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Wellness Wheel at 2022 NCE in exhibit hall

Himani Divatia, M.D., FAAP (from left), William “J.K.” Vervilles, M.D., FAAP, Abhishek Surampudy, M.D., and Allen Friedland, M.D., FAAP, show off the Wellness Wheel in the exhibit hall at the 2022 AAP National Conference & Exhibition.

Happily ever after: worthy pursuit or unattainable goal?

September 1, 2023

Many movies follow a familiar pattern: Bad guys create problems. Good guys go after bad guys. There is a struggle between good and evil. Good people triumph and live happily ever after.

Many of us are striving to live happily ever after. That goal also is what the AAP Section on Medicine-Pediatrics promotes with the J. H. Milligan-Barr Physician Health and Wellness booth at the AAP National Conference & Exhibition.

Post-pandemic, pediatricians are facing emotional exhaustion, depersonalization and other signs of burnout. Many individuals are questioning or exiting their chosen calling.

The surgeon general recently published Framework for Workplace Mental Health and Well-Being, which includes five essential elements to create a balanced approach to well-being: protection from harm, connection and community, work-life harmony, mattering at work and opportunity for growth. Another wellness model from Margaret Swarbrick, Ph.D., includes eight domains: physical, spiritual, social, intellectual, emotional/mental, occupational, environmental and financial.

As section members were preparing the interactive Wellness Wheel for the booth at this year’s National Conference in Washington, D.C., I wondered how many domains of wellness there really are. Did I even know which dimensions impact my daily wellness? What if there really is only one dimension, but we are chasing multiple dimensions like a modern filmmaker dealing with multiverses in a singular universe?

More importantly, what is wellness and which dimensions lead to happily ever after? Why are we trying to analyze and dissect this elusive thing called wellness?

I concluded that analyzing the dimensions of wellness has value, but not mathematically. Meeting all the criteria does not guarantee wellness. Instead, breaking down domains helps us focus on aspects that we may not have thought about. The Wellness Wheel, and the domains on which it is based, is a holistic tool to take care of ourselves and reach happily ever after. As we self-reflect on areas of need in our lives, we get closer to achieving our goal.

Each year, I am excited to share new ideas and tools for well-being, especially with early career physicians who often are figuring out how to maintain financial and professional stability, pay off loans, and build families and fortunes. Like psychologist Abraham Maslow’s pyramid, the domains of wellness build on each other. Basic domains such as finances and physical comfort and safety need to be taken care of so we can focus on intangible domains, such as social, emotional and spiritual health.

Being aware of the different dimensions and identifying how to tackle each one is essential. Just like the movie hero who has the luxury of tackling villains one at a time, we can address each dimension one by one.

However, as important as the adage “Physician, heal thyself” is, wellness cannot be achieved individually. Our health care systems should provide resources for each domain, such as employee assistance programs, free counseling/coaching, child care savings, support planning vacations and access to financial planners. Systems also should ensure that we are able to access these resources and provide a space of safety and empowerment for leaning into ourselves. In the end, we will have a greater sense of well-being and even may become our own heroes, inching ever closer to happily ever after.

Dr. Surampudy is a member of the AAP Sections on Internal Medicine-Pediatrics and Pediatric Trainees.

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