“When evolving a healthy culture, the essence is the ability to be open and learn from one another. “
Burnout- Exploring the taboo
We are at the intersection of an awareness that burnout stems from something much deeper than we have expected. It is something that will be necessary to become conscious of in order to move forward. Our collective misunderstanding of what and how burnout emerges in our healthcare system must become seminal work if we are to heal our system and ourselves amidst the system.
We have been scratching the surfaces and spinning our wheels trying new methods that may help our providers stay effective and efficient. The irony of understanding the nuances of burnout is that it is an essential element in determining our state of true well-being, something we are supposed to be experts in. It’s time to learn what was left out. To begin to heal our souls, to reclaim that service for ourselves and others that we once believed in. Our future depends on it.
Health of The System
We are specialized in the systems of the body within healthcare. We are often siloed and refer to our colleagues from other departments only when necessary. What we may be missing is the corresponding nature of how the body operates in an optimal homeodynamics and how our system reflects that very process. Just imagine if we combined the expertise of the specialists with the generalists, and even added our patient feedback what we could all do together. In fact, that is what we have right under our noses; we just aren’t looking at an abstract picture and seeing an incredible template for change.
We know that the healthcare system is broken. But what we might not be seeing is our latent potential within ourselves to be a catalyst for change. In this multimedia, we explain how we are the system. With this information in hand, we must no longer settle for unhealthy conditions. It is a radical paradigm shift in mentality and structure, but we are primed and ready and must be so ff we desire to address burnout, exodus, and ill health within the system.
You have more power than you think and it all starts with you.
Inner Self Love Process
Generally we can agree that self love is our attempt to rebalance our actions with our well-being. The emergence of the “self-love movement” indicates our actual attempts at a true understanding of health need evolution and work. We can also agree that this juggling act occurs in the physical and mental realm. We are rapidly becoming more aware that there are a multitude of factors, including the emotional and spiritual realm, that must be included. This desire to become aware of self love is our attempt to balance our inner and outer ecosystem, to create a sense of homeodynamics. Until we understand this, we fail at those very our efforts. In our rapidly changing world it is not only crucial, but necessary, especially as healthcare experts, to catch up on our knowledge. We are constantly being assailed by more products, media, and news sharing how a health product, device, or medication will help. At Awakening Healthcare, we see how this material fixation (with a radical imbalance of our inner world and health) is causing a catastrophic collapse in our cultures while lessening our human potential and consciousness. We must start within.
Patient Experience Evolution
A new and exciting way exists. Awakening healthcare is the opening, and invitation, to align yourself with a higher reality. Can you (re)imagine staying grounded, with compassion for your physical limitations, while simultaneously expanding your consciousness to grow outside of it? It is not a contradiction but a reality to grow beyond belief, find peace, and find fulfillment even when life seems to be working against us. What no one mentions is that it is in the impossible moments that you can free yourself. It is not a mistake that you were led here. You know that alternative ways of navigating illness exist; outside of fear, limitations, anxiety, and depression. We can be aware that, at times, we can still feel good — even if we are facing chronic illness. These moments are not luck, they are deliberate glimpses of your true self beyond the limitations we have being in a body.
We have connected with patients like yourself who have found this key to wholeness. We want to share the key with you. The current way we treat disease and illness leaves it out completely. In the new paradigm, we will continue to introduce and implement these modalities and concepts into the medical community. But until then, we got you. WE invite you to become curious, open your heart, and begin again. Here we see you as the whole and we know how amazing it will feel to connect with this energetic signature. Find your tribe of empowered souls and recognize an amazing life exists even while facing the unknown.
Providers True Calling
Step back in time. Remember that moment you discovered you were called to help those in suffering? Clarity, excitement, purpose, and uncertainty may wash over you as you recall bravely deciding to step into the unknown. You may also have an entirely natural resistance to “go there” because of what has transpired since. The current climate within our healthcare systems is sick. We once again are being invited to stand in that face of uncertainty but this time to save our very own. We are revisiting that initial call in time but now with certainty of what does not work and what needs to be up-leveled. Taking our experiential wisdom, finding the others, and using it to consciously build new homes for healthcare. This requires healthy, courageous, and aligned new leaders who devote themselves to the whole over the few.
