All health care providers know this can be a grinding field often scattered with burned-out colleagues. I think about the importance of self-care from time to time and occasionally actually do something that likely counts as self-care.

One thing I’ve focused on recently is the spirit-lifting power of gratitude. Like many of my colleagues, a fast-paced work schedule coupled with high-stakes outcomes sometimes make gratitude seem far away, like an old friend whom I’ve lost touch with. Yet I’ve learned a lot about gratitude and appreciation and their healing powers from both patients and colleagues.

I work in an opioid treatment program caring for patients with opioid use disorder (OUD). As a group, these patients have faced an inordinate amount of emotional and physical trauma in their lives, and their personal stories often draw a clear trajectory from birth to substance abuse. Despite their trauma, many patients exhibit gratitude and appreciation that is inspiring and a great example of how important those things are.


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My patients are almost always thankful when they enter and leave my office. Even when things are not going swimmingly for them, they are some of the most overtly polite and civil people I have met. They voice their appreciation for big and little things. A patient told me at our first meeting, “I really like what you’ve done with your office!” These comments occasionally leave me speechless, especially when the person parts with “have a blessed weekend!”

This gratitude has rubbed off on me. Over the past few years, I’ve learned the power of gratitude and appreciation for those of us doing the tough work that is medicine. I now try to routinely tell my coworkers how much I appreciate their efforts, especially when they go out of their way for a patient.

I have tried an experiment where I see what happens when I say hi to every patient I pass in the hallways. It ends up being a lot of hellos but it has yielded wonderful results. Many of our patients are not used to being treated with respect and often walk with eyes down and flat expressions, hoping to avoid unnecessary human interaction. However, when faced with me walking by saying “Good morning!” some of them instantly transform, often looking up and returning the greeting. They mostly appear to appreciate it greatly.

Before I was a PA-C, I was an ATC (certified athletic trainer). I worked with a lot of high school, college, and professional athletes. One of my jobs was staffing football games for Cleveland High School in Seattle. At that time, the football program was unpopular (with only 19 players trying out 1 year) and had a long string of losing seasons. A young head coach took over the program and he was the master of appreciation. Following games often lost by lopsided scores, he would have the players and coaches stand around in a circle in the locker room holding hands. It was called the appreciation circle. He would offer a specific appreciation for one of the players or coaches and then the next person would do the same. Each share took about 30 seconds, not long. Each player was expected to say something and they all came up with heartfelt and authentic things to say about what someone had done during the game.

This brings me to my appreciation circle:

  • I am grateful for my improving ability to appreciate the things that make being a PA-C in this state so meaningful. I appreciate being 1 of 2 PAs on the Washington Medical Commission and the connection and empathy it appears to bring to other commissioners and staff in understanding what PAs are. It also allows PAs to develop a deep understanding of what our MDs and colleagues do.
  • I appreciate practicing in a state with a fantastic PA association (Washington Academy of PAs) that works closely with our MD colleagues in the Washington State Medical Association to improve and modernize PA practice over the last decades. This collaboration culminated recently in the adoption of new PA laws allowing PAs to practice to a fuller scope while continuing to build and enhance the traditions of PAs working side-by-side with MDs and learning daily from them.
  • I appreciate working with my amazing patients and appreciate the opportunity the Washington Medical Commission has afforded me to give voice to patients who sometimes may feel like they have none.
  • And finally, I appreciate the increasing trust that this and other states place in PAs and NPs as well as the acknowledgment we receive for the important roles we have played in expanding care and improving the health and safety of all patients, regardless of their income or insurance status.

That’s a lot of appreciation and I’ve had some good teachers along the way.