Sunday, August 23, 2015

Why #IlookLikeASurgeon is Necessary for Innovation in Healthcare

Andrew M. Ibrahim MD 


Over the last two weeks the #ILookLikeASurgeon movement has gone viral on Twitter, with over 72 million impressions and 5,000 participants. Countless surgeons have joined Twitter for the first time just to post their photo and join the community.


Scrolling through the snapshots and stories, two statements are clear. First, surgeons come from all backgrounds, across gender and geography, overcoming odds and static traditions. Second, surgeons have lives outside the OR. It has been humanizing and inspiring to see notable surgeons and mentors proudly display their roles as a parent, spouse, entrepreneur, cyclist, artist, or community member. It's less of an "I can do it all" stamp, and more of a "stay true to yourself" reminder.


The images, in aggregate, celebrate diversity in surgery--revealing its strength and hope for the future.  Such diversity is a necessary foundation for innovation. The challenges facing healthcare certainly require many full time clinicians, but also need physicians who can bring something else to the table. In the past it has been limited to bench research or surgical education. But if we want to harness the energy of this movement we ought to broaden our ideas of diversity even further to embrace a breadth of surgeon innovators with a love for technology, a spirit of entrepreneurship, an intuition about policy reform, an aesthetic for the arts and so on.


Wisdom on how #ILookLikeASurgeon can move forward may be found in the prose of literature professor, Matthew Shenoda, who offered this advice to young writers:
Aside from all of the standards of reading and writing and honing in your craft, is to live; to find the spirit within you; to find the fire and understand why you do this.
Don't isolate yourself from the rest of society like many writers tend to do, but really engage in society; understand the tempo and rhythm of humanity and bring that to your work.
Study your own history, understand knowledge of self and bring that to your work.
Engage in the human experience on every level you can and bring that to your work.
And understand that this a healing art.
Understand that this art has more power than any of us truly realize and come to it with that humility, come to it with that understanding and help shape the lives of other people through this art.
But my biggest advice is to feel an urgency in your work, and to bring that to table.
Know that this art can transform lives, it can change people...
If young people do that, and bring that with the fire of youth, they're unstoppable.


AM Ibrahim 2012
Being true to yourself as a surgeon can be met with resistance. While my small attempts to humanize patient interactions -- asking ED patients about their favorite sports teams, giving pediatric patients a cartoon dressing, sneaking floor patient’s real coffee from Starbucks or playing a patient’s favorite music while pushing them back to OR -- were sometimes recognized as valuable, more often they were discouraged as “inefficient” or a “waste of time.” My choices in research elicited similar responses. In addition to peer reviewed scientific publications, I chose to also publish a painting with an essay about caring for a patient with a terminally ill spouse. While sometimes discredited by my surgical peers (one suggesting to not even list it on my CV), it was an important expression about what we experience caring for surgical patients. And if the data on quality of life for surgeons is any indication on what ails our profession -- 40% report being burned out, 30% depressed -- it may be exactly those kinds of humanizing interactions that we should be encouraging, rather than silencing.   


Most recently, I decided to forego the traditional two years of bench time “in the lab” to pursue research in health policy and innovation. Some of you may be reading this thinking, “Great! Of course we need surgeons to train in policy and pursue research that helps guide healthcare reform.” Still, many surgeons were quite comfortable to enumerate aloud all the better ways to spend my time. Fortunately for every detractor, there have also been advocates. Not surprisingly, many of them are also the same leaders who were the first to tweet and support the #ILookLikeASurgeon movement.

More than just celebrate diversity (a tremendous feat on its own), the #ILookLikeASurgeon movement has paved the way for a new era of surgeon-innovators. Our leadership and mentors now have a duty to embrace the diversity of surgeons -- their backgrounds, their skill sets, their passions, their visions, their career goals -- and create environments where our true selves can be developed as a strength rather than discouraged as a weakness.  Celebrating diversity is the first step to innovating our profession.


Andrew M. Ibrahim MD | @andrewmibrahim
Robert Wood Johnson Clinical Scholar
Institute for Healthcare Policy & Innovation
University of Michigan

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