Awakening healthcare provides the formula to assist the right individuals to cultivate, ground, and awaken to a new healthcare paradigm. You are not here by mistake. You are being called, again. This time it looks different, but with your experiential wisdom and dedication, you have exactly what it takes to rebuild this system. Change is happening, no matter what. Let’s make certain we are applying the true and ethically aligned individuals to steward this shift. If you feel like you have seen and understand the distortions and know that old ways are not how we move forward, join us. Your tribe awaits you. We provide support for a healthy team to birth the new-age environments where our limitations and constrictions become expansion and opportunities.
We are broadening our vision to reclaim our calling, join us
Glossary
Regeneration
Regrowth of lost or destroyed parts
Spiritual or moral revival or rebirth.
Up-regulating our collective intelligence by enriching, re-defining, and providing a conceptual framework to match and uplevel our current
reality’s needs.
Define
Re-define
Dual definition (audience based)
ANTI- FRAGILE- definition
As initially defined by Nassim Nicholas Taleb, it is a property of systems in which they increase in capability to thrive because of stressors; it is fundamentally different from resilience and robustness as common terminology utilized in the healthcare context.
We would add – An individual, relationship, or system that has the bandwidth (space, energy, applied resourcefulness, and commitment) and capability to learn, grow, and adapt under adversity while coming through better and not bitter.
This is a concept that Awakening Healthcare values as an essential core evolutionary principle in creating a healthy medical culture and a sustainable healthcare system.
CULTURAL HEALTHY PARADIGM- conceptual framework
Awakening Healthcare’s introduction to a potential way of life, where our basic needs are met and we can understand and accept the complexity and nuance of life and can harness our innate abilities to adapt to those complexities. When our basic needs are met, we can earnestly care about the whole as much as self-interest e.g. we can help others to meet their needs as this furthers the interest of us all.
ENERGY - definition
According to the American Heritage Dictionary of the English Language, Fifth Edition
n.
The capacity for work or vigorous activity: synonym: strength.
n.
Exertion of vigor or power.
In practical and applicable terms, understanding how you can develop skillsets to control your potential energy vs your kinetic from a nuanced perspective.
EMBODIED EMPATHY - conceptual framework
When we develop through the stage of embodiment we then can display the fuller range of empathy. It is a process and awareness through the depth of our won personal understanding of self. We then can “meet” the other where they are and be completely present to the unknown without changing what is.
HOLISTIC - dual definition
According to Merriam Webster.
1 as of or relating to holism
2 relating to or concerned with wholes or with complete systems rather than with the analysis of , treatment of, dissection into parts
holistic medicine attempts to treat both the mind and the body. Holistic ecology views humans and the environment as a single system.
Awakening Healthcare is working toward addressing this from a practitioner’s POV. Taking into account the patient’s subjective experience, their environment or taking into account the different systems of the human body. In the current healthcare system, there are limitations to how holistic care is delivered. For example, there is a high degree of diversity in how providers define holistic and incorporate it into their practice; institutions or individual practitioners may lack the appropriate resource or referral to address their patients’ needs. The care stops in the office often not because the providers lack care but rather knowledge, time, and resources to improve the scope to include what happens outside the biology, chemistry, or office.
Holistic in terms of a patient’s perspective often includes multiple resources, non-traditional modalities and far reaching efforts to meet their needs. Patients facing the complexities of long term illness need a paradigm when seeking outer ways to embody wholeness are supported. When we are facing the potential for our death it is natural for the soul to yearn for wholeness. We invite healthcare to recognize this and do a better job supporting us as patients who seek other modalities. We are directly showing where the current system is lacking. Health is an interconnected relationship between and balancing of the parts of a whole where the parts no longer hold precedence over the whole. This can only be understood by a subjective experiencer or one who has been through the process with awareness. We envision a climate of co-collaboration with our practitioners that is a living, breathing relationship toward that greater wholeness.
HIGH RESOLUTION SYSTEM CHANGE - conceptual framework
A permanent shift in action whereas the individuals that comprise an organized whole have the ability to see and process through a denser or finer lens of reality. This amplified image allows one to see more clearly without the nuanced distortions, whether emotional or mental, that may bias the actual circumstances. Awakening Healthcare believes that the introduction of these concepts can go a long way to solve our current healthcare system challenges.
