In a time when physician burnout continues to strain health systems nationwide, The Permanente Medical Group (TPMG) has committed to an ambitious goal: making the well-being of its physicians not only measurable, but actionable. From developing an in-house professional fulfillment survey to embracing augmented intelligence (AI) to ease documentation burdens, TPMG is redefining what it means to care for the people who deliver care.
The Permanente Medical Group wanted a practical, data-driven strategy for moving past the narrow metrics of physician burnout toward sustained professional fulfillment. The health system staff developed a program that blends measurement tailored to local needs, executive commitment, operational leader engagement and targeted technology innovation and deployment—so that physicians feel the impact of institutional investments in their day-to-day work.
When Amanjot Sethi, MD, a urologist and director of wellness operations for TPMG, took the podium at the 2025 American Conference on Physician Health™ in Boston, he did more than summarize this program. He framed The Permanente Medical Group’s efforts as both a moral obligation and an operational priority—to track what matters, to act on what the data says, and to close the feedback loop with frontline physicians so improvements are visible and sustainable.
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.
TPMG’s first advance, Dr. Sethi stressed, was to move beyond measuring burnout as a lagging indicator and instead identify actionable drivers of both burnout and professional fulfillment. The result was a compact, 15-item survey developed by a multidisciplinary team of physician leaders, well-being and measurement experts with input from the division of research.
“We realized that to take something off the shelf would have been much easier. But to meet the needs of our organization at the time… we needed to design a metric that was measuring these drivers at the same level as our other strategic imperatives,” he said.
The instrument’s key attributes are clear: concise enough to encourage high response rates, targeted to operational areas leaders can influence, and built to allow department-level analysis that protects confidentiality while supporting meaningful discussion.
That departmental focus is critical, Dr. Sethi emphasized. To be useful, measurement must lead to conversation, tests of change and timely feedback—otherwise surveys quickly lose credibility.
“In addition to looking at the organization-wide data, it’s very important to look at the data in the context of your own department,” he said. “We even encourage chiefs not to get caught up on one number, but to look at the trends, see what you can learn from them, and use this data as a springboard to conversation in your departments.”
Engage the operational leaders
A central tenet of TPMG’s strategy is that operational leaders are the linchpin for durable change.
“We believe that in order to be successful in improving the well-being of our physicians, we must engage the operational leaders, the leaders who are directly involved in day-to-day decisions and leading our physicians,” Dr. Sethi said.
This is because the direct leader is one of the most influential factors on a physician’s professional satisfaction. That influence is why The Permanente Medical Group invested in making the survey results both readily available and actionable for department discussions.
Chiefs receive department-level dashboards and structured toolkits—discussion guides, slide decks and a menu of interventions tied to each of the 15 items—so they can convene honest conversations, co-design small experiments and measure whether the changes work.
“We try and shrink the change for our leaders. We ask them to focus on three things,” Dr. Sethi said. “Review your data, have the conversation with your department, and agree on one test of change.”
Rather than burden chiefs with a laundry list of tasks, TPMG gives them a short, practical playbook to facilitate the conversation, encourage tests of change, track progress and close the feedback loop with their teams.
“Moving the needle on well-being doesn’t always require groundbreaking or costly interventions. Even some of the seemingly smallest department-level changes can have tangible impact,” said Dr. Sethi. “It’s encouraging that we’re seeing improvements across all drivers of professional fulfillment.
“In fact, our most significant gains have been in previously low-scoring areas such as practice support and clerical burden, demonstrating the impact of targeted initiatives,” he added.
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®.
Invest at the top and make it visible at the front line
TPMG’s work is not just a check-the-box well-being program. It is a sustained investment embedded in organizational strategy, with CEO and executive support that elevates well-being alongside quality and access.
“Our CEO and Executive Director, Dr. Maria Ansari, a physician herself, is fiercely committed to TPMG not only providing high-quality care but also taking care of the people who deliver that care,” Dr. Sethi said.
But executive sponsorship alone is not enough. TPMG focuses on making programs and resources tangible to physicians and care teams across its wide geography and size—about 10,000 physicians, and 40,000 nurses and staff, serving nearly 5 million patients in Northern California.
That scale required a distributed leadership model and clear performance expectations: chiefs were held accountable for engaging their teams, and in past years TPMG used performance measures to incentive leaders to encourage measurement participation and follow-through.
“We have had performance measures tied to ensuring that the conversation to support physician well-being was prioritized in each department,” Dr. Sethi said.
That gentle accountability, paired with toolkits and coaching, helped move conversation and action off the slides and into daily practice.
Technology as an accelerator
Measurement and leadership are necessary but not sufficient to enact lasting well-being. TPMG has also leaned into technology—particularly AI and EHR innovations—to remove clerical burden and reduce “pajama time.”
“Our CEO has been a strong advocate of rapid speed to execution to adopt AI tools and technological innovations,” Dr. Sethi said. “Our technology leaders and their teams have made remarkable progress in helping physicians leverage technology that eases administrative burdens and reduces after-hours EHR time.”
But technology deployment is careful and iterative. The organization measures the impact of tools on physician time, edits workflow, and listens closely to physicians about where automation actually helps versus where it creates new work. TPMG’s approach is consistent with the group’s larger philosophy that technology must be implemented in ways that maintain physician agency and clinical accountability, and it must be governed so privacy and safety are preserved.
Feedback that builds trust
Perhaps the most practical and human lesson Dr. Sethi emphasized is the imperative to close the feedback loop.
“If we go back to our physicians, to our departments, to our teams and say, ‘Hey, here's what we heard. Here's what we decided together. Here's an intervention you helped design, and here's what we learned… that's going to have a significant impact,” he said.
When physicians see the results of their input turned into concrete changes—whether a scheduling tweak, a new workflow, or a