Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

3 Steps to Develop Your Philosophy of Caring


Identifying the principles that guide your care of patients will bring more meaning and purpose to your work. This can bring both you and your patients joy and fulfillment.

If you’ve ever found yourself asking, “Why do I do this? Why do I choose to encounter suffering every day, and yet find meaning in it?” then you aren’t alone. Some specialties may face these questions more than others, as people ask pediatricians, “How can you treat sick children?” or palliative care physicians, “How can you choose to work with people who are dying?” Many times, the response is that this work is fulfilling and meaningful, even if we can’t quite articulate why. This response emerges from what is called a Spirituality or Philosophy of Caring (SOC/POC).


Spirituality or philosophy of caring

A spirituality or philosophy of caring is a central set of organizing principles that gives you a way of understanding the meaning behind your work. Because we encounter human suffering on a daily basis, we frequently grapple with questions regarding the meaning of life and death from patients, families, as well as within ourselves. While it may be tempting to avoid thinking about these questions, suppressing these thoughts may lead to burnout. A spirituality or philosophy of caring can help you make sense of suffering, as well as your role or greater purpose in encountering or alleviating suffering. This may allow you to fully and meaningfully engage with patients’ suffering without being overwhelmed by it, landing in the zone of balanced compassionate caring, which carries benefits for the well-being of clinicians and patients alike.


An SOC or POC is typically developed in the midst of clinical practice when engaging with patients who are suffering. Clinicians may cultivate meaning in the clinical encounter through Dr. Jean Watson’s description of the “transpersonal caring moment.” She describes this as when the physician enters the life space of a patient, detects their condition of being, and feels this condition in such a way that generates a sense of meaning and purpose. Entering into another human’s vulnerability creates a sense of transcendence that facilitates the healing process, both of patient and clinician. As physicians question and grapple with the meaning and purpose of life, death, and suffering, they begin to integrate their own answers to these questions—and their role as a healing professional—into a central SOC or POC. This SOC or POC acts as an “orienting system” that shapes how physicians view each patient and how they conceptualize their role in their vocation to heal.


A POC or SOC develops and operates in every physician whether he or she is conscious of it or not. While a clinician could go his or her entire career without articulating his or her SOC/POC, studies have identified clear benefits in self-reflecting and explicitly identifying one’s own philosophy of caring. Articulating one’s own spirituality of caring has been shown to decrease stress and burnout, as well as increase the capacity for cultivating authentic compassion in patient care. An explicit SOC/POC has also been correlated with increased job satisfaction and quality of life among healthcare professionals. However, these benefits only occur when an SOC/POC is actively integrated into one’s profession, rather than solely stated or articulated. Active integration requires drawing upon these beliefs and values to inform, guide, and shape actions and decisions with patients.


Knowing your POC or SOC can provide a sense of meaning and purpose to your work in the helping professions, especially with regard to humanistic, existential, or phenomenological questions. This can create a sense of deep connectedness to one’s own purpose and to the suffering of the patient in a way that buffers against burnout. An explicit SOC/POC provides a framework for proactively transforming the encounter with human suffering into a moment of profound meaning. Viewing an SOC/POC as an ongoing “quest” rather than a means or end in and of itself enables its resilience through adaptation and evolution in the face of new or increased encounters with suffering, as well as greater capacity to be authentically attentive and responsive to the needs of the patient. An SOC/POC can serve as a “reserve resource” from which physicians may draw as a source of motivation and direction. It reminds us of our purpose, enabling us to stay authentically engaged with patients who are suffering and transform that suffering into meaning.


Here’s an exercise to start developing your SOC/POC:


1. Pause and reflect.

As Thich Nhat Hahn says, “If we cannot stop, we cannot have insight.” Take a few minutes at the end of each day to reflect on your patient encounters that day. What did you find particularly challenging? Particularly meaningful? How did you define suffering and life throughout your day?


2. Identify what gives you positive energy to continue your work.

Is it the satisfying feeling of an accurate diagnosis? The interactions with a patient’s family? The conversation surrounding a patient’s goals of care? Collect these moments and piece them together into understanding your sense of meaning in the helping professions.


3. Ask yourself about the story of your work and career.

What were your initial motivations for entering a helping profession? How have they changed, and what moments changed them? How do you transform suffering into meaning? Try meditating and journaling to identify your story. This process can have benefits for patient outcomes as well as for your own well-being in buffering against burnout.


Considering starting 2021 with articulating your own SOC/POC. What drives your encounters with patients and which aspects of that do you hope to cultivate this year? In keeping your SOC/POC at the center of your clinical practice, how do you hope to grow?