When Dallas Nephrology Associates launched its first physician well-being survey with the AMA’s Organizational Biopsy®, leaders hoped for meaningful insights. With about 70% of physicians participating, the results provided both affirmations and areas for improvement.
“As physicians, we are trained to be super resilient, work extremely hard and we are very good at not showing signs of stress, but it exists,” said Archana Rao, MD, a nephrologist and executive vice president of Dallas Nephrology Associates.
“We need to create well-being for our patients and to do that, we need to focus on the well-being of our physicians. We’ve got to be intentional about it,” Dr. Rao said, noting that is where the Organizational Biopsy helps because Dallas Nephrology Associates can learn how physicians and their care teams are feeling and where the health system can help.
Dallas Nephrology Associates 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.
“I’m very grateful that our physician base … responded very well. We had an overwhelmingly large number of people who did participate in the survey,” she said, emphasizing that “we are very happy about that because we wanted to hear their authentic voices. The more people share their thoughts, the better we are going to be at implementing changes that are necessary.”
“We’re excited about the results, and we are actually starting to work on identifying the next steps we need to do,” Dr. Rao said.
Overall, 33.4% of physicians at Dallas Nephrology Associates reported experiencing symptoms of burnout in 2025, compared to 42.1% of nephrologists across the U.S. This is also lower than the national physician comparison of 43.2%, according to the AMA Organizational Biopsy survey results.
There’s high job satisfaction
At Dallas Nephrology Associates, 84.7% of physicians expressed feeling satisfied with their job, which is higher than the national level of 76.5%. Meanwhile, 25% of physician respondents said they feel a great deal of stress because of their job. This is lower than the national rate of 45.1% and compared to nephrologists as a whole at 42%.
“We’re happy that we are not starting at a very low point. We’re starting at a fairly high level of job satisfaction,” Dr. Rao said. “We’re happy and we feel validated that we are on the right track because when we started this, we didn’t know what we would find.”
Additionally, 59.7% of physicians at Dallas Nephrology Associates said they feel valued by their organization. This is compared to 50% of nephrologists across the country and 54.5% of physicians overall.
“It really goes back to the origin of Dallas Nephrology Associates. It started as a small practice, very collegial, very familial atmosphere,” she said. “And I have to applaud the leadership, which has been stable and carried that value forward, so we still function like a family.”
“Every organization has a cultural tone. There are certain organizations that work as a corporation. Some of them work more as a family,” Dr. Rao said. “We know that we work as a family because we actually took a survey and we biopsied ourselves before the leadership, and this is how our physicians think—that we are a family. Maybe that feeling valued comes from that.
“Culture is so hard to pinpoint. It’s a sense of belonging and a sense of feeling, and many of us feel that loyalty and sense of belonging,” she added. “But over the last 50 years, it’s the leadership. It’s the way they approach things, the way they make people feel included, all of which probably has led to that feeling valued.”
More EHR efficiency is needed
As a specialty-specific group, Dallas Nephrology Associates “wanted to come out of this with some work,” she said. “And I knew a big part of it is the general physician burnout around pajama time, EHR time spend and time efficiency. There are only 24 hours in a day. Physicians all over the country share the same concern.”
According to Dr. Rao, it was no surprise to learn of the tremendous burden that the lack of EHR efficiency places on physicians.
In fact, 23.6% of physician respondents reported spending more than eight hours on work outside of work, compared to 22.5% at the national level. But 16.7% of physicians reported spending two hours or less on the EHR after work, which is lower than the national level of 24.5%.
Meanwhile, there are areas that seem to be working with sharing responsibilities with the care team. For example, 61.2% of the time, conducting medication reconciliation with patients and comparing it to the medical record are done by a member of the team. Also, 51.4% of prior authorizations are tackled by a team member, freeing up time for the physician.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine®.
Some struggle with navigating careers
Beyond the EHR experience, Dallas Nephrology Associates learned that physicians with less than five years in practice were struggling with navigating their careers.
While 85.7% of physicians with less than five years in practice reported job satisfaction, 42.9% said they are experiencing symptoms of burnout.
“They want a little bit more help and mentorship,” said Dr. Rao, noting that “we are happy with that because this gives us something concrete to work on.”
“We launched a company-wide mentorship program in 2024, but our physicians were slow to participate,” she said. But “now we know that this is an area that we need to really focus on with this group. We have a starting point and we’re going to work on it.”
However, “the most puzzling of it all was the mid-career physicians who expressed a little bit more career frustration,” Dr. Rao said, noting that only 54.6% of physicians with 11–15 years in practice reported job satisfaction.
Male physicians are more stressed
Additionally, “the one outlier was that, surprisingly, our male physicians felt more stressed than their female colleagues,” Dr. Rao said, noting “we are a little bit puzzled, but we’re looking into it.”
This was puzzling to Dr. Rao because, for years, research has shown higher levels of burnout among women physicians compared to men. In fact, according to an exclusive AMA survey, 47.2% of women physicians reported burnout symptoms compared with 38.9% of men.
The Organizational Biopsy results revealed that 81% of male physicians reported job satisfaction compared to 92.6% of women physicians at Dallas Nephrology Associates. This gap was also reflected in feeling valued. While 62.9% of women physicians noted feeling valued, only 35.7% of male doctors reported the same.
“Nephrology is a very intense, involved specialty. We care for the sickest people,” she said. “This job is very challenging, but over the years, policies and different aspects beyond our personal control have not been favorable financially for nephrologists, so that might be a source of a lot of angst. But we’re looking into other ways.”
“We’re exploring the data and uncovering what we can do to help,” Dr. Rao said. “But we were validated that we are on the right track even though we have work to do.”
Communicating the results
Transparency has been central to Dallas Nephrology Associate’s approach. Leaders first reviewed results with the executive board alongside the AMA team, then shared findings at an all-physician meeting. Regular team meetings and email updates will continue to provide progress reports and solicit feedback.
Additionally, “we have tasked ourselves with a project to create the steps and begin to implement it,” Dr. Rao said. “Each step of the journey will require communication to keep physicians updated, whether it is to talk about a new initiative, share more results or ask for more feedback.”