OUTCOMES - dual definition
Practitioner Outcome – a measurable, quantifiable end point either in a study or through the course of disease or process. Secondary outcomes are usually associated or connected to the primary outcome. Side effects can be considered adverse outcomes.
Patient Outcome – in terms of dealing with complex illness, the outcome is not quantified in an end point. Instead, an outcome is an ongoing process with potential of multiple downstream effects, of how well one may be coping, physically, mentally, emotionally, spiritually. These downstream effects often cause further dysregulation if proper resources and basic needs are threatened. Outcomes are almost non-existent for a patient unless otherwise it is an acute injury or has few variables.
Awakening Healthcare feels that in order to come up with high resolution patient outcomes at the height of a complex illness and mental health crisis, we need fundamentally different epistemological approaches to deal with the upstream variables in complex illness. Regen believes this may assist in better off-ramping for patients and offer an opportunity for holistic care. In order to step up to this medical paradigm, we must reroute our foundations to have the bandwidth to navigate the exponential need.
*See our references on post outcome affects and poor psycho-social reintegration into life post-transplant
CONCEPTUAL FRAMEWORK- definition
Analytical tool with several variations
A plane of linked concepts and their interrelatedness; or a body of interrelated objectives and fundamentals (concepts, ideas, findings, conclusions in research) usually trying to solve a problem. From our perspective newer conceptual frameworks need to be developed.
COHERENCE- definition
According to the American Heritage Language Dictionary (Fifth Edition)
adj
Assembled into or viewed as a whole
adj
Of, relating to, characteristic of or made by several people acting as a group
noun
an undertaking, such as a business operation set up on the principles or system of collectivism.
Currently, “the collective” is the predominant narrative or narratives the majority is experiencing. Often, the phenomenology leaves fewer outside of the system or collective “hive mind” that can offer instinctual insight with balanced, multi-perspective reasoning. The ability to utilize developmental Socratic style communication is critical in change-making from high resolution logos over emotion or worse yet, personal or collective blind spots and biased trauma responses that can easily perpetuate in group dynamics.
For Awakening Healthcare, introducing and implementing a conceptual framework for “the collective” into the healthcare system has important implications.
EMBODIMENT - definition
Largely a spiritual term, it refers to the stage of development where we are coming into our state of awareness in our being-ness. We feel this when we see with deeper clarity and display greater sense-making capabilities. Embracing the process of true embodiment we can make the most informed decision from a unified perspective. Embodiment is the state of being in our truest nature. We govern ourselves rather than being governed.
EXPONENTIAL GROWTH - definition
The quality exhibited when the rate of change — the change per instant or unit of time — of the value of a mathematical function is proportional to the function’s current value, resulting in its value at any time being an exponential function i.e., a function in which the time value is the exponent.
HIPPOCRATIC OATH - definition
The ethical code attributed to the ancient Greek physician Hippocrates, adopted as a guide to conduct by the medical profession throughout the ages and still used in the graduation ceremonies of many medical schools. It includes ethical standards that remain of significance in modernity, the oath is considered the first formalization of ethical standards that are considered universal and foundational. These standards include non-malfeasance (“first do no harm”), patient confidentiality and a strict adherence to a code and even lifestyle which seem to set the physician apart. This code is still used in medical schools today.
FIRST PRINCIPLES OF MEDICINE - definition
Agreed upon standards encompassing human health and public health which include Confidentiality/Autonomy, Beneficence, Non malfeasance and Justice. Specifically for the medical profession these are further elaborated in nine principles of medical ethics as outlined below.
Principles of Medical Ethics
A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
A physician shall support access to medical care for all people.
——- American Medical Association , Code of Medical Ethics
PHILOSOPHICAL FELLOWSHIP - definition and conceptual framework
Ran Lahav’s belief that the practice of philosophical contemplative companionship as a group practice can be the cultivation of deeper wisdom. John Vervaeke’s metatheory on cognition and wisdom, awakening from the meaning crisis; also refers to the development of deeper wisdom via a fellowship through intentional conversation amongst united equals.
Awakening Healthcare values this method of development, growth, and wisdom as a means to deepen our implementation process. Coming from a philosophical approach leaves space for all feelings and thoughts to be equally valued to unify with greater authenticity for better outcomes. This approach is a steppingstone in the patient centered care model, the reinvigoration of the teams, or even implementation of system wisdom.
