Oath to Self-Care and Well-Being

The recent Charter on Physician Well-being calls for a partnership and commitment among medical professionals and healthcare organizations to address the epidemic of physician burnout and to promote a culture of well-being.¹ Physicians who are well are better abe to serve their patients, students, colleagues, profession, and society.¹

Pledging a professional oath in medicine, such as the Hippocratic Oath or the Declaration of Geneva, is a ritual practiced globally by physicians. Central to the pledge of the oath is to care for patients with the utmost sincerity, empathy, and kindness and to uphold the highest ethical standards of patient care for physicians today. Much has changed in the science of medicine, but at its core, the art of medicine remains unchanged. The tenets of the Hippocratic Oath have stood steadfast for millennia even though the current ethical map and scope of the medical profession are vastly different. Historically, physicians have ignored the need to care for themselves and report a sense of conscience toward patients, colleagues, and their clinical practice as a reason for working through illness and expecting colleagues to do likewise.² This unconditional allegiance to the profession can be a dangerous contributing factor to physicians’ lack of attention to their own well-being. While the Hippocratic Oath traditionally referred to the care for patients, this same language should extend to physician self-care as well. In response, the World Medical Association amended the Declaration of Geneva in October 2017 to include a single statement on the need for physicians to take care of their own health with the same intentionality and devotion that they apply to their patients.³

The current complexity of medicine warrants a distinct oath that embodies a reciprocal interaction to benefit the servant and the served. On behalf of the Collaborative for Healing and Renewal in Medicine (CHARM), we introduce the Oath to Self-care and Well-being for all physicians and healthcare providers (Box). Akin to the Hippocratic Oath, this Oath to Self-care and Well-being serves as a professional pledge to be applied in its current version or as a platform modifiable by physicians and learners in the creation of their own oath and promise to self-care and professional health. This oath was conceptualized and developed by the Faculty Development subgroup of CHARM upon extensive literature review on physician well-being interventions and relevancy of oaths to healthcare. The Collaborative for Healing and Renewal in Medicine is a national group of medical educators, academic leaders, and experts in burnout research and well-being interventions from both surgical and nonsurgical specialties at over 72 institutions. Our mission is to promote investigation of the impact of burnout, develop tools for resiliency, gather best practices, and advocate for the recognition and inclusion of well-being initiatives among learners and physicians.

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-Mukta Panda, MD^a,, Kevin E. O’Brien, MD^b, Margaret C. Lo, MD^c