Interpersonal and Individual Commitments - Practice and Promote Self-care​

"Individual physicians who learn and incorporate self-care skills can enrich their own well-being. As part of their ongoing professional development, physicians may benefit from opportunities to enhance emotional awareness, mindfulness, and self- reflection. Organizations and training programs could provide education, resources, and protected time for physicians to devote to these practices. Additionally, organizations could encourage healthy choices by incorporating healthy food and exercise facilities at or near the workplace and incentivizing participation in lifestyle initiatives."
from the Charter on Physician Well-Being, JAMA. 2018;319(15):1541-1542. doi:10.1001/jama.2018.1331

​Research, Articles & Ideas
Self-Care as an Institutional Value
The prevailing ethos of putting the Triple Aim first at all costs - resulting in inordinate amounts of work is put on the backs of clinicians - simply cannot be maintained. But under the Hippocratic Oath, a lot of physicians feel compelled to comply in the "best interests of the patient". Is there another way?

Oath to Self-Care and Well-Being
This new, self-standing oath was developed in 2020 by the Collaborative for Healing And Renewal in Medicine (CHARM, the same sponsor for the writing of the Charter on Physician Well-Being). Medical schools and residencies might consider building it into their ceremonies and even medical staffs could consider adding it into their onboarding materials for new physicians and healthcare staff.

1. We SOLEMNLY PLEDGE to embrace and promote the well-being of our self, our colleagues, and the medical community as part of our responsibility to the effective care of our patients, ourselves, and in partnership with our healthcare organization.
2. We WILL SEEK TO DEVELOP and ADHERE to habits that promote and maintain humility, meaning, and wholeness of self in our work and interactions.
3. We WILL BE ATTUNED to the physical, emotional, mental, and spiritual needs of our self and others and share our practices of well-being for the benefits of our patients, our colleagues, and the advancement of healthcare.
4. We WILL COMMIT to integration and balance in our professional and personal life and seek help when we feel we ourselves or our peers are overburdened, fatigued, or less compassionate.
5. We WILL CHAMPION for a healthcare system that values the well-being of its personnel, uses best evidence for an instituitional culture of wellness, and recognizes that in so promoting the patients we care for are ultimately best served.
6. We WILL FIND the courage to be vulnerable and confront professional wrongdoings to the best of our ability while at the same time showing compassion and respect for all members of the healthcare team.
7. I MAKE these promises of well-being to myself and to the vocation of medicine with my highest commitment.

Modified Declaration of Geneva 
Consider the Geneva Oath, which added self-care as an expected new norm of medical professionalism in 2017.

AS A MEMBER OF THE MEDICAL PROFESSION:
I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
I WILL RESPECT the autonomy and dignity of my patient;
I WILL MAINTAIN the utmost respect for human life;
I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I WILL RESPECT the secrets that are confided in me, even after the patient has died;
I WILL PRACTICE my profession with conscience and dignity and in accordance with good medical practice;
I WILL FOSTER the honor and noble traditions of the medical profession;
I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;
I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;
I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;
I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;
I MAKE THESE PROMISES solemnly, freely and upon my honor.

Protecting Time for Mental Health Care
Kristin Jacob, MD of Spectrum Health in Rockford MI studied whether or not protecting the time of medical residents to access mental health helped them take better care of their needs. Unpublished findings showed an increased utilization of EAPs, personal wellness plans, and the likelihood of connecting with a mental health professional in the future as needed. (Coalition of Physician Well-Being, July 2021 Presentation)

​SW Idaho Resources

Mindfulness and Meditation
ACMS members group that meets regularly in Boise. Specific dates listed here: www.adamedicalsociety.org/mindfulness

Dimensions Work and Well-Being Toolkit for Physicians
This is a free, high-quality, self-guided resource toolkit for personal change published by the University of Colorado School of Medicine.

Friends, Mentors, and Creatives
Ada County Medical Society has started an initiative aimed at connecting physicians to each other who have the same outside interests or pursuits. This might include physical activities like mountain biking or creative and artistic endeavors. The Member Connection Center also promotes opportunities for self-directed mentors and mentee connections.