• Series: A Thriving Practice Culture

    Part 2: Find a Touchstone

    Family physician Mark Greenawald, MD, FAAFP, of Carilion Clinic Family and Community Medicine in Virginia, believes that a thriving practice culture—a workplace that is respectful, uplifting, and fulfilling—is the product of choice rather than chance. In other words: If you want it, you have to help create it. In this three-part series, Greenawald offers some practical tips for how to get started.

    Mindset Matters

    Many family physicians report that they struggle to maintain a positive mindset. And while it’s tempting to relegate inner work to the back seat, it turns out that mindset matters. In a practice, attitude—especially physician attitude—is contagious. “Physicians can either be a ballast for the negative or a catalyst for positive change,” says Greenawald.

    If you want to act and feel more positive overall, it can help to find a person or habit that helps you maintain perspective about your life and work. For example, you might establish a gratitude practice, write a personal vision/mission statement (and revisit it often), explore meditation, or regularly share with a trusted friend or colleague. Whatever you choose, the ultimate goal is to regularly remind yourself of what you value in life so that you can more easily connect to those things, especially during difficult times.

    In the course of his work on practice culture, Greenawald has interviewed a number of “bright spot” physicians, which he describes as “physicians who are breathing the same air and swimming in the same environment [as the rest of us], but have a positive attitude and are taking care of themselves.” A common thread among these physicians is that they deliberately anchor themselves in meaningful habits and connections that help them maintain a balanced perspective throughout the day. By doing so, says Greenawald, “they don’t let the small stuff become any bigger.”

    Change Your Outlook on Challenges

    Still, choosing positivity may be easier said than done. One simple starting point is looking for opportunities to reframe the events of your workday. For example, imagine you’re struggling to find a function in your EHR and getting more and more frustrated. Instead of focusing solely on the EHR's failings and letting that frustration define your day, take just a moment to stop and reflect on a good interaction you had with a patient or colleague. Reframing won’t make it less frustrating to use a poor product, of course, but it may counterbalance a negative experience with something positive.  


    More from Greenawald

    Written by AAFP editorial staff.

    Mark H. Greenawald, MD, FAAFP, is Vice Chair for Academic Affairs and Professional Development, Carilion Clinic Department of Family and Community Medicine, and an associate professor of family and community medicine at the Virginia Tech Carilion School of Medicine, Roanoke, Virginia. He is on faculty at Carilion Clinic’s family medicine residency program, chairs the Carilion Clinic physician well-being committee, and serves as the director for the American Academy of Family Physician’s (AAFP’s) Chief Resident Leadership Development Program.