To address the systemic drivers of physician burnout and support the full spectrum of professional fulfillment and well-being, the physician who helps lead well-being efforts at The Permanente Medical Group has learned the importance of using physician feedback to drive meaningful changes, having critical conversations and tracking progress. And doing all of that is impossible without meaningful leadership participation at all levels.
“A critical tactic in our strategy was to very purposefully engage our operational leaders,” said AMA member Amanjot Sethi, MD, during an episode of the “AMA STEPS Forward® Podcast.” Dr. Sethi is a urologist who directs wellness operations at The Permanente Medical Group, a member of the AMA Health System Program and recognized organization in the AMA Joy in Medicine™ Health System Recognition Program.
“It wasn’t just about our wellness leaders, but engaging our operational leaders at every level of our organization including our department chiefs to make sure that this wasn’t going to be a program or a strategy that’s living in a silo,” Dr. Sethi said.
“It’s not about the individual physician being more resilient,” he added. “It’s all of us together, as an organization, rolling up our sleeves and putting in the work to ensure that we—as an organization—are as resilient as possible in the face of significant challenges.”
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“It’s one of the foundational pieces of our strategy to make sure that we’re getting feedback directly from physicians,” said Dr. Sethi.
There is one survey instrument that is an important resource: The joy and meaning in medicine measure, which gauges the most relevant drivers of professional fulfillment and burnout.
“That data is collected once a year and measures themes such as workload, wellness, the impact of clerical and administrative burden, professional development and psychological safety,” he explained.
Leaders use the data to understand areas of opportunity and measure the impact of any interventions they design, Dr. Sethi noted.
Additionally, leaders are encouraged to ask: “What are the things that we have control over and can change over the next few months that can improve our professional experience?” he added.
Department chiefs must have critical conversations with physicians.
The chiefs’ role in such discussions is “to provide the forum and psychological safety to have these discussions and to encourage people to land on things that are under the control of the department, but also identify the boulders … that we need to move at the medical center level ... or across the organization even,” Dr. Sethi said.
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Clerical burden was the most commonly identified area for improvement in the survey in 2019. This became a common focus of intervention in individual departments, which was tracked as well. Each department receives their data to track progress and outcomes.
In October 2020, the joy and meaning in medicine measures showed improvement on 11 of 15 survey items.
A follow-up survey in 2021 “was actually deployed during one of our highest surges—during the Omicron surge,” Dr. Sethi said, noting that “we saw many of these items drop.”
While such trends can feel discouraging, Dr. Sethi and his colleagues at The Permanente Medical Group see the opportunity for continuous improvement.
“What we understand is we need to be getting this feedback. We need to know where our physicians are at and we’re not going to shirk on that responsibility,” he said, emphasizing that “collecting and acting on this feedback is as important as ever.”