Subjective Experiencer - Definition/Framework/Subjector's Alpha Experiment
A subjective experiencer is one who has a lived experience with illness. More than that, it is someone who has learned, by necessity, how to live as best as humanly possible with that illness. Please see essay to learn more.
SENSE-MAKING - definition and conceptual framework
According to Gary Klein, sensemaking is the ability or attempt to make sense of an ambiguous situation. More exactly, sensemaking is the process of creating situational awareness and understanding in situations of high complexity or uncertainty in order to make decisions. It is “a motivated, continuous effort to understand connections” (which can be among people, places, and events) in order to anticipate their trajectories and act effectively.
Daniel Schmachtenberger asks questions such as; What can we trust? Why is the ‘information ecology so damaged, and what would it take to make it healthy?
Daniel has a series on the war on sense-making and offers a multitude of structural frameworks on how to begin to answer these complex inquiries while re-creating sustainable institutions from a heuristic yet multidimensional nuanced approach.
Awakening Healthcare feels this is necessary to research and develop in order to create a healthy medical ecology.
SYSTEM HOMEODYNAMICS - definition
The concept of homeodynamics that we introduce here offers a radically new and all-embracing concept that departs from the classical homeostatic idea that emphasizes the stability of the internal milieu toward perturbation. Indeed, biological systems are homeodynamic because of their ability to dynamically self-organize at bifurcation points of their behavior where they lose stability. Consequently, they exhibit diverse behavior; in addition to monotonic stationary states, living systems display complex behavior with all its emergent characteristics, i.e., bi-stable switches, thresholds, waves, gradients, mutual entrainment, and periodic as well as chaotic behavior, as evidenced in cellular phenomena such as dynamic (supra)molecular organization and flux coordination. These processes may proceed on different spatial scales, as well as across time scales, from the very rapid processes within and between molecules in membranes to the slow time scales of evolutionary change. It is a dynamic organization under homeodynamic conditions that makes possible the organized complexity of life.
Martha Rogers, system for nursing education puts it this way;
Principles of Homeodynamics
The principles of homeodynamics describe the nature and direction of change. The four postulates are evident in each of the three principles.
Three Principles
1) Resonancy- The constant change in flow from a lower to higher frequency. It is a flow of energy between people and everything around them.
Putting it into Practice: Nurses might incorporate activities such as art and music to assist a patient who is ill in an attempt to help them adjust to change in flow. Furthermore, use of touch, talking or imagery can enhance well-being.
2) Helicy – Any small change in any of the environmental fields causes a ripple effect, which creates larger changes in other fields. It is basically continuous evolution or change that results from the interaction of the human-environment field. Change is constant and unpredictable. Explains the fact that many forces are mutually interacting and constantly evolving.
Putting it into Practice: As a nurse even the smallest of our actions can make a difference, including the simplest of things such as spending time with our patient, and the way we speak to them.
3) Integrality – Human and environmental energy fields that are mutually and continuously changing–we
effect our environment and our environment affects us
Putting it into Practice: As a nurse we share a connectedness with our patient, and we share the mutual
simultaneous experience. Person and environment become one field. For example, meditation,
music or humor can be used to produce a positive environment.
Awakening Healthcare understands that in order for healthcare to return or develop into a healthy sustainable environment, we must begin to address and value the whole. This begins on the individual level by incorporating psychosocial factors as well as the innate capabilities required to make necessary long-lasting change and achieve long term outcomes. Approaching the system as a whole will similarly lead to implementable, actionable, lasting changes rather than small adjustments likely to lose potency with time and attrition.
AHA Patient’s Bill of Rights
These rights can be exercised on the patient’s behalf by a designated surrogate or proxy decision-maker if the patient lacks decision-making capacity, is legally incompetent, or is a minor.
The patient has the right to considerate and respectful care.
The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information concerning diagnosis, treatment, and prognosis.
Except in emergencies when the patient lacks decision-making capacity and the need for treatment is urgent, the patient is entitled to the opportunity to discuss and request information related to the specific procedures and/or treatments, the risks involved, the possible length of recuperation, and the medically reasonable alternatives and their accompanying risks and benefits.
Patients have the right to know the identity of physicians, nurses, and others involved in their care, as well as when those involved are students, residents, or other trainees.
The patient also has the right to know the immediate and long-term financial implications of treatment choices, insofar as they are known.
