How improving physician onboarding can help satisfaction and well-being with Rebecca Lauderdale, MD

. 10 MIN READ

AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.

New physicians are a group that’s especially at risk of burnout. Rebecca Lauderdale, MD, physician well-being champion at Hattiesburg Clinic, joins to discuss the steps her health system has taken to support early career physicians. Dr. Lauderdale shares physicians’ most requested improvements and how changes to onboarding new physicians increased their job satisfaction. AMA Chief Experience Officer Todd Unger hosts.

Speaker

  • Rebecca Lauderdale, MD, physician well-being champion, Hattiesburg Clinic

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Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about meeting the needs of early career physicians to address burnout in this at-risk population. Joining me today is Dr. Rebecca Lauderdale, the physician well-being champion at Hattiesburg Clinic in Hattiesburg, Mississippi. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Lauderdale, thanks so much for joining us.

Dr. Lauderdale: Thank you, Todd. It's my pleasure to be here today.

Unger: Now, is physician well-being champion your actual title, because it's a great one.

Dr. Lauderdale: Sort of. It's not an official title, but it is the job that I've had for the past several years even before the pandemic. I've worked on physician well-being initiatives at Hattiesburg Clinic for about four years.

Unger: Well, that's great. And as you know based on what we've been through over the past few years, very needed. And we're here to talk to you today because Hattiesburg has stood out as a leader in the well-being space and has the data to prove it. Last year, you completed our AMA Organizational Biopsy, which measures six key performance indicators that contribute to burnout. And Hattiesburg scored better than the national average on just about every indicator. Hattiesburg is also a physician-owned and governed institution. Is there any connection in your mind between the two?

Dr. Lauderdale: We think that there is. We believe that our being owned and governed by our own physician partners means that we have more autonomy and we can be more nimble when we need to make changes in ways that can affect the well-being of our physicians and providers, as well as our other staff so that we can continue to provide excellent patient care. So we do, we think that it has a lot to do with why our numbers are good.

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Unger: Even though you scored very well on your burnout assessment, you were still able to draw some insights from the analysis that could help you build on that success. We're eager to hear more about what you learned.

Dr. Lauderdale: So one of the things that we found that was a little surprising to us is that our early career physicians and the group in their first five years of practice had a higher rate of burnout than the rest of the organization by 10 points. So we found it important at that point to start investigating and find out why that might be true so that we could do something about it.

Unger: Well, let's get into the whys there. One of the first things, I think, is about onboarding. Any specific changes that you made in your approach to onboarding that have helped?

Dr. Lauderdale: So we aren't sure yet, as we don't have data that shows us specifically that our physicians who have participated in our new Onboarding Academy have been positively affected as far as burnout is concerned. But that's because we haven't been doing it for a long time. We first did our organizational biopsy last year about this time last year and we started our Onboarding Academy for the first 12 months of physicians joining our organization in 2020, or 2021.

So we've been doing that for two full years and just started our third class of new physicians just last month. And we hope that one of the things will come out of that is our new physicians will feel more a part of the organization, they'll know more about what they need to experience more joy in their practice, they'll know who to talk to about what problems and how they do have ownership in a way that's different in an organization that's not physician-owned and governed.

Unger: Now, you also asked your physicians what their top three things would be to improve their well-being. What did you find? And are you acting on those results?

Dr. Lauderdale: We are. So the very top was more social connection. So we have had a few different initiatives for that purpose.

First of all, we had a big party for our entire physician and support staff at our local zoo back in the spring. And everybody had a really great time. We had about 2,500 people come. We invited all of our employees and their families. And we got excellent feedback about that.

But more targeted to physicians, when we did find out that our younger—earlier career physicians were the ones who had higher burnout rates, I invited them all to dinner. And about 15 of them came and we had a really good conversation around the things that they thought would be beneficial. And again, it was so important for us to have that meeting because otherwise I wouldn't really have understood—we wouldn't have understood what they needed.

And what they told me was that they needed better connections with their other partners, their referring partners, people in other departments. We're spread over a 19-county area of South Mississippi and many of us only work with one or two other physicians in our office, but we have 300 physician partners. And so this summer, we had a series of physician dinners where we invited all of our physician partners to come, to sign up, to have a nice dinner together and we talked about our practices, the things that bring us joy in our practice, the things that people misunderstand about how we practice, and the ways that we can support each other in how we communicate and how we care for patients together.

And we got unanimously very positive feedback for those dinners. And they gave us some more ideas for things to do as we go forward.

Unger: You know, it makes so much sense. A new person comes on board and you don't have necessarily kind of the lay of the land in terms of the organization and you don't know anyone. And so, I guess it's kind of easy to skip over what might be truly significant factors in bringing someone on that would help them address the symptoms of burnout there.

Another thing that is not a surprise, because we hear a lot about it, is the EHR, or Electronic Health Record, as a big source of burnout for physicians in every part of their life cycle. How are you dealing with that stressor for both new and more seasoned physicians?

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Dr. Lauderdale: So I think the most foundational for us has been we use our EMR is Epic. And before we ever decided on what EMR to use back in the early 2000's, our physicians were involved in making that decision. And we have had a very robust and active EMR committee made up of physicians. And they have made as a group decision, along with our CMO over that period of time.

And so that first of all, has been really important. And then second, we've done some events around rollouts of new EHR updates that were significant changes to workflow. We call them Happy Hours. And so our CMO and assistant CMO have had events where they would drop in. We had lots of workstations set up. We had a fun little sort of scavenger hunt on paper of things to find that are going to be different about the workflow. There were door prizes and ways to interact with each other as we did it.

So we turned it into a social event and we had a really great turnout. And we had people who were able to experience the changes before they rolled out. They were able to ask questions. And it just went a lot more smoothly.

So we are taking that feedback from our partners and using that in more targeted ways in the upcoming months to help them optimize things like responses to patient messages, which take up so much of our time nowadays. And so many of them could be automated, but a lot of us just don't feel like we have the time to stop and set up those automations. And so we're going to give them a chance to do that and ask them to fill out our Organizational Biopsy Survey when we roll that out again next month.

Unger: Really smart. I know you're also planning to apply for the AMA's Joy in Medicine Recognition Program in 2024—

Dr. Lauderdale: We are.

Unger: —for the standard of care and physician well-being. That's a big step in your well-being journey. Where do you see the greatest opportunities to continue that journey going forward?

Dr. Lauderdale: So I think that helping our—helping our partners and their teams, our workflow and our teamwork, are the places where we have probably the most work to do, but also the highest yield. And so we're hoping to get some feedback from this year's Organizational Biopsy that might help us target some areas that we can begin to work on.

Unger: Dr. Lauderdale, thank you so much for sharing your insights and of course for all the work that you and Hattiesburg are doing to address physician burnout, particularly in new physicians. The AMA is, of course, laser-focused on reducing physician burnout. It's a core pillar of our AMA Recovery Plan for America's Physicians.

I encourage everybody out there to learn more about those efforts at ama-assn.org/recovery. That's it for today's episode. We'll be back soon with another AMA Update. In the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.


Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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