For years, leaders at Colorado Permanente Medical Group (CPMG) at Kaiser Permanente had been building the foundation for physician well-being.
There was a physician wellness committee. There was leadership commitment. There were stay interviews, skip-level meetings, recognition funds, community gatherings and a growing understanding that physician well-being was closely tied to patient care and organizational success.
Still, when it came to applying for recognition from the AMA Joy in Medicine® Health System Recognition Program, there was a familiar hesitation: Were they ready?
“I hesitated to apply because I kept thinking, ‘We’re not quite ready,’” said Lise Barbour, MD, a palliative care physician and vice president of people and culture at CPMG. “While we were doing much of the work, we needed to implement a validated measure of burnout before we considered applying.”
That changed this year, when CPMG applied for Bronze-level recognition for the first time.
The AMA Joy in Medicine Program empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive. It is organized around six domains that contribute to well-being: assessment, commitment, efficiency of practice environment, teamwork, leadership and support.
For CPMG, applying for recognition became a way to benchmark progress, identify gaps and make physician well-being even more visible across the organization.
Colorado Permanente Medical Group 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.
Start with existing work
Colorado Permanente Medical Group’s decision to apply was not the beginning of its physician well-being work. It was an extension of it.
“We were really motivated to pursue the Joy in Medicine recognition as a natural extension of our already longstanding commitment to physician and care team well-being,” said Heidi Clune, MD, a family physician and director of wellness for CPMG.
For more than a decade, Dr. Clune said, the medical group has been developing a deeper understanding of how physician well-being affects patient outcomes and organizational success. That work also aligned with a broader push among Permanente medical groups to make well-being a shared strategic priority.
Other Permanente regions helped CPMG prepare. Dr. Clune said colleagues at Washington Permanente Medical Group, in particular, served as mentors during the application process. “This combination of growing awareness, sustained investment and our alignment with our other regions made now the best year to apply.”
As the leader in physician well-being, the AMA provides organizational solutions that help physicians and health systems optimize practice efficiency, reduce burnout, and rediscover the Joy in Medicine.
Use the application as a mirror
The process of applying for recognition from the Joy in Medicine Program helped CPMG see its strengths more clearly.
Dr. Clune pointed to strong executive leadership commitment, a well-being infrastructure that includes a wellness committee and a culture that links clinician experience with patient care.
But the application also showed where more work was needed.
“The process really gave us a clear evidence-based view of both where we’re strong and where we can grow,” Dr. Clune said.
Those growth opportunities included making well-being work more consistent across teams, better measuring results through engagement surveys and embedding well-being more deeply into day-to-day operations.
The application process also helped the well-being team strengthen partnerships with other parts of the medical group, including operations and the Department of Medical Informatics.
“We’ve realized we both have the same goals to improve the lives of our physicians,” Dr. Clune said.
That matters because well-being cannot sit with one committee alone. It has to be built into how work gets done.
Build leadership buy-in
CPMG’s well-being work dates back to 2013, when its first physician wellness committee formed. At the time, Dr. Barbour said, there was recognition that physicians had distinct needs that warranted a focused approach.
The following year, the committee hosted its first wellness conference. Dr. Barbour remembers executive leaders attending with some skepticism. Then the keynote speaker presented data on physician burnout and well-being. It changed the conversation.
“That really helped our leadership buy-in,” Dr. Barbour said. “This is actually something that’s not just a flavor of the month. It’s really important and we need to invest in.”
In 2017, CPMG created its first dedicated physician administrative role focused on well-being. Dr. Barbour served in that role.
That dedicated leadership became especially important in 2019, when the organization faced financial stressors. Rather than pull back, leaders invested in physician retention, with well-being as a major part of the strategy.
Some of the work from that time continued through the COVID-19 public health emergency and into today. That includes stay interviews, skip-level interviews and recognition funds that leaders can use for one-on-one meetings and community-building activities. Stay interviews are one-on-one meetings with leadership that aim to fix problems early and improve workplace retention. Meanwhile, skip-level interviews are one-on-one discussions with a senior leader that deliberately bypasses the direct leader.
Several members of the original wellness committee have since been elected to the board of directors, Dr. Barbour said. That means decisions are viewed through the lens of the quadruple aim, which includes improving the work life of physicians and other health professionals.
Measure what matters
CPMG now uses the Mini Z survey, embedding it into its annual physician engagement survey. The Mini Z is a validated tool used to assess burnout and other parts of professional well-being. The AMA STEPS Forward® toolkit on burnout assessment includes a list of validated tools to assess burnout and well-being, including the Mini Z Worklife Burnout Reduction Instruction and the AMA Organizational Biopsy®.
Dr. Barbour said using the Mini Z helps CPMG compare itself not only with national averages, but also with other Permanente Medical Groups.
The organization also ties well-being initiatives to engagement action planning. This year, every level of leadership has accountability for engagement, with goals and metrics from the CEO to local leaders.
“We have kind of a scorecard that we look at regularly,” Dr. Barbour said. “That’s been a really good way to integrate the work being done for wellness and well-being into everything that we’re doing.”
CPMG shifted to the Mini Z because previous engagement surveys measured resilience, which Dr. Barbour said was not the same as measuring burnout. A change in survey vendors allowed the group to add custom questions.
“We were like, finally, we can put the Mini Z in,” she said.
Look beyond recognition
Receiving Joy in Medicine recognition would validate that physician well-being is embedded in CPMG’s culture, Dr. Clune said.
“For our physicians, it would affirm that their voices matter and that they’re supported in building sustainable and meaningful careers,” she said.
But it is also important to understand that recognition is a milestone, not an endpoint.
Next priorities include deepening consistency across specialties, improving measurement and continuing to embed well-being into daily operations. CPMG also offers community dinners, monthly wellness hours and Schwartz Rounds.
For other medical groups thinking about applying for the first time, Dr. Clune advised starting with an honest self-assessment.
“Make sure that you have or build strong leadership commitment,” she said. “Listen to your clinicians and focus on meaningful change, not just being able to check those boxes.”
Dr. Barbour echoed that point. Looking back, she said, CPMG may have been closer to ready than leaders realized.
The lesson: Do not wait for perfection before using the application as a guide.
“I’m so grateful to Heidi for just saying, ‘We’re going to do it this year,’” Dr. Barbour said. “And we did it.”
For health systems considering applying for recognition from the Joy in Medicine Program, the first step is to review the application criteria and compare them with existing work. Then identify what is already strong, what needs to be documented and what gaps need leadership attention.
The process can validate progress. It can also show what needs to happen next.
For CPMG, that was the point.
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.
