When Wayne B. Jonas, MD, started practicing medicine in 1981, he was the only physician responsible for two entire battalions and their families – about 4,000 people. He learned quickly how to deliver person-centered, relationship-based care that helped his patients stay healthier while also treating their diseases, illnesses, and injuries. Once outside the military, he saw how payment models began to emphasize procedures over conversations, and EHRs added the onerous burden of medical documentation. Dr. Jonas – and other clinicians nationwide – no longer had enough time with patients or their communities to provide adequate care.
“Clinicians are being overworked and stretched too thin. There is never enough time in a day or in an appointment to meet the needs of our patients,” says Dr. Jonas, a physician at the community hospital on Fort Belvoir in Northern Virginia, clinical professor of family medicine at Georgetown University, and president of the Healing Works Foundation.
Less face time with patients and increased administrative burdens have driven burnout to epidemic levels, affecting nearly half of all physicians in the United States1 and a similar percentage of nurses2. Dissatisfaction with quality of life and work-life balance and a decline in wellbeing are common.
Return to the Core of Healing
Finding meaning and engagement in work helps clinicians combat burnout and build resilience1.
Six core wellness factors can help you focus on what matters most to you and weave self-care and wellness into your life:
- Learning: Giving back to others or society by focusing on what truly matters.
- Loving: Having deep and satisfying social relationships.
- Relaxing: Being able to relax deeply and remove yourself from stress and worries.
- Sleeping: Adequate deep and restful sleep.
- Eating: A balanced, nutritionally dense, minimally processed, mostly plant-based diet.
- Moving: Routine movement in daily activities and exercise.
Identifying Your Needs
Easily identify your needs and priorities by taking the Primary Care Personal Health Inventory (PHI), which assesses meaning and purpose in life, current wellness needs, and readiness for change. The PHI’s simple 1-5 rating scale will help you identify which core wellness factor(s) you should focus on.
Discuss your results during a Healing Oriented Practices and Environments (HOPE) Note visit with a colleague. The HOPE Note is a patient-guided process to identify the person’s values and goals in life and for healing.
The PHI and the HOPE Note visit give you space to think.
“Having a reflective moment about your life is healing,” says Alyssa McManamon, MD, FACP, a hematologist-oncologist and an associate professor of medicine at Wright State University Boonshoft School of Medicine. Dr. McManamon and Dr. Jonas are co-authors of “Healing and Cancer: A Guide to Whole Person Care,” which strives to bring the concepts of healing and whole person care further into health care delivery so that people with cancer feel better and live longer.
“What you need in order to accomplish what matters most to you will rise to the top,” says Dr. Jonas. Both the PHI and the HOPE Note ask you to choose three changes you’d like to make. They are available on Healing Works Foundation’s website for primary care and cancer care.
Getting Started
Improving even one core wellness factor can make a big difference in your life. For example, for a long time, Dr. Jonas was so busy that he ignored sleep. Then he adjusted his schedule to get 7-8 hours of sleep a night. He found he felt, thought, and acted better. He even made better decisions.
“Sleep impacts all areas of wellbeing for mental and physical health, risk factors, and the ability to have good judgment and be compassionate. Getting enough sleep has made a huge difference in my life,” he says.
When Dr. McManamon was the lone oncologist in a community-based practice, she also experienced burnout. She started listening more to her body and doing simple things like drinking more water. A daily morning meditation and yoga have helped Dr. McManamon relax and reduce stress.
Other ways to weave self-care into your day include:
- Listening to soothing music.
- Taking a 10-minute walk outside each day.
- Combining meditation or beathing exercises with journaling.
“In choosing the changes you’d like to make, consider your non-negotiables, things that you won’t feel good without doing,” says Dr. McManamon.
Addressing the Core Wellness Factor of Learning
Along with helping you combat burnout, taking the PHI, doing a HOPE Note visit, and weaving wellness practices into your day help you learn how to deliver whole person care to your patients.
This type of care is person-centered, relationship-based care that takes into account the social, spiritual, emotional, and behavioral aspects of health as well as the environment in which the person lives. Whole person care integrates evidence-based conventional medical care, complementary medicine, and lifestyle medicine.
Delivering whole person care enables you to give back to others and society by focusing on what truly matters.
“Most clinicians who shift to whole person care find a renewed joy in their practice,” says Dr. Jonas.
“As clinicians, we cannot provide whole person care without honoring our own wholeness,” says Dr. McManamon. She also notes that having personal experience or familiarity with complementary medicine and lifestyle medicine helps clinicians advise patients and build connections with them.
Expanding whole person care to our team is the next step. Learn more about this in our upcoming blog, “Restoring Joy in Medicine through Whole Person Team-Based Care.”
Tools and Resources from the Healing Works Foundation
Free Tools for Primary Care
Primary Care Personal Health Inventory
HOPE Note Toolkit for primary care
CME Course – Introducing Whole Person Care Into Your Practice: Clinician as Healer in Primary Care
Free Tools for Cancer Care
Oncology Personal Health Inventory
HOPE Note Toolkit for cancer care
Integrative Oncology Solution Guide
Whole Person Cancer Care Course: Clinician as Healer (course with CME credits)
More Resources from Healing Works Foundation
Jonas WB and McManamon A. Healing and Cancer: A Guide to Whole Person Care. Rodin Books. 2024.
Using the Personal Health Inventory with Your Patients
Pocket guides
Clinician Well-Being: AMA Perspective, an interview with Dr. Jill Jin
Other Resources
AMA Steps Forward toolkit: Burnout and Well-Being
AMA, 7 ways to beat physician burnout by rebuilding relationships
References
[1] Shanafelt and Noseworthy. Mayo Clin Proc. 2017 Jan; 92(1):129-146) and a similar percentage of nurses.
[2] Dyrbye et al. BMC Nurs. 2019 Nov 21;18:57.