As the largest medical group in the country with a physician workforce of nearly 10,000, The Permanente Medical Group (TPMG) is a leader in building a comprehensive approach to physician well-being.
A key part of that work is its customized measurement strategy that includes multiple years of physician well-being survey data. This gives the organization a clear view of trends, priorities and factors driving both well-being and burnout across the system.
However, collecting the data is only part of the equation. TPMG uses insights from its data to drive meaningful change in how physicians work, how leaders support them and how well-being is integrated into day-to-day operations.
These efforts have helped move the needle on addressing the actionable drivers of burnout, improve physician well-being, and increase doctors’ sense of feeling valued within the organization. And, in 2025, its work helped TPMG earn Gold from the AMA’s Joy in Medicine® Health System Recognition Program, the program’s highest honor.
The AMA’s Joy in Medicine Program empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive.
While the recognition is a point of pride for TPMG, the organization insists that it represents a milestone rather than a destination. In many ways, the Gold-level recognition further supports the momentum throughout the system to continue analyzing what is working, identifying gaps and improving the physician experience.
“The award is a recognition of our commitment as an organization to prioritize the well-being of our people,” said Ellie Farahabadi, MD, an internist and the executive leader overseeing people for TPMG. “We don’t think of Gold as the end of our journey. We see it as validation that we’re on the right path and demonstrating our ongoing commitment.”
Ongoing is the watchword. TPMG’s culture of continuous improvement sets a solid foundation for building upon and fine-tuning well-being efforts across the system.
“We’re not here to rest on our laurels,” said Amanjot Sethi, MD, a urologist and director of wellness operations for TPMG. “This recognition helps us with accountability and momentum, with continued improvement as our overarching goal.”
The 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.
Using recognition to drive reflection
Gold-level recognition from the Joy in Medicine Program also serves as a barometer for measuring its physician well-being work.
“We see this award as another opportunity to examine the work we’re already doing and to assess its impact,” Dr. Sethi said. “The AMA Joy in Medicine framework provides a valuable structure for evaluating our own processes and tracking our progress in addressing the multiple dimensions of well-being.”
This includes evaluating and assessing its efforts to see how they measure up to the Joy in Medicine Program’s six domains: assessment, commitment, efficiency of practice environment, teamwork, leadership and support.
Through this self-reflection, TPMG can also determine where to focus next. This includes providing practical support that addresses drivers of joy and well-being, as well as factors that contribute to burnout, like workload, administrative burden, autonomy, flexibility, recognition, psychological safety, community and connection.
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.
Making well-being a system priority
While TPMG has a rich history of investing in strategies and programs to support its doctors, one of the most important steps in elevating this work was intentionally integrating physician well-being into the highest level of organizational strategy.
This shift has allowed the organization to prioritize and sustain its physician well-being efforts by embedding them into day-to-day operations, rather than relying on a single program, moment or initiative to make a lasting impact.
The systemwide integration has helped TPMG continue to move the needle in areas that can be particularly challenging to change, such as practice support, administrative burden and autonomy, according to Dr. Farahabadi.
Much of this success has been achieved by breaking down silos and making physician well-being a shared responsibility across the organization, rather than work that falls solely on the shoulders of a single well-being committee.
“Oftentimes, well-being leaders in organizations are in a silo and might be doing things that don’t have the impact that you can see on the surveys,” said Dr. Farahabadi. “Here, it’s really about partnerships between operational leaders, technology teams, clinical teams and others to implement significant changes that impact the day-to-day practice.”
For instance, TPMG technology and leadership teams recently worked together with physicians to develop and implement practice support tools and solutions designed to decrease EHR documentation and clerical burden. Among them is an ambient AI scribe technology tool that, with patient consent, accompanies physicians into exam rooms.
“It has reduced the documentation burden considerably and has been a gamechanger for many physicians who are spending significantly less time charting after work hours,” Dr. Sethi said.
Turning systemwide trends into local action
Embedding well-being into organizational strategy also means looking beyond systemwide averages. To do this, TPMG analyzes trends and behaviors across the organization. Then each individual department head also receives data for their team, allowing them to make targeted actions and changes based on their specific data.
This offers each location and department leader an organization-wide foundation, while allowing them to address its department’s distinct needs, opportunities and challenges, using broader trends as a benchmark and guide.
