We need the hierarchy in healthcare for efficient, evidence-based clinical decision-making. Professionals with clinical authority and accountability, along with patients’ preferences are positioned higher on this hierarchy.
For example, doctors and Advanced Practice Nurses write orders for nurses to follow and prescriptions for patients to fill and nurses to help explain. Nurses delegate tasks to nurse assistants and unlicensed personnel with supervisory expectations. Physical and Occupational Therapists do the same for assistants who are trained to work with them. There is sound reasoning for this hierarchy as the people with the most relevant education, expertise, and responsibilities are directing the clinical course of care.
We also need to treat each other, our patients, and ourselves with dignity as equal human beings. This may seem obvious from an intellectual standpoint, but sometimes there is confusion or old habits that lead to mistaking positional status as a sign of exclusive dignity or lack thereof. This is especially true in toxic cultures where blaming or bullying may be embedded in behavioral expectations. (I explore these dynamics in many of my books and articles.)
Fortunately, there is a creative way to provide healthcare professionals with experiences where they tap into their own and each other’s dignity. In a nutshell, medical improv practitioners adapt status activities from the world of theatre education and applied improvisation to facilitate an exercise called “Dignity Exchange”. People often have profound light bulb moments as they embody what dignity is and what it is not!
I find in teaching this activity that most people already know what dignity is and isn’t. My expertise is in raising awareness about how both feel while maintaining psychological safety, and then helping participants reconnect with dignity for themselves and each other. This process of rediscovery can be quite profound.
If you are curious to learn more, please join me Wednesday November 11, 2026 at 6p EST where I’ll present an online event: USING MEDICAL IMPROV TO PROMOTE DIGNITY IN HEALTH CARE, through the Applied Improv Network. It’s free, and I hope it will be informational, thought-provoking. and inspiring.
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Join the Watch Party here.
