From the Trenches

What Does Well-being Mean to You Today? Supplement Resource to Coaching Practice

by Kerri Palamara, MD, MACP

Well-being Wheel

We talk a lot about well-being, but it is often hard to define for others and for ourselves.

The idea of the Well-being Wheel exercise is to personalize what well-being means for you today. Well-being means something very different to different people over time, and it changes for us as we change and as the world around us changes. Several factors have been identified as contributing to both our personal and our professional well-being, but with these abstract concepts, if we don't stop and think about it and define it for ourselves, it is hard to know if we ever actually get there. The more we are aware of what well-being means for us today, the more we can engage with those variables and start to build a sense of control and self-efficacy as we work toward them, almost as if they are a goal. In doing so, we connect our own motivations and values with working toward these constructs for ourselves.

Most of us will never reach the fully defined vision of our well-being in each dimension. But when you start to live in the AND space as opposed to the OR space (that is, understanding that you may have factors of well-being that are going well and factors that may not be going as well as you'd hoped, rather than I either have well-being or I don't), you are able to appreciate what is working, feel good about that, and use that to fuel yourself toward what is next for you on this journey toward well-being. That is the purpose of the Well-being Wheel exercise.

If you view the Well-being Wheel exercise, you will see that there are different components of well-being defined here—financial, physical, recreational, social, mental, spiritual, emotional, and occupational. Each has a blurb below it describing in general what this component of well-being may mean; for the person doing the exercise, the idea is to consider what these terms mean to them and to personalize each one. How are these factors represented in their life? The next step is to consider how in touch with each of these factors they are. Is this something they are aware of and are working toward? Is this something they haven't given much thought to before? Here, they will give themselves a rating of 1 to 10 and connect the dots to create an image for further reflection.

Steps to completing the Well-being Wheel:

  1. View the well-being components—how are these factors represented in your life? Be specific. It could be actions, people, places, feelings, needs, or values. How connected are you with these areas? How important are these areas to you?
  2. Reflect upon these components and rate your satisfaction levels with each factor on a scale of 1 to 10, where 1 (lowest satisfaction) is closest to the center of the circle and 10 (highest satisfaction) is at the edge of the circle. Note—this is not rating how you THINK you are doing, but how SATISFIED you are with this area.
  3. Connect the dots to create a spider-like diagram or “inner circle” of your satisfaction levels. This allows you to identify any gaps quickly and easily between where you are now and where you want to be.

The purpose of coaching is to help people go from where they are to where they want to be. Therefore, this image they create is immensely helpful in framing a coaching conversation. In this conversation, you won't usually cover the entire wheel. The goal is to give them something to think about and work on, then focus the conversation on what might be most useful to consider in greater detail. To get started on this conversation, invite them to envision ways they might be able to work on improving or sustaining their well-being—doing so creates an opportunity to reflect, find areas where they can commit to change, and set goals around that. If you are familiar with the GROW Model, this is a very effective tool to move the conversation forward. If you are not, you can also ask them to consider what this would look like if this were going well, and how they might be able to move toward that vision. If things seem to be going well, consider asking them to reflect on what they are doing RIGHT that is supporting them.

Whenever I do the Well-being Wheel exercise with people, I always invite them to close with commitments, next steps, and takeaways. There is so much to be learned from this exercise, so taking a moment to stop, acknowledge, and affirm those lessons is a helpful way to end.

Complement Resource

Revisit Your Well-being Champion Training: Coaching

Compassion Moments: Skills for Patient Care and Self Care

by Sonia Raaum, MD, FACP

Explore Compassion Moments to integrate skills into clinical encounters and self-care. Included is an overview of how skills can be integrated into interactions and clinical reasoning via the SOAP format used by many health care professionals.

View Here!

My Physician Well-being Experience

by Geetha S. Kamath, MBBS, FACP

They say a journey of a thousand miles begins with a single step.

I have practiced medicine for 20 years as an internal medicine and primary care physician. Throughout this time, I have taught students and residents and served veterans. In addition to being a full-time physician, I am also a wife and a mother to 3 wonderful kids.

The stressors of juggling work, family, and all other social responsibilities led to years of disrupted sleep, lack of self-care, and erratic eating habits. As I cared for my patients with chronic health issues such as diabetes, hypertension, arthritis, and obesity, I realized the impact of lifestyle, behavioral health, and hormone disruptions on these health issues. I then started to see the effects of stress, lack of sleep, and poor lifestyle choices on my own health and well-being. While looking up stress-management resources for my patients, I felt that I could also benefit from these resources. I can promote yoga, meditation, and the Eastern philosophy of mindfulness as evidence-based modalities of well-being. I gained experience and training in these healing practices during my early years in India. I appreciate that these practices are preventative tools.

I worked at the Veterans Affairs hospital as part of its whole-health program. The program focuses on both physical and mental well-being. During this time, I learned of the benefits of acupuncture, biofeedback, and motivational interviewing. My patients' general well-being improved as a result of these integrative health practices.

As an ACP Well-being Champion during the COVID-19 pandemic, I realized that physicians such as myself had put self-care on the back burner in a health care system that was overwhelmed. This time caused me to see that self-care is a necessity and not a luxury. Flight attendants always ask you to ensure that your own oxygen mask is on before helping others. In that same line, we as physicians cannot help our patients adequately if we are not first taking care of ourselves.

ACP has created resources to assimilate wellness into our busy daily routines. We are now charged with disseminating these resources further among the ACP membership and beyond.

During the ACP Internal Medicine Meetings, we have presented Mini But Mighty Skills workshops on topics such as “Communicating Needs for Win-Win Outcomes” and “How to Apply Compassion.” These short sessions further helped me develop my skills in wellness coaching and self-care. I have been helped to understand that when we are stressed, we struggle to see the big picture. At times like these, the support of our colleagues and organizations such as ACP becomes crucial.

Social media has grown in its influence, especially during the pandemic. When we could not meet together in person, we still had a wealth of support available online in physician community groups. These groups cover a host of professional and personal subjects ranging from physician side-gigs to travel groups.

The following quote sums up my thoughts well:

“Beneath every behavior there is a feeling

And beneath each feeling is a need

And when we recognize and meet that need rather than focus on behavior,

we begin to deal with the cause not the symptom.” —Ashleigh Warner

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Back to the March 17, 2023 issue of ACP IM Thriving