When three major health system CEOs shared the stage with the AMA, their message was unmistakable: Caring for physicians’ well-being is a strategic imperative, not a nice-to-have. It is a measurable, strategic, and financial priority that deserves the same attention as safety, quality and operational performance. This shift marks a cultural inflection point and signals a new norm—physician well-being should be measured, budgeted and reported like any other performance goal.
“The business case really is simple. Happy doctors are more productive, they deliver better quality care, there’s less dysfunction and there’s higher satisfaction,” Joseph G. Cacchione, MD, a cardiologist and CEO of Jefferson in Philadelphia, said during an AMA-led panel at Becker’s in Chicago about the business case for physician well-being.
“When we talk about physician well-being … we truly mean it in the same breath as quality, safety and capital investment. This directly impacts access, revenue, sustainability and turnover,” said Steven Kalkanis, MD, a neurosurgeon and executive vice president of Henry Ford Health in Detroit. He is also CEO of Henry Ford Medical Group and Henry Ford Hospital.
In addition to Drs. Cacchione and Kalkanis, the panel included:
- Heather Farley, MD, MHCDS, an emergency physician and vice president of professional satisfaction at the AMA.
- Luis Garcia, MD, a surgeon and president of Rush Medical Group in Chicago. He is also a delegate for the AMA Integrated Physician Practice Section Governing Council.
Henry Ford Health, Jefferson and Rush University System for Health are 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.
For decades, physician burnout was seen as an individual problem. Today, leaders from Henry Ford Health, Jefferson and Rush University System for Health are treating well-being as a systemwide responsibility.
During the panel, each leader shared how to elevate physician well-being as a priority across health systems.
Make it measurable
“You can’t improve what you don’t measure and when it comes to physician well-being and burnout, it is critical that we measure the right things,” said Dr. Farley. “That means measuring the organizational drivers of burnout and well-being, not just the personal components like fitness or sleep hygiene.”
The AMA is helping health systems measure and scale change through the Joy in Medicine® Health System Recognition Program, which provides a road map for health system leaders to implement programs, policies and workflow efficiencies that support physician well-being, and the Organizational Biopsy®, an assessment tool and set of services developed to support health systems in holistically measuring and taking action to improve the health of their organization.
Through the Organizational Biopsy, health systems can identify the organizational drivers of physician burnout—workflow inefficiency, lack of autonomy and administrative overload—rather than focusing solely on individual resilience. While there is a role for individual well-being, the focus should be on driving systemic change.
“The Organizational Biopsy was created by physicians for physicians to assist organizations in assessing and making progress in fostering professional satisfaction and well-being,” Dr. Farley said.
AMA’s Joy in Medicine Health System Recognition Program builds on that foundation, outlining evidence-based steps that organizations can take to reduce burnout and celebrate progress. Those recognized at the bronze, silver or gold levels demonstrate measurable gains in leadership, commitment, teamwork, efficiency of practice and support.
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.
Lead from the top
At Henry Ford Health, Dr. Kalkanis oversees thousands of physicians, nonphysician providers, researchers, residents and fellows. For him, physician well-being is as fundamental as financial stewardship.
“In this environment, we need everybody at the top of their game,” he said. “At the end of the day, we want to elevate the patient experience, and we know that the well-being of our team is one of the biggest determinants of that.”
Henry Ford Health tracks well-being metrics, such as engagement and turnover, allowing the health system to make changes in real time.
“We really believe that our team members’ well-being drives continuity and quality,” said Dr. Kalkanis. “For me, it’s about discretionary effort. Imagine if everyone on your team was fully engaged and working at the top of their potential—or even 10% or 20% above it.
“When people are truly engaged and happy, that’s how teams win. That’s how systems win. And, most importantly, that’s how patients win,” he added.
Henry Ford Health also created programs to make well-being part of daily operations. These efforts include a confidential peer support network, a “Connect the Dots” program that funds team gatherings and a dedicated physician mental health clinic. When physicians feel supported and valued, they are better equipped to provide excellent patient care.
Build the business case
For Jefferson, physician well-being is not only a core organizational value, but also an operational priority.
“The estimate for us is if we turn a doctor over because of being unhappy, it costs around $600,000. For a nurse, that’s probably about $150,000 if you include time to recruit, hire, orient, onboard and more,” said Dr. Cacchione. “There’s definitely a business case not to have physician or nurse turnover.”
Beyond dollars, Dr. Cacchione stressed that turnover erodes trust between physicians and patients.
“Creating a physician workforce that has a sense of well-being, ultimately engenders stronger relationships and more public trust,” he said.
Redesign culture and workflow
Dr. Garcia has led a similar transformation in Chicago at Rush University System for Health. Drawing on his own experience as a surgeon working 80 to 100 hours a week, he now focuses on removing friction from the physician experience.
There is an ongoing shortage of physicians and other health professionals, and a challenge many health systems face is: How do we support physicians so they can work at the top of their license?
“This becomes a topic of importance systematically, organizationally, from the top down, from the bottom up and to the left and to the right,” Dr. Garcia said. “Everybody needs to be in collaboration talking about this. This is not a sprint, it’s a marathon.
“Physician well-being is a topic that needs to be visited and revisited at different levels in an organization,” he added. “Organizational commitment to resources that impact well-being leads to physician satisfaction and better patient care.”
At Rush, a newly formed Office of Clinician Experience leads many of the initiatives in support of physician well-being. The team understands the value and the complexity of their work, said Dr. Garcia. “We could choose to throw our hands up in the air and say it’s too much to tackle and just ignore it like we have done in the last 30 years, or we can start somewhere.”
“We’re not in an overnight journey,” he said. “It’s a multiyear journey that would allow us to categorically say that any clinician that comes to Rush is going to have a phenomenal practice and would leave Rush only to retire. That’s our goal.”
One of the opportunities identified at Rush is the physician onboarding process. To Dr. Garcia, “the best opportunity to be successful is in the first impression that you give somebody,” which can be done when a physician is being onboarded.
“By standardizing the onboarding process across Rush, we have eliminated redundancies and unnecessary steps. It is important to fulfill the process and set the right level of accountability but also make it a valuable and positive experience for our physicians,” he said.
Additionally, Rush is exploring predictive analytics to identify practice inefficiencies and opportunities to reduce physician turnover. At Rush, a 1% reduction in turnover represents about $3 million in savings for the organization.
Prepare for a new generation
All three CEOs acknowledged that the physician workforce itself is changing. Younger doctors place greater value on balance, flexibility and purpose.
“Understanding the current workforce and incoming physicians is really important to being competitive and able to attract that next group of doctors,” said Dr. Cacchione.
“The top reported reasons for physicians wanting to reduce their clinical hours was that their current—not surprisingly—workload far exceeded what they saw as a clinical FTE and a lot of inefficiencies in the clinical workflow contributed to that,” said Dr. Farley. “They’re struggling with work-life integration and they’re also feeling they’re not valued by their organizations.
“They don’t feel like they have a voice. They don’t feel like they have agency in the work that they’re doing and all of that really tracks with what we know about burnout and the drivers of burnout,” she added. “At its core, burnout is a result of a chronic imbalance between job demands and job resource.”
“We should not think that this is the time for us to take our foot off the gas. … We really are at a critical inflection point in our U.S. health care system in terms of our physician workforce,” said Dr. Farley. “It’s imperative that all of the key stakeholders … work together to restore some of that balance between job demands and job resources so that physicians are not faced with the dilemma of either continuing to work full time and burning out or having to reduce their clinical hours in order to just survive.”
