Why It Matters
Health care leaders can retreat from challenges, or tackle them head on. We must remember that finding and maintaining our sense of purpose as health care professionals is not only a personal quest, but also a collective responsibility.
Editor’s note: This is a preview of IHI President and CEO Kedar Mate’s IHI Forum keynote.
At its core, purpose defines our sense of why: why we exist, why we do our work, why we live our lives. Purpose is intention and a sense of direction — but also, importantly, it’s a source of meaning for us as individuals, as teams, and as whole organizations.
A sense of purpose is what keeps you going, even when the work is tough and not everyone understands or agrees with what you are trying to do. Twenty years ago, for example, I was working for the World Health Organization (WHO) on an HIV treatment program. We were trying to get antiretroviral medications to millions of people across low-income countries in Africa, Asia, and Latin America. Many at that time assumed that you could not treat HIV in resource-limited settings.
My team and I believed otherwise, and we were slogging through the messy world of customs officers, dealing with procurement officials in approximately 50 countries who did not understand why we needed refrigeration or why medications needed to move through the ports more quickly. I felt exhausted by these conversations, but, oddly, I felt enormously grateful as I rode the bus home every night. We were trying to do something special; we were trying to get 3 million people on life-saving HIV treatment in two years. In 2003, tens of thousands of people were on these treatments in the US. But in low-income countries, where very few people had access to this life-saving therapy, it was an entirely different story.
The “3 x 5” initiative (treat 3 million by 2005) was hard and sometimes tedious work, but the sense that we were doing something important energized us. We were making progress despite all the barriers, and that sense of overriding purpose deeply connected our team.
Faced with an ever-evolving health care landscape, labor unrest, and staff leaving or retiring in huge numbers, asking leaders to focus on lofty ideas like purpose might seem out of touch. But, as I have started to investigate this further, I have found that the literature shows that connecting to our purpose — or even trying to understand or discover our purpose — is relevant to many challenges in health care. For example, a higher sense of purpose is associated with better individual health behaviors and greater resilience at work. Helping employees find a sense of purpose can improve performance, enhance well-being, and reduce turnover.
Finding Purpose Through Adversity
Sometimes, a personal experience can inspire a sense of purpose that benefits not only yourself or someone close to you, but also those in the wider world. This is the case with Kyle P. Christiason, MD. When IHI President Emeritus and Senior Fellow Don Berwick and I recently had the privilege of speaking with Kyle for a recent episode of the IHI Turn on the Lights podcast, his sense of purpose was clear.
Kyle’s journey started with the experience of his child, Ben. Ben was sex-assigned female at birth and went through severe gender dysphoria starting at an early age, leading to emotional distress and suicidal thoughts. As their family struggled to find good support for Ben, Kyle and his wife — both health care professionals — were humbled by what they realized was a significant gap in their knowledge regarding transgender health. They eventually found an academic medical center specializing in transgender health that was out of network and four hours from their home. Realizing that he did not want other families to face the same struggles to get access to competent transgender care inspired Kyle to start UnityPoint’s Prairie Parkway LGBTQ Clinic in Cedar Falls, Iowa. His family’s journey has motivated a desire to not only provide high-quality, inclusive, and accessible care, but also to ensure that patients and families feel seen and supported from the moment of their first interaction with the clinic.
What Gets in the Way of Purpose?
As IHI’s President and CEO, I find a powerful connection between my personal and professional sense of purpose every day. As a clinician, however, my sense of purpose is challenged on a regular basis. Our health care system in the US is designed to secure as much value out of every clinical interaction. This leads to increasing pressure and an emphasis on activities and not on building the relationships that we know are the key to healing and providing more lasting impacts on health. When I am in a clinical practice environment, my desire to spend time developing a connection to someone can run into direct conflict with the need to move to the next activity. I know I am not the only clinician who experiences this.
Opportunity shapes purpose. Social and structural factors shape purpose. Changing life circumstances shape purpose. This means purpose is not a static phenomenon. Purpose connects us to who we are, and it evolves in some cases as we evolve as humans. Purpose gives us joy and meaning.
Our purpose as health care professionals is to make people healthier. When the system we are working in gets in the way of that, it undermines our sense of purpose. The things that interfere with us doing what is right for our patients — the things that cause moral injury — separate us from joy and meaning.
As health care leaders, we can retreat from these challenges, or we can tackle them head on. We have an obligation to remember that finding and maintaining our sense of purpose as health care professionals is not only a personal quest, but also a collective responsibility.
How can we create and sustain a culture that values and supports the human connection between us and our patients, as well as among ourselves? The work we do to improve quality can help.
I have seen quality improvement work restore joy, meaning, and purpose to colleagues in systems all over the world. Health care organizations that build clinical operating systems that get rid of daily hassles; empower us to solve problems in real-time; provide real-time coaching and feedback; and fundamentally connect patients and clinicians in authentic and constant relationship make it easier to do the work we love — helping patients heal.
Editor’s note: Look for more each month from IHI President and CEO Kedar Mate, MD, (@KedarMate) on improvement science, social justice, leadership, and improving health and health care worldwide.
Photo by Chantal & Ole | Unsplash
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