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).
Leaders at Northwell Health know that caring can’t just be focused on the more than 2 million patients they treat annually.
Physicians also need support for themselves so they can heal whatever ailments they may be personally facing and that includes being able to, without fear, seek care for mental or behavioral health concerns.
Northwell Health—New York’s largest health system with more than 4,000 physicians and 900 hospitals and care centers—has worked to remove barriers that would stop its employees from accessing mental health care when they need it.
As part of that journey, Northwell Health replaced intrusive and irrelevant credentialing questions with questions that don’t impede physicians and other credentialed providers from seeking care, which is part of the support pillar of AMA Joy in Medicine® Health System Recognition Program.
It was during the COVID-19 public health emergency that Annabella V. Salvador, MD, an emergency physician, senior vice president of medical affairs and deputy chief medical officer at Northwell Health, began spearheading an effort to change some of the credentialing questions the health system asked their credentialed providers, including the physicians.
She led the charge after she heard about the heartbreaking loss of New York City emergency physician Lorna Breen, MD, who died by suicide in the early days of the COVID-19 pandemic.
The effort started even before the Dr. Lorna Breen Heroes Foundation was created because Dr. Breen’s story was personal for Dr. Salvador, who was already very passionate about physician well-being. Dr. Breen completed her residency in emergency medicine and internal medicine at Northwell Health’s Long Island Jewish Medical Center and Dr. Salvador collaborated with Dr. Breen on multiple regional meetings for the American College of Emergency Physicians.
Dr. Breen treated patients with COVID-19 at New York Presbyterian, working 12 hours shifts in the emergency department and frequently staying after her shift ended to take care of patients. She didn’t have a history of depression or anxiety, but the long hours and her own bout with COVID-19 took a toll. She feared seeking help, though, because she worried that she could lose her medical license or be ostracized in the medical community.
“I felt like it was our obligation to make changes to address the issues surrounding physician burnout and physician wellness,” Dr. Salvador says.
Some of those issues: A culture that looks at mental health care as a weakness and one where licensing boards often require physicians to disclose current or past mental health care and hospitals often require it for credentialling.
“When we heard about her loss and—having known her—it really left a mark on me. To honor her, I felt like it was our duty to make changes to the credentialing questions,” Dr. Salvador says.
Revamping invasive questions
Before the Dr. Lorna Breen Heroes Foundation was founded and created a toolkit to help organizations make changes, Dr. Salvador took a look at the credentialing questions with a team of people at Northwell Health and began editing to make them physician well-being friendly.
