Being Positively Deviant (and inviting others along for the ride)

"The reasonable man [sic] adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man." — George Bernard Shaw

In my work helping to lead clinician well-being efforts, it has become a regular habit of mine to ask colleagues who are successfully navigating and even thriving in the midst of our demanding work, or what we might call “positive deviants,” if they have any “secrets” to their approach.  These are the colleagues who obviously love what they do and experience joy doing it while others struggle mightily.  They’re doing similar work, often in the same organization, but with a widely different outcome. 

Indeed, this question is quite relevant given the data regarding physician distress, where studies consistently (and persistently) indicate the majority of us continue to be “failing to thrive.”  Positive deviance encourages the adoption of often unconventional yet successful practices by those who, despite facing similar challenges, find ways to achieve more desirable outcomes.  These often simple practices deviate from what we have come to accept as the norm and can often include innovative approaches to time management, administrative efficiency, psychological reframing, prioritizing self-care, and fostering supportive professional relationships. 

While their answers vary based on context and personality, there are a few common themes that have emerged over the years of my inquiry and are supported by research.  The first is that almost without exception these positive professional deviants assign meaning to their work that elevates it beyond transaction to a sense of calling.  In doing so, they know their work matters and makes a difference, even in the midst of potential tedium and hassle.  They also are willing to try new things when their present process is not working, and are never content with the “status quo” when it is not achieving desired outcomes.  Additionally, they have all developed the habit of being able (and willing) to reframe situations to tap into “possibility thinking” even as I would not consider any of them to be “excessively” optimistic.

While some organizational cultures are threatened by such qualities (labeling them “Mavericks” or even “disruptive”), positive deviance can benefit healthcare organizations by creating a culture of collaborative experimentation and improvement. This can foster a more supportive and resilient healthcare environment even in the midst of organizational entropy.  

But perhaps the most telling insight from my query of my “positive deviant” network was how many of them shared with me that, “No one has ever asked me this before!”  It’s time that we do so more often.  By seeking out and learning from those who have found ways to maintain their well-being, we can adopt new strategies that enhance our own lives.  Take a moment this week to observe your colleagues and identify someone who seems to be thriving despite the challenges of our work. Initiate a conversation with them about their strategies for maintaining well-being and consider how you might incorporate some of their practices into your own life.  Share your findings with a peer and encourage them to do the same.  By fostering a culture of positive deviance, we can collectively improve our well-being and continue to provide the best care for our patients.  Now that does sound positively deviant!