What is Your Why?

Feb 16, 2023

by Mick Krasner, MD

On a recent flight to Atlanta where I was asked to speak to emergency physicians and trainees, I watched a Ted Talk by Simon Sinek, an inspirational thinker, and author who believes in a bright future and our ability to build it together. At the time I was also asking myself: what do I have to share with this group of highly skilled medical professionals who work in one of the busiest and most challenging acute care settings in this country? What could help them in their day-to-day confrontation with overwhelming demands that greatly exceed resources? With boarding and managing patients admitted, awaiting beds where there are none available, and still attending to the incoming acutely ill? With being on the front lines of a healthcare system that seems to be falling apart at meeting its mission and promoting burnout among its staff?

At the same time, it had been only a short three weeks since I left my clinical practice of 32 years to further pursue new goals and opportunities. In this Ted talk, Simon spoke of how all inspiring leaders think, act, and communicate in similar ways that are the opposite of everyone else. He stated that these inspirational individuals think, act, and communicate from the inside out. And he meant by this that they begin with the why of what they do, not the what or the how. It had me reeling a bit, considering this large change that I had just made in my life, and I begin to interrogate at a deeper level my why that was at the heart of this decision, and at the heart of so many other decisions that have defined my life.

As I sat there, at 30,000 feet, looking down onto the patches of clouds and patchwork of land below, I worked on more closely defining and naming the why that has been part of me for so long. It began to take shape as I wrote a few statements such as the following: My why is to support the precious resources of the health professional community so that patients and communities can be placed at the center of healthcare, so that healthcare can work for all, and professionals who work within health care can flourish, find meaning and joy.

From this statement that articulates my why I am now clearer about the what and the how to realize this why. That what and how looks something like the following: The way to build healthcare that works for all, placing patients and communities at the center, and supporting the health professionals within it to flourish is through building skills and knowledge, enhancing self-awareness and compassions, improving accessibility, and removing barriers for patients, staff, and clinicians. Although this may still seem quite abstract, the details of my subsequent behaviors, actions, relationships, and conversations that flow from this why what, and how are suddenly much easier to identify.

When I spoke with the physicians, residents, and students in Atlanta I asked them what I will ask you. What is your why? Can knowing and articulating your why help you manage your work’s inevitable challenges, frustrations, disappointments, and uncertainties? As you learn and grow in skills, knowledge, and experience-the what and the how of a career in medicine-what is the relationship between your well-being, meaning, and flourishing in your work with your why?

Working in medicine is inspirational. And as Lisa Rosenbaum in her series on teamwork a few years ago in the NEJM wrote, we in medicine have made the extraordinary seem ordinary. Perhaps, even though we work, day in and day out, within complex environments that at times get in the way of doing what we know needs to be done for our patients, staff, and colleagues, we can remember the astonishing nature of our profession. And knowing our why and acting out of an awareness and an embodiment of our individual and collective why’s we can inspire ourselves and those around us in whatever leadership roles we have, to find meaning and flourish.


  • Krasner. February 6, 2023. Start with why — how great leaders inspire action | Simon Sinek | TEDxPugetSound. YouTube.  https://www.youtube.com/watch?v=u4ZoJKF_VuA
  • Rosenbaum, L. The not-my-problem problem. Teamwork-Part 3. NEJM 2019; 380(9): 881-885



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