In the demanding world of healthcare, professionals are conditioned to act quickly and efficiently during crises such as severe bleeding, cardiac events, and injuries. Nonetheless, internal conflicts—those related to team interactions, leadership frameworks, or individual challenges—frequently result in indecision. The comfort of disarray can instill a dread of transformation, eclipsed by a deeper apprehension of remaining stagnant.

This reluctance to evolve carries significant repercussions. It can undermine team spirit, hinder communication, and ultimately impact patient care. The pattern of inaction and anxiety is noticeable in numerous healthcare environments, leaving enduring effects on both individuals and teams.

Having transitioned from a trauma surgeon to a strategic facilitator, I have realized that change is not merely a one-time event but an ongoing process. Many healthcare workers find themselves ensnared in this loop, struggling to escape.

### The Physician’s Change Cycle

1. **Discontent**: An increasing sense of dissatisfaction manifests, whether stemming from a position, team interaction, or value discord. Professionals endure, frequently sacrificing their integrity to accommodate.

2. **Breaking point**: Discontent escalates to a pivotal moment, marked by a blatant disregard for conventions, a significant incident, ethical dilemmas, or fatigue. The body persists, but the spirit is diminished.

3. **Decision**: A crucial moment occurs—a resignation, a withdrawal, or a staffing alteration is contemplated. Brief optimism emerges from the possibility of change.

4. **Fear**: Doubt soon ensues, with the fear of the unknown becoming overpowering. Identity and judgment are scrutinized, rendering both staying and leaving seemingly untenable.

5. **Amnesia**: Fear skews recollection, rendering dysfunction bearable; the past is idealized, and the suffering that prompted change is overlooked.

6. **Backtracking**: Ultimately, individuals frequently opt to remain, stifling the part of themselves yearning for change.

This cycle transcends personal experiences to become a widespread systemic and cultural dilemma within healthcare contexts. When professionals linger in misaligned settings, the fallout affects communication, relationships, safety, and overall efficacy, fostering a toxic atmosphere that influences both colleagues and patients.

### Breaking the Cycle: Two Paths

1. **Extreme pain**: Change is often prompted only when distress becomes insufferable, leading to breakdowns, lawsuits, resignations, or personal loss. The system tends to progress primarily through crisis.

2. **Self-honesty**: A more valiant approach involves acknowledging resistance, fear, and identity ties, and opting for change despite these obstacles. This necessitates humility, clarity, and support.

Strategic facilitation can offer this support through structured, emotionally aware processes such as coaching, mediation, and education, guiding individuals and teams from stagnation to action, nurturing truth, alignment, and reconciliation.

For those recognizing themselves within this cycle—whether feeling trapped, dealing with troubled leadership, or pursuing misaligned careers—understand that change is achievable. However, it demands design, facilitation, and initiation before the discomfort becomes intolerable.

Fear is not a diagnosis, and stagnation is not a strategy.

*Shannon M. Foster is a trauma surgeon.*