I hope those of you reading this blog post are, like me, looking forward to the beginning of the national STREAM physician training program. Even if you are not planning on joining the program, I hope you might take something away from this little essay.

I celebrated the completion of my twelfth year as a physician here at Nationwide Children’s Hospital, having started in the Division of Sports Medicine August 1, 2010. I have never been more content with my job.

I am not a Pollyanna. I do not have a perpetual smile on my face. Some of my workdays can feel like a grind. You may see me in clinic when I have my ‘game face’ on seeing patients or hear me complain when there is yet another EPIC update that leaves me struggling to find what button I should click [to wit: the EPIC in basket cleanup which commenced also on August 1, 2022 – now where will I keep those lists of patients I need to track?].

And yet, I am more content now than I was, say, five years ago. Many of my peers from medical school – approaching 60 years of age, having gone through the pandemic as we all have – are talking about retirement. I have no desire for that right now. I am enjoying being a physician now more than I ever have. I would attribute at least part of this contentment to some active changes, including meditation, I have made around personal wellness over the last year.

I had a throwaway line I would drop fairly frequently as recently as a year ago when a medical group might suggest downloading a meditation app to address physician burnout. There is an epidemic of physician burnout, the details of which will be explored in the STREAM program. I have read that an average of one physician in American commits suicide daily. I would think to myself or say out loud to my colleagues: “don’t tell me to download a bleeping app when the house is burning down.” I’d settle in on that opinion and leave the app or some other intervention alone.

And nothing would change. Neither with myself nor with the environment in which I was working.

What convinced me to look more deeply into physician personal resilience was a confluence of events in my life, starting with the Ohio State Faculty Leadership Institute program I began in September 2021. I began to read about the characteristics of great leadership. I learned of the concept of the quadruple
aim in health care. That is, to optimize health care performance we must address patient satisfaction, improve patient outcomes, deliver affordable care, and ensure the health and wellness of physicians and health care personnel.

Simply caring for patients is not enough if we don’t care for ourselves.

And how do we do that? There are systemic barriers throughout healthcare which make it seemingly impossible to attend to our own well-being at times. I will not enumerate these issues here. The reader surely has their own litany of grievances, and these issues will be explored in the STREAM program. Moreover, as with any issue in our profession and the world at large, the barriers I face as a white cis-gender male are very different than the barriers many of colleagues’ face.

As I dove more into leadership and wellness, reading more and listening to more podcasts on my commute, I became convinced of the fact that the wellness of ‘the system’ and my ‘personal’ wellness are in fact a reciprocal relationship. Yes, ‘the system’ needs to become more physician friendly. And, yes, the physician – that is, me – must take ownership of our own wellness if we are to be the instrument of change in reconfiguring and lowering the current barriers and unnecessary stresses. If we change, the system has a chance to change. If we don’t change, the system will never change. So many philosophers have put this so much more eloquently. I will share this quotation from the late Buddhist monk Thich Nhat Hanh:

“It is ridiculous to say: ‘Wait until I finish this, then I will be free to live in peace.’ What is ‘this’? A diploma, a job, a house, the payment of a debt? If you think that way, peace will never come. There is always another ‘this’ that will follow the present one. If you are not living in peace at this moment, you
will never be able to. If you truly want to be at peace, you must be at peace right now. Otherwise, there is only ‘the hope of peace someday.’”

The preservation of the health and wellness (and even the very life) of physicians is not only an essential good in and of itself but is also integral to the delivery of high-quality care to the patients we serve. Yes, the system needs to change. But, if all we do is complain about the ‘system’ and wait for it to change, we will never be at peace. We are ‘the system.’ And if the system must change to better ensure our health and wellbeing, we must change first.

“If you truly want to be at peace, you must be at peace right now.”
I hope to share your own journey to personal and system wellness in the STREAM program. I look forward to becoming more at peace. I look forward to your own experience in wellness. And I look forward to making my institution, Nationwide Children’s Hospital, an even better environment for the health of all its workers as well as patients.