Members Only | 11.21.24
Wellness Corner: Who Do You Know? Part 2
By Dr. Deb Roman and Dr. Ed McEachern
In part one of this two-part feature, Dr. Roman and Dr. McEachern introduced their work on the Idaho Physician Well-Being Action Collaborative (IPWAC) and the Compassionate Communities Healthcare Movement. Continuing reading about how they cultivate connection, well-being, hope, and inspiration to move forward, together.
A Dynamic Approach
Ed and I often receive phone calls from people in other states asking us how we developed a coalition of diverse individuals from several sectors of our community who are enthusiastically and successfully working together to address complex healthcare issues. We have reflected on our experience and identified three integral aspects of our work together that differentiate our approach from more conventional, process-oriented efforts:
1. Cultivate A Circle of Friends
To advance cooperative and effective action, we believe it is essential to nurture and expand our relationships. We integrated an approach to cultural and social change illuminated by Dr. John Paul Lederach, a pioneer in the field of international peace building. John Paul has worked for decades to address violent conflicts around the globe, demonstrating that social and cultural change start when a small group of people decide that circumstances are intolerable. Before they develop a plan to address the situation, they ask each other:
Who Do You Know?
Not who do you know who agrees with us, but: Who do you know with whom you have a relationship who you can welcome to join our conversation? John Paul proposes that our friendships provide an essential, sturdy, and flexible foundation as we work to address complicated issues. With friends, we are more likely to listen carefully and respectfully, consider new ideas, recognize our biases, and strive to understand each other. Our vision emerged from concern about the declining health and well-being of our physician friends, so we started by inviting a small circle of friends who share our concern to respond to this crisis.
In an effort to strengthen our relationships, we have integrated two practices. First, we take time at the start of each meeting (and between meetings) to check in with each other, and when someone shares that they are going through difficult times, we provide a space for conversation and support. When caring relationships are prioritized, our work together is organic, creative, and meaningful.
Second, we address each other by first names. This simple practice makes it easier to connect as individuals, each with our unique struggles, dreams, and insights, rather than focusing on titles. Doing so also nudges us to consider our attachment to identify and its effect on the quality of relationships that we develop.
Our circle of friends is continually growing. Ed and I encourage each of the IPWAC participants to welcome people with whom they have relationships to join us, especially individuals who see the world in ways that are vastly different from their own. At times, discussions among people with diverse opinions ignite strong emotions, but rather than shying away from disagreements, we make space for respectful inquiry into the reasons that we feel strongly about a particular idea. These times are unique opportunities to learn together, expand understanding, and uncover shared values.
"Friendship is a moving frontier of understanding, not only of the self and the other, but also of a possible and yet unlived future." — David Whyte
2. Embrace Spontaneity
While we organize an agenda for each meeting, we remain flexible, and when our conversations are filled with enthusiasm and creativity, we do not interrupt the excitement. We trust that the energy and wisdom of the group will provide direction. Feelings of vulnerability may arise when “thinking out loud" and straying from a planned agenda. Yet, in these spontaneous moments, previously unseen insights often emerge, inspiring continued enthusiasm. We often smile when we think back to the moment when we recognized that the hospital system and insurance company executives, pharmacists, physicians, legislators, and medical societies in our group all agree that prior authorization reform is imperative. Discovering this unexpected common ground was a good reminder that many of the assumptions that contributed to the contentiousness of our first meeting were inaccurate, and that has motivated us to work to transcend our biases and view ourselves, our community, and our work with a wider lens.
Our approach integrates the concept of “unordered space” as described by Cynthia F. Kurtz and David J. Snowden. Kurtz and Snowden suggest that facts and patterns emerge from the experience rather than a well-defined framework. They propose that in unordered space, knowledge arises from dynamic relationships in the moment and is a function of trust, stories, and connections.
Many participants share that they enjoy the freedom of this organic, nonlinear approach, and are surprised and inspired by all that we accomplish when working together in this way. We find that, with practice, it becomes easier to trust ourselves, each other, and the creative process.
3. Reach Out to ‘Unlikely’ Friends
Colleagues often ask us: “How did you convince that person to meet for coffee or come speak at your retreat?” Our response is: “We just asked!” Importantly, we do not reach out to people to convince them to support or join our efforts. We invite them to meet with us to get to know them, to share ideas and insights with each other, as we would with a new acquaintance, a potential new friend.
We ask questions like, “What do you feel are the most important issues that we are facing right now?” and “What do you think are the best ways to address them?” We explore our work with them, sincerely asking for their input, and, similarly, invite them to share their work with us. We spend much of our time together learning about each other.
When we connect with authenticity and genuine respect and envision new possibilities for healing in our world, the ripples generated are many and varied. Even if we do not work together in the traditional way, hopefully we both come away from the conversation with novel ideas, inspiration, and a new friend.
In a presentation many years ago, John Paul Lederach shared that in his experience, if we hope to achieve sustainable social change, “First and foremost, we must be friends."
Our Invitation
By sharing our experience, we hope to inspire people to join us or develop their own physician well-being action collaboratives so more people can come together in community, and with kindness and genuine respect for each other, work to enhance the well-being of the physicians who dedicate their lives to care for us.
Generating system-level change may feel overwhelming, or perhaps even beyond reach, yetour experiences have taught us that when friendship is the heart of our work together, substantial social and cultural transformation and healing are possible.
"Social healing is made up of space moments of resonance, voices touching voices in a common space." — John Paul Lederach
Dr. Deb Roman and Dr. Ed McEachern founded and facilitate the Idaho Physician Well-Being Action Collaborative (IPWAC) and work together on the board of the Compassionate Communities Healthcare Movement (CCHM). They share presentations and workshops on the transformative potential of friendship-centered community circles. Please feel free to connect with them at drdebroman@finding-health.com or edward.mceachern@gmail.com.
References
The Pocket Guide for Facing Down a Civil War: Surprising ideas from everyday people who shifted the cycles of violence. John Paul Lederach Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Shanafelt, West, Dyrbye, Trockel, Tutty, Wang, Carlasare, Sinsky
The new dynamics of strategy: Sense-making in a complex-complicated world. Cynthia F. Kurtz and David J. Snowden
The Moral Imagination: The Art and Soul of Building Peace. John Paul Lederach
Building Peace: Sustainable Reconciliation in Divided Societies. John Paul Lederach