The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action. In case of such refusal, the patient is entitled to other appropriate care and services that the hospital provides or transfer to another hospital. The hospital should notify patients of any policy that might affect patient choice within the institution.
The patient has the right to have an advance directive (such as a living will, health care proxy, or durable power of attorney for health care) concerning treatment or designating a surrogate decision-maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy. Health care institutions must advise patients of their rights under state law and hospital policy to make informed medical choices, ask if the patient has an advance directive, and include that information in patient records. The patient has the right to timely information about hospital policy that may limit its ability to implement fully a legally valid advance directive.
The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect each patient’s privacy.
The patient has the right to expect that all communications and records pertaining to his/her care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law. The patient has the right to expect that the hospital will emphasize the confidentiality of this information when it releases it to any other parties entitled to review information in these records.
The patient has the right to review the records pertaining to his/her medical care and to have the information explained or interpreted as necessary, except when restricted by law.
The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. The hospital must provide evaluation, service, and/or referral as indicated by the urgency of the case. When medically appropriate and legally permissible, or when a patient has so requested, a patient may be transferred to another facility. The institution to which the patient is to be transferred must first have accepted the patient for transfer. The patient must also have the benefit of complete information and explanation concerning the need for, risks, benefits, and alternatives to such a transfer.
The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient’s treatment and care.
The patient has the right to consent to or decline to participate in proposed research studies or human experimentation affecting care and treatment or requiring direct patient involvement and to have those studies fully explained prior to consent. A patient who declines to participate in research or experimentation is entitled to the most effective care that the hospital can otherwise provide.
The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and other caregivers of available and realistic patient care options when hospital care is no longer appropriate.
The patient has the right to be informed of hospital policies and practices that relate to patient care, treatment, and responsibilities. The patient has the right to be informed of available resources for resolving disputes, grievances, and conflicts, such as ethics committees, patient representatives, or other mechanisms available in the institution. The patient has the right to be informed of the hospital’s charges for services and available payment methods.
Peer Mentor Handbook
Written as a collaborative effort by a long term patient/patient advocate/peer mentor and a physician with input from several practicing peer mentors; this book is an introduction and overview of the field of peer mentorship which is evolving at a rapid state in a changing healthcare landscape.
This handbook also serves as repository of information, resources and skills for the aspiring or working peer mentor.
Patient Experience Evolution Series
Traditional medicine has evolved into a phenomenal force with state of the art treatments and cures we could not have dreamed of some few years ago, however the healthcare system may have outpaced the lesser understood skills also needed in healing and many areas remain fragmented. We invite you to broaden your perspective of what is possible.
Providers True Calling Series
Dr. Shah and Stephanie discuss health and cultivating conscious awareness in modernity. Regenerating Healthcare, our project that holds space for philosophical fellowship regarding the evolution of medical culture.
Health Of Healthcare
Our mission is to help re-center the healthcare system around self- knowledge and self-governance while empowering both practitioners and patients to participate in their healthcare as a means to evolution.
Essays
The Subjective Experiencer Essay
The human experience often leaves us wearing different masks in certain settings and this isn’t any different when facing illness. We tend to tell one thing to our practitioners and another to our families at times. Being deeply vulnerable and honest at such a here and now pivotal moment can be a great challenge and we run the risk of isolation or burnout and shut down (Yes, the patient experiences burnout as well!). The subjective experiencer has been through it. They not only provide crucial information about the illness and process there-of, but also touching on key concepts that are poorly or not addressed emotionally and spiritually at this time. The experiencer often has processed much of the inner dimensions of this life event and can offer WISDOM.
What is the subjective experience and why can’t we see it?
A subjective experiencer is one who has a lived experience with illness. More than that, it is someone who has learned, by necessity, how to live as best as humanly possible with that illness.
We have starkly underestimated the potential of our patients. Our current lens of perception, albeit advanced in certain arenas, has been completely blinded to the grand evolutionary opportunity in plain sight, surrounding us daily. Only when we are willing to admit this, can we honestly evolve. There is a misunderstanding — a projection — that patients do not want to participate in their health. This is in fact a glaring blindspot in healthcare. Like any blindspot, it is an invitation to seek deeper. Often we don’t understand the need for emotional skills, time, or resources needed by our patients. We also don’t understand what resources outside the system that are currently available. (We are actively creating a video series that takes a deeper dive into this important topic.)
