Reducing burnout requires commitment from entire health system

Sara Berg, MS , Senior News Writer

For Southern California Permanente Medical Group (SCPMG), participating in the AMA Joy in Medicine™ Health System Recognition Program allows them to hold up a mirror to their organization to look at their work around well-being from a different perspective. By following the set of criteria mapped out by the program, SCPMG continues to focus on efforts to reduce physician burnout and improve satisfaction.

Physician burnout demands urgent action

The AMA is leading the national effort to solve the growing physician burnout crisis. We're working to eliminate the dysfunction in health care by removing the obstacles and burdens that interfere with patient care.

The Joy in Medicine Health System Recognition Program represents the AMA's commitment to advancing the science of physician burnout. It also aims to empower and propel health systems to reduce burnout so that physicians—and their patients—can thrive.

“While receiving recognition is nice, the importance comes from the application process because it encourages and highlights interdependence between multiple areas within our organization,” said AMA member Dawn Clark, MD, an ob-gyn who also serves as chief wellness officer for the Southern California Permanente Medical Group in Pasadena. “It really reinforces the importance of weaving the clinician experience throughout the organizational DNA and reiterates the fact that every part of our organization is responsible for this fourth aim.”

In a recent discussion, Dr. Clark shared how the work SCPMG doing around well-being fits each criterion.

“We as physicians have the honor and privilege to care for other human beings, so we need to be at our very best,” said Dr. Clark, adding that “this commitment portion is valuable to the clinicians and the patients that we serve at SCPMG.”

“You're talking about the organization putting the clinician experience in their strategic plan,” she said. “This helps open dialogue up with our executive teams and our board of directors.”

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SCPMG has been assessing physician well-being every three years since 2013 but began annual assessments in 2019 with a goal of a 60% participation rate or higher. The first year saw a 45% participation rate. But with the pandemic, SCPMG didn’t distribute their regular physician well-being survey.  

Instead, “we did the AMA Coping with COVID-19 survey and our percentage rates dropped significantly. I believe we were at about 22%,” Dr. Clark said, noting that the pandemic was likely the main reason for low participation because people were “focused on the clinical care and operational changes that were happening on a daily basis and maybe less so about filling out a wellness survey in that moment.”

This looks at whether “we are efficient enough during the day to get the work done so that we can go home and spend time with our families to recharge, rejuvenate, practice some self-care and come back so that we are able to give the quality care that our patients deserve,” Dr. Clark explained.

For example, SCPMG looks at EHRs to see where physicians are spending the most time to provide support, she said. “We also have physician-led trainings to optimize all of our physicians’ skills using the electronic health record and it’s truly a wonderful program,” which “saves us hours each week.”

Read about how peer-led EHR training saves physicians’ scarcest resource: time.

“Leadership can negatively or positively impact work units,” said Dr. Clark. “If you have a poor leader, then of course it can decrease the clinician satisfaction scores and increase burnout.”

At SCPMG, it’s about “training our leaders to be empathic and to listen to the front line” and having “a diverse population of leaders in ethnicity, gender and thought,” she added. “We are a physician-led group, so we have professional development for all of our physicians and then special training for our leaders and it continues throughout the life of their career with SCPMG.”

“We’ve always felt that health care is a team sport at Kaiser Permanente … long gone are the days where the clinician is the captain of the ship,” said Dr. Clark. “We all know that we can’t provide patient-centered high-quality care without an entire team.

“We continually work to have every person in our organization … work at the top of their license,” she added. “This concept of teamwork is incredibly important not just for the people who give health care, but for the people who receive health care.”

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“We have to remember that our people are just that—we're people. We have feelings, we get burned out, we need emotional well-being support, and we have mental health struggles,” explained Dr. Clark. “We have tried to the best of our ability to create a myriad of different support systems for our people to choose from whether it's group counseling, individual counseling or peer support.”

For example, “with the COVID pandemic, what we've tried to do with our group is ensure that they know about all their benefits,” she said. “We went in and we redesigned our website for easy access to all of our mental health and emotional well-being support programs.”