attitudes and discriminatory behavior in our justice system, healthcare system, educational system, and all forms of media. It does not stop with this protest. We must continue to examine our own hearts and minds. We must hold each other accountable and continue to have uncomfortable conversations in order to create new systems that benefit EVERYONE.”

Seeing possibilities come true give us more capacity to “hold tension between what is and what could be.” Uncomfortable Conversations are a shining example of something we know could be possible, something author Parker J. Palmer calls the Tragic Gap:

“By the tragic gap I mean the gap between the hard realities around us and what we know is possible—not because we wish it were so, but because we’ve seen it with our own eyes.”

#REFLECT: Where do you see possibilities for change that give you hope?


As 2021 continues to unfold, how do you tend to self-care, community and resilience? I will continue posting reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.