How do we start to remove the blindspots to this bias? Only when we begin to authentically provide for ourselves, then we begin to see that patients often do want to heal. We can develop better skills to improve our “care” in the moment or suggest alternative options for those we “care” for. This is where medicine is dramatically lagging. If healthcare is our calling, we must face our bias and do what it takes to participate in our own health along with the system’s health. When we have gone through our own process, we see that it takes a multitude of resources for our own wellbeing. We begin to see the full picture. When we recognize where we have separated the parts from the whole within ourselves, we can then have compassion for our patients who are lacking the resources they truly need. Blindspots to what we need to address are often difficult to navigate, there is resistance because it’s painful to realize what you don’t see.
Integrating a subjective experiencer on a healthcare team is an easily accessible way to help patients and a direct path to salvaging the current system. What the experiencer brings to the table are much needed resources to help the patient transcend the complexities of their illness. Through the introduction of these resources into the system, all those within the team also improve in their evolution and understanding. This is a direct path to prevent catastrophic collapse of the current system. It is one of many paths that are being brought forth. Our work lies in opening our minds to embrace novel solutions from outside of the system.
Seeing what’s already there
Often our experiencers have a deep desire to be of service with the same community in which they have traversed…this time gracing others with the lived experience and offering that embodied grace and gratitude. The system desperately needs this now more than ever. They are our modern day shamans, guides and healers of the soul. As one Dr. put it, “we know we need you (the experiencer) but we have a moat surrounding us, you cannot just come into the system without proper credentials”. The practitioners often face a complete disempowerment when advocating for needed resources and sadly we are fundamentally broken and give up trying in the current system. We are missing our leading edge by not having energy or a voice to see change come to fruition.
As it should turn out, reality created the space for us, THE EDUCATED AND TRAINED PATIENT VOICE, THE SUBJECTIVE EXPERIENCER. Some people have the privilege of the education of medicine, some have to live and embody what medicine is in service to. Often for both this requires many years, even decades. Both are essential in how we perceive true healthcare and healing. One aspect is enough, but when we utilize both our patients and our healthcare team members benefit as well. We unlock the full integrated-applied transformational potential. We ALL learn and grow this way. This is a homeodynamic system where the parts of the whole come full circle. It’s a state of completion that helps everyone.
Patients can transcend their experience to the degree of not just living with or overcoming it, but to integrate more fully into their life. It’s not just possible. It is what we should be fighting for.
Illness is life-changing, and providing an on-staff subjective experiencer provides someone to feel while still being connected to the overall process (and importantly the healthcare team). This is the optimal way to face such a transformational life process. Healing is not only physical. Everything is on the table in extreme cases. If we as healthcare institutions step up to the challenge, if we can leave room for the patient experience and truly commit to our patients needs — we will exponentially propel healthcare. We will be creating an authentic understanding of the illness process for providers, and profoundly affecting long term outcomes into the future. Providing a trained subjective experiencer on healthcare teams has the opportunity to further connect and heal patients, experiencers, and providers which ultimately creates a system with wisdom, resilience, and ultimately love.
When we begin to see illness as an opportunity rather than an affliction we begin to create a new cultural paradigm where we traverse the complexities together, on the same team, with coherence and love.
Barriers to Implementation
Broadly there is an understanding that the subjective experience and there have been a handful of pioneers that have adopted the subjective patient experience without seeing the full potential and laying a path for a long term, sustainable aspect of the system or systems. Each time the subjective experiencer has been adopted into the system a lack of proper allocation, proper job descriptions, and an inability to see the potential within the system at large. Because we are failing in the pilot programs due to less cohesive implementation; we have not achieved dissemination and external validation in multiple institutions leading to adoption as the gold standard.
A Visionary Outlook
Our environment in healthcare institutions is muddy to say the least. We have normalized chaos, and have lost our vision to create healthy, implementable change at the expense of the little comfort we (as patients and providers) have within the system now. We must face integral concerns and looming questions as to, “who is in charge”. This is a crucial element and possible requisite to the team dynamic of the future, understanding we are all in charge. Only then can we claim we contribute and provide true comprehensive CARE to the patient while valuing the importance of care of the healthcare workers.
