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).
When it comes to developing quality leadership skills at Mid-Atlantic Permanente Medical Group, Ameya Kulkarni, MD, says that it’s critical to keep in mind the physician’s chief aim—patient care.
“What makes a good physician leader is really focusing on the patient at the center of the experience,” Dr. Kulkarni says. “Great physician leaders have to be clinically excellent, and they need to be able to see beyond the world that's in front of them—not the narrow lens of only the patient in front of them but being a good steward of the system.”
Dr. Kulkarni is an interventional cardiologist and associate medical director with Mid-Atlantic Permanente Medical Group (MAPMG), which includes nearly 1,800 physicians in more than 60 medical and surgical specialties, caring for about 800,000 patients in Maryland, Virginia and Washington, D.C.
Positive leadership can protect physicians from some of the damaging effects of stress in their profession. This, in turn, can reduce physicians’ chances of experiencing burnout and leaving their jobs or the field of medicine entirely. That’s why leadership is a pillar of 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. MAPMG earned bronze-level distinction in 2024.
Building a framework for a career
With a strong case built for the need for good physician leaders, it’s important to have an organizing principle. At MAPMG, that’s the “hire to retire” strategy, which takes into consideration what career phase physicians are in when targeting them for training, support and opportunities.
“Basically, the strategy says from the moment a physician is hired in our practice until the moment they retire, every part of that journey, there are different needs at different career stages,” Dr. Kulkarni says. “Then, everything we do for physicians to build connection or build leadership are in the context of where they are in their journey.”
Dr. Kulkarni says that as a foundational strategy, “hire to retire” is about three years old, but as an idea it has existed in the organization for much longer as a driver for career fulfillment and retention.
“We formalized the strategy as the core of how we think about where physicians are and what they need,” he says. “Now it underlies everything—our events, our social connections, our professional development of leadership, our pathways. It's the thing that we build everything on.”
The strategy has four stages with “enculturate” being the first, which begins as soon as a physician accepts a position with the medical group and ensures that a good first impression is made and logistical, clinical, professional and social support is given. Years one through three are the “engage” stage, which brings awareness to the various interest-based micro-communities within the larger medical group community that physicians can get involved with.
