This story is one of more than 20 health system profiles featured in the 2025 AMA Joy in Medicine® magazine (log into your AMA account to view).
Like many other health systems, The Southeast Permanente Medical Group struggled during the COVID-19 public health emergency with decreases in staff levels and nursing support.
“We had to reimagine what teamwork looks like and redefine how our teams connect and work together,” says Nikki Baker, MD, a pediatrician and associate medical director for People and Culture with The Southeast Permanente Medical Group, which serves 323,000 patients in metropolitan Atlanta and Athens, Georgia.
Ensuring that everyone on the care team did the right work set for their scope of practice and defining standard work for the nursing teams were two big pieces of this restructuring.
“Our people are our ‘secret sauce,’” says Dr. Baker. “Through robust teaming and collaboration, we deliver second-to-none value-based care.”
Much of the standardization work the medical group embarked upon in 2023 and 2024 resulted from the “Top Scope” project, which did a gap analysis to assess the work physicians and nurses were presumed to be doing versus the actual work they were doing.
“What we found is over time there was sort of a drifting away of what each medical staff support was actually doing,” says Dr. Baker.
Physicians were doing administrative tasks such as faxing a document or filling out a form. “We needed to make sure that those administrative tasks were falling into the right bucket and that the right person was assigned to do that work,” says Dr. Baker.
The goal was to define the physician's work as well as the supporting roles of nursing and other health professionals on the team, then creating some standardization to that work so that it didn’t shift or change for the doctor regardless of what office they were working in or which work support staff was supporting them.
Structuring teams to improve efficiency
The Southeast Permanente Medical Group is one of the largest multispecialty medical groups in the Southeast, employing 725 physicians and 322 advanced practice and allied health clinicians.
As part of its restructuring, the medical group created caregiving medical teams of physicians and other health professionals, supported by licensed practical nurses, registered nurses or a medical assistant.
Each person on the team has a specific role they are required to do to optimize the care of the patient. For example, in addition to rooming the patients, the nurses and medical assistants are responsible for previewing and updating their charts and informing the patient of any gaps in care such as the need for immunizations, cancer screenings or other lab work.