Introducing a subjective experiencer onto the team, and it’s dynamics, changes things. What we don’t understand is the mechanics of change, it is natural when creating change to feel uncomfortable. Sustainable change challenges our belief systems and this is our opportunity to grow within ourselves. Introducing the subjective experiencer onto the healthcare team challenges our current level of thinking. It inherently affects the hierarchy we impose within the system. If indeed our calling is to be of optimal service to our patients, we must expand upon what we understand to be true about patient care. We all must face our biases, limitations, and challenge the barriers together. The only way we do that is when we are able to perceive the vision past the difficulties of change.
An evolutionary model that embodies these principles requires people who don’t technically “belong” together to join for benefit. You have to work with the very people that you are in service to who have a desire to improve the system as well. Those who are able to see the blindspots from the other side . Not everyone wants to be a patient experiencer but there are those who realized throughout their experience that their calling is to share necessary wisdom that is being missed or left out in the current model. To truly evolve within the system, we have to see that the future of the field is the objective and the subjective communicating together (the subject and the object, the patient and the provider). This concept of love and wisdom requires the growth of everyone in the system. It requires (a leveling up in) awareness that is necessary no matter what. Conscious communication, a maturation of team dynamics, honesty, and emotional literacy must be involved as it should be in any operating system.
The Only Way Forward
Here we are now, in a system deeply afflicted by the ravaging implications and destructions of COVID-19 (a destruction that amplified and exposed many pre-existing issues within the healthcare system). In the aftershocks we are seeking sanctuary and mechanisms that actually work. The solutions are multifactorial but one is obvious — adding the most naturally empathic individuals onto our teams. These people are our source of hope, energy, and love. They know the nuances of traversing a highly complex and devastating crisis while coming through better – not bitter. Ironically, this is the exact process that our providers are facing. This is a pivotal moment in whether we can recover in our calling.
Walking our own hero’s journey : facing ourselves and the abyss, burning all that isn’t true while accepting that which we have no control over — this does something to us. We change. And this leaves a knowing and a desire to share the totality of our experiences. How, through it all — the light and the dark — we wouldn’t change a thing. We can find grace after going through hell. This wisdom is not only helpful for our patients, it transforms and broadens the perceptions of the providers and teams as well. Most people have no idea that this process, this understanding that needs to be integrated, is the exact same that providers have gone through.The irony is that its patients that can provide something for the providers and the system. The only thing that holds us back is our ego (see our programs on Understanding the Ego and Integrating the Shadow)
Our work is to provide solutions in the current model or build the foundational principles of a new model. We move beyond healthcare. We clearly understand the problems and integrate new implementations from embodied experience. This is a great expansion of what healthcare providers are taught and will be the new discourse of the future.
A subtle, hidden barrier (the shadow aspect of implementing the subjective experiencer onto the team) is that we must do our own shadow work so we do not take advantage or abuse the gift of the subjective experiencer on the team. The love, the heart, the wisdom, the excitement and the beauty of the subjective experiencer who is finally invited to participate in helping their peers; it is precious, it needs to be protected. We have to have a deep understanding of their role, which means we need to first face our traumas, biases and expectations. We need to face issues such as : politics, legislation, payment/reimbursement structures/incentivization, insurance, insurance models, service coverage, access, workforce and labor shortages and a complex web of third-party entanglements (to name just a few overarching systemic themes).
This we understand is one component of a reasonably improved model of care, but not perfect. But, we feel , we must begin somewhere.
Moving beyond the definition of the problem / Broadening our perspectives
Introduction: We believe the key to solving our current complex problems within the healthcare system lies in traversing both upstream and downstream of our problems. We are good at identifying problems, our difficulty lies in the scope of examining the problem with the concepts that are at its root. Often, we conflate a concept or a group of concepts with another one entirely. Other times, we have not bothered to flesh out a concept to serve our modern problems. Additionally, we have very accurate definitions but our problem lies in implementation.
We introduce an approach to examining current problems within your own context, one that we invite feedback and participation with.
Moving beyond the definition of the problem
We propose a process of moving beyond simply examining data but actually extracting the concepts from the patterns that are seen. We find that members of the healthcare system are very adept at defining and describing, as well as categorizing. It is our categories that may need greater perspective. We introduce three categories to help move beyond problem to potential:
1- The concepts needed to address a specific problem are not present in the current paradigm. (This is actually rare but there are examples and we want to create a discourse around these.) We will continue to build a glossary of definitions focused on those objects, fundamentals and concepts. Please see our glossary for some examples of newer concepts and terminology that we have found helpful.
