How to Create a Culture of Well-Being in Your Practice


Every organization has a culture, either by default or by design. Why not cultivate one that helps people thrive?

Fam Pract Manag. 2018 Jul-Aug;25(4):11-15.

Author disclosure: no relevant financial affiliations disclosed.

Copyright © 2018 Mark H. Greenawald, MD.

It’s Monday morning, and you roll out of bed ready for another day at work. As you anticipate your day ahead, what emotions are you experiencing? Excitement? Worry? Dread? What emotions do you think your practice team is experiencing? As you walk through the door of your practice, what expressions do you see on everyone’s faces?

Today, many physicians and health care workers are feeling worn down. Professional burn-out is at unprecedented levels, particularly among family physicians.1 Even if you are not feeling burned out, you may be living in what I call “survival mode,” simply trying to get through the day.

That was me a few years ago. I was suffering from sheer exhaustion, isolation, and unresolved grief and shame from the loss of a patient, but I didn’t realize how bad things had gotten — until I found myself in tears after a minor traffic stop and my wife insisted it was time to get help. When my therapist asked if this stressed-out life was the life I wanted to live, I realized I had to make a change. I altered my practice to find balance and improve relationships and developed a framework that I now teach to other physicians.

I’m proof that you can create a different future, one in which you and your practice team regularly and honestly say, “I love my work.” Imagine a practice like that, one in which everyone consistently felt energized and glad to be part of the health care team, helping to contribute to the important work of patient care.

Too often when faced with such a vision, our minds immediately decide it’s impossible because we feel so many of our challenges are caused by things “out there” that we can’t control. You might find yourself thinking, “My work life won’t get better until ___.” Often, what fills that blank is something that may not happen for some time, if ever. I’ve heard many colleagues fill in that blank with “retirement,” for example. This stance forfeits the power you have over your professional happiness, and that of your team. Before your mind immediately goes to “yeah, but” and you start listing all the reasons a thriving practice culture can’t or won’t happen, stop and consider the possibility of a better future.


  • Building a deliberate practice culture starts by asking the simple question, “How do we want to be together?”

  • A practice culture that focuses on service, teamwork, attitude, reflection, renewal, and self-care will help its members thrive.

  • To change the culture of your practice, you must intentionally do something different than what you are doing now.


Culture is simply the way a group thinks, acts, and interacts. It is composed of the behaviors, beliefs, values, and symbols the group accepts, often without thinking


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Dr. Greenawald is vice chair for academic affairs and professional development at the Carilion Clinic Department of Family and Community Medicine in Roanoke, Va. He chairs the clinic’s Physician Well-Being Committee and was conference chair of the AAFP’s first annual Family Physician Health and Well-Being Conference in 2018....

Author disclosure: no relevant financial affiliations disclosed.

Copyright © 2018 Mark H. Greenawald, MD.


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1. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014 [published correction appears in Mayo Clin Proc. 2016;(91)2:276]. Mayo Clin Proc. 2015;90(12):1600–1613....

2. Kuzel AJ. Ten steps to a patient-centered medical home. Fam Pract Manag. 2009;16(6):18–24.

3. Greenleaf RK. The Servant as Leader. Indianapolis, IN: Robert K. Greenleaf Center; 1991.

4. Frankl VE. Man's Search for Meaning: An Introduction to Logotherapy. New York: Simon & Schuster; 1984.

5. Losada M, Heaphy E. The role of positivity and connectivity in the performance of business teams. Am Behav Sci. 2004;47(6):740–765.


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