AAIM Perspectives
AAIM is the largest academically focused specialty organization representing departments of internal medicine at medical schools and teaching
hospitals in the United States and Canada. As a consortium of five organizations, AAIM represents department chairs and chiefs; clerkship, residency,
and fellowship program directors; division chiefs; and academic and business administrators as well as other faculty and staff in departments of
internal medicine and their divisions.
Oath to Self-Care and Well-Being
Mukta Panda, MD,
a
Kevin E. O’Brien, MD,
b
Margaret C. Lo, MD
c
a
University of Tennessee College of Medicine at Chattanooga, Department of Internal Medicine;
b
University of South Florida
Morsani College of Medicine, Department of Medicine, Division of General Internal Medicine, Tampa;
c
University of Florida
College of Medicine, Department of Medicine, Division of Internal Medicine, Gainesville.
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 able 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 col-
leagues 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 dis-
tinct oath that embodies a reciprocal interaction to ben-
efit 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 modifi-
able 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 lead-
ers, and experts in burnout research and well-being
interventions from both surgical and nonsurgical spe-
cialties at over 72 institutions. Our mission is to
AAIM Perspectives
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writ-
ing this manuscript.
Acknowledgements: The three authors thank the following
members of CHARM for their contributions: Hasan Bazari, MD,
Diana McNeill, MD, Alyssa McManamon, MD, Colleen Christmas
MD, Christina Cellini, MD, Elizabeth Gaufberg, MD and Jonathan
Ripp, MD.
Requests for reprints should be addressed to Mukta Panda, MD,
MACP, FRCP, University of Tennessee College of Medicine at Chat-
tanooga, 975 East Third Street, P.O. Box 255, Chattanooga, TN
37403.
E-mail address: mpanda@uthsc.edu
0002-9343/$ -see front matter © 2019 Elsevier Inc. All rights reserved.
https://doi.org/10.1016/j.amjmed.2019.10.001