2 – The concepts exist, are widely known and accepted but are not applied in practice or treatment. (We will continue to discuss those that we believe of crucial importance in our essays but also through our multimedia.) It is important we keep at the forefront an honest and complete evaluation of the underlying issues and dynamics that have culminated in our modern problems. Our aim is to position new leaders and builders with a clear understanding of problems without an attachment to parts we may have played in participating in these problems. We also want to introduce a space for standard setting that is truly free, and not burdened by repeating the patterns of the past.
3 – The concepts exist but are not applied as a standard or model leading to significant disparities in the experience of healthcare. We address these in dual definitions in our Glossary and also in our Multimedia.
A new type of framework
As the concepts that need to be re-defined, appropriately implemented or newly created, are identified; we have a great opportunity to create an entirely new process. A living, breathing framework which is still comprehensive in scope. Further grounding and making practical true transparency, open access, and participation by those involved. What this looks like exactly may vary per specific institution. Again, we only introduce a beginning point from which to build an evolving framework. This is one way to not only broaden our view of scientific concepts while saving valuable time to allow the growth of an idea and concept and shorten the time to publication and adoption into practice. We would like to share what we believe are those attributes of new conceptual frameworks that critically different from the current paradigm:
EVOLUTION – We want to address the spectrum that exists between words such as paradigm, perspective, world view, theory and contrast these with words such as framework, model, standard; not to imply hierarchy, but generally the first group of words are more abstract and the last group more concrete. Also generally, perspectives and paradigms can inform the formulation of frameworks such as in empiric, scientific research but the process can flow the other direction as well. For example, where observed, measurable relationships or processes then lead to the formulation of frameworks (again as an analytical tool to either solve a problem or better understand the world). It may take several such frameworks to lead to the development of a paradigm (or a guideline, a gold standard). However, far more commonly the process flows the other way. For example, in medical research a novel drug may be developed based on laboratory findings or biochemical understanding of a specific disease. Just as commonly , the observed nature of a disease process by doctors or nurses may lead to the development of a theory which then can be attempted to be verified or tested. In these cases, if we don’t know the biochemical basis of the disease, a treatment is tested even without knowing the exact details of all the biologic interactions happening. Our understanding of mental, emotional, behavioral disease or effects is far more abstract as there are less verifiable, measurable outcomes that have thus far been solidified. We believe it is important to keep in perspective for both health practitioners as well as those outside the field, that the framework for a particular disease process (for example or even the functioning of a particular part of the body) is constantly evolving.
FLUIDITY – Furthermore, we believe it is important to view the downstream more “concrete” structures as a bit more fluid. Concepts as members or components of a framework can change and evolve — we must leave room for this process. We believe this is the key to future creation of solutions to the problems we face. Such a perspective can lead to new models, standards and hypotheses that can be verified, validated, and tested but there needs to exist an inter-connectedness between as well as a bi-directional flow. (See also our glossary.) Therefore, we should expect to continue to update our frameworks as new data but also new people and ideas are introduced.
COLLABORATIVE – Our aim is to introduce a starting point for the building of conceptual frameworks to both upstream improve our human understanding of health, wellness healing and also the downstream effects of implementation and integration into practice and application. We expect and joyously welcome diverse perspectives to help deepen and broaden our understanding.
STRUCTURE and INTEGRITY- We must understand the complexity of the issues we face in healthcare, we must do our due diligence to not not shy away from the bad and the good. Building without first going back to foundation and basics is unchecked growth which by another name is malignancy.
We share our ideas here as a beginning point. You may disagree, that is wonderful and normal. We welcome your input via fellowship and Socratic dialogue. In fact, help us write a better, newer version. Contact us and start building better foundations together with our community.
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Our mission is to up level our collective intelligence by exposing the solutions that have existed within our blind spots while empowering people to take right action.
Our vision is to design the new paradigm.
Here are just some of our examples to inspire others to develop and design their own implementation, solutions and methods : Implemented subjective experiencer,
self-awareness for providers, trust building, cross collaboration to reinvent the healthcare team, support network for leaders.