“Whether clerical burden is identified as a challenge across the organization or within a particular department, leaders still need to engage their teams to understand the why—what clerical burden looks like in their department and which interventions may help—because the underlying causes and specific solutions can vary across departments and specialties,” said Dr. Sethi.
That’s why TPMG leadership encourages and empowers departmental leaders to work with their physicians to develop and implement local solutions to make a positive impact on how they practice medicine every day.
Leaders are expected to review their data, discuss the findings at the department level, prioritize local interventions and solutions based on what they learn, and then close the feedback loop. This creates a cycle in which physician feedback is translated into conversations, interventions and measurable action.
“Departments can make even minor changes that have a big impact in terms of reducing administrative burden or giving people more autonomy,” said Dr. Farahabadi.
Dr. Sethi agreed, noting that “so many of the initiatives that come out of department-level conversations have been very simple tests of change or interventions that have had made a significant impact on the day-to-day lives of physicians in that department.”
These smaller, locally driven changes go a long way toward improving the physician experience. Just as important, they give physicians a voice in identifying challenges and shaping solutions that affect them firsthand.
Helping physicians feel valued
Leadership also plays an important role in another TPMG strategic priority: Ensuring that physicians feel valued, appreciated and recognized.
“We ask our leaders to think deeply about leadership behaviors that contribute to our physicians feeling valued and recognized for their contributions,” said Dr. Sethi. “We also want to better understand how we can help our physicians feel the impact of all the great work that’s happening across the organization to support them.”
To do this, the organization has collected feedback from physicians about which leadership behaviors make them feel most valued. A dedicated work group is now digging deeper into those behaviors and using the research and data to develop curriculum, leadership development programming and other professional development tools.
TPMG has also built a strong recognition culture with many internal honors celebrating excellence in areas such as innovation, leadership and teamwork. The philosophy behind that recognition extends beyond simply celebrating achievement. It is also about making sure doctors feel seen and heard, and understand the positive impact they have.
“That’s what our physicians want,” said Dr. Farahabadi. “As an organization we want to make a positive impact on the lives of our patients as well as the lives of our physicians and other members of the healthcare team.”
Strengthening community and connection
The emphasis on feeling valued is closely tied to community, another important component of TPMG’s well-being strategy.
In the organization’s annual professional fulfillment and well-being survey for physicians, community and camaraderie regularly rank among the highest scoring indices.
“A defining strength of our medical group is our deep-rooted value of community and camaraderie,” said Dr. Sethi. “Maintaining that culture and connection requires intentional efforts.”
In the years since the COVID-19 public health emergency, TPMG has deliberately worked to rebuild and strengthen those relationships that suffered so much during the pandemic.
Each year, TPMG hosts hundreds of opportunities and events designed to help colleagues build community. This includes a mandatory annual program focused on strengthening interdepartmental teamwork. Each department dedicates four hours to connecting with another department with the intent of increasing camaraderie, working through workflow challenges, sharing pain points and collaborating on opportunities for improvement.
For instance, Dr. Sethi noted that his department, urology, recently connected with the interventional radiology department, a department it works with frequently.
“We came together and discussed how to optimize workflows in ways that met the needs of physicians in both departments,” he said. “In addition, we also strengthened that sense of community by having conversations outside of the EHR or email, sharing our challenges and learning to understand each other on a different level.”
TPMG also offers doctors a robust array of programs that bring together like-minded physicians to support each other, including peer support groups, commensality groups, and Balint-style sessions. These programs give physicians outlets for building psychological safety and connection, while sharing their experiences and challenges in a non-judgmental setting.
“We’ve doubled down in making sure that these opportunities for peer support are offered as consistently as possible,” said Dr. Sethi.
Keeping momentum going
Together, all these efforts, initiatives and systemwide integrations reflect the larger philosophy behind TPMG’s approach to physician well-being. Overall, it does not rely on a single program, committee or intervention that will solve physician burnout for good.
Instead, TPMG weaves well-being into the fabric of how the system operates, complete with strong engagement and measurement strategies that help assess if its efforts are making a difference.
That’s why Gold-level recognition is not simply another award for the system to hang its hat on. Instead, it offers both validation of the work underway and accountability to continue pushing forward with an understanding that a strong well-being strategy is always evolving, growing and never truly finished.
Download the 2025 AMA Joy in Medicine® magazine (log into your AMA account to view) to see whether your organization is part of the prestigious group of 164 organizations across 40 states and the District of Columbia that are currently recognized for their dedication to physician well-being.
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.
