While physician burnout and attrition remain challenges to the medical profession, healthcare organizations are making progress lessening these problems. The AMA’s 2025 National Physician Comparison Report found that last year burnout among doctors continued to decline, dropping to 41.9%, down from 43.2% in 2024 and 48.2% in 2023.
Among the organizations that recently have achieved improvements addressing stress and burnout is Sanford Health, the largest rural healthcare system in the U.S. Heather Spies, MD, clinician well-being officer at Sanford Health, recently discussed the system’s efforts in this area during the Becker’s Healthcare webinar sponsored by the AMA, “How Sanford Health is strengthening clinician well-being and fulfillment.”
“Our clinician experience is really important to us. If we don’t focus on our people, things are not going to go well,” Dr. Spies said during webinar, which is available to watch online.
Sanford Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Finding a road to joy
An ob-gyn who still is in practice part-time, Dr. Spies took on her leadership role overseeing clinician experience and well-being six years ago when Sanford Health committed to enhancing well-being program. It quickly made a quantifiable impact: From 2021 to 2025, Sanford Health’s measure of clinician engagement more than doubled, and the system achieved a 14% reduction in its metric for burnout.
Dr. Spies and Sanford Health had help from the AMA along the way. Sanford Health is a participant in the AMA Joy in Medicine® Health System Recognition Program, which empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive.
“To just have a time frame and a road map was a really helpful too,” said Dr. Spies, who is also member at-large for the AMA Integrated Physician Practice Section Governing Council.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine.
Taking time to build relationships
From the start, Sanford Health aimed for covering its entire system. It’s a challenging scale, since the health system, which is headquartered in Sioux Falls, South Dakota, encompasses 58 medical centers and 289 clinics, nearly all in the upper Midwest stretching from Michigan’s Upper Peninsula to the Dakotas. Sanford Health also includes more than 2,400 physicians and thousands of other health professionals.
Dr. Spies repeatedly stressed that their relationships with each other and with their leaders are central to reducing stress and burnout for these physicians and other health professionals.
“Start with relationships, just start building them,” she said. “It takes time, but I think that’s foundational for your culture.”
A key component of developing these relationships is for leaders to listen to physicians’ concerns, and to respond to them honestly and clearly, even when that response may be disappointing.
“Focus on a strong culture of listening, feedback and then giving the why—If not ‘yes,’ why, if ‘not yet,’ why,” Dr. Spies said.
Making connections, offering assistance
That emphasis on relationships is part of the experience of Sanford Health physicians and other health professionals from when they first start working for the system. As part of their onboarding, Sanford Health gathers each cohort of new physicians and other health professionals who started together for an in-person, half-day check-in one month after they’ve begun practice.
They use the time together to discuss what resources they are finding they need and to arrange for that assistance, which can range from help with communications skills to financial planning. Dr. Spies acknowledges that the logistics of these gatherings can be “a huge challenge, but very much worth it.”
“From the very beginning, we’re really showing them how much we want them to invest in relationships and teamwork and communication with each other,” she said.
Sanford Health has a dedicated clinician experience liaison for each of its six regional markets who can help address the concerns of physicians in their respective areas. The system also provides a clinician assistance program (akin to an employee assistance program) with 12 Sanford Health psychologists who can provide one-on-one support when needed.
“We’ll get an urgent call every few months and pair that clinician with someone in real time” in person or virtually, Dr. Spies said.
Developing leaders and finding solutions
Sanford Health’s emphasis on relationships as central to physician well-being extends to its leadership development program, which launched a few years ago. Known as RISES (Reach, Impact, Strategy, Empower, and Serve), the two-year program annually enrolls a cohort of 30 clinicians who are up-and-coming leaders from across the system.
RISES brings them together for in-person sessions that include case studies, guest speakers, small-group discussions, and an hourlong well-being check.
“It’s a safe space for us to say, ‘What are you experiencing that are challenges, and what can we do to help each other along?’” Dr. Spies explained.
Each cohort also has to identify a problem at Sanford Health midway through the program and develop a project for addressing it. Their ideas have made an impact on markets and sometimes the entire system, according to Dr. Spies.
Using AI to save doctors’ time
Sanford Health also uses technology to help support relationships. The system is piloting the use of ambient healthcare technology—the use of augmented intelligence (AI) to transcribe patient-doctor conversations during appointments—with hundreds of clinicians. Sanford plans to provide ambient technology to any physician who wants it by 2027.
“I would rather sit and look at my patient face-to-face to make sure they feel heard,” rather than look at a computer while typing notes, Dr. Spies said. In addition to improving interactions for both patients and physicians, AI transcriptions of patient visits are saving doctors significant amounts of time.
Dr. Spies reported that clinicians are able to go home earlier and have more time during the day for conversations with colleagues.
“The more we can remove barriers to care in our day-to-day work for every single person in that team, the more we’re going to work well together, the more we’re going to find joy in our day, and the more we’re going to prevent burnout,” she said.
Put well-being at the center of decisions
In addition to Sanford Health’s metrics, Dr. Spies is seeing the impact of the system’s initiatives in meetings and passing interactions with colleagues.
“It’s a shift in culture that we’re lucky enough to see actually comes out in the data as well,” she said.
She stressed that such improvements don’t happen quickly or without a fundamental commitment.
“Treat clinician well-being as a long-term strategy, not just short-term goal,” Dr. Spies said. “It has to be at the system level, it has to be right in the center of remembering to consider it in all the decision you make.”
AMA STEPS Forward® offers real-world solutions to common challenges in healthcare today. Explore a variety of innovative, physician-developed resources designed to help prevent physician burnout, optimize workflows, improve well-being and enhance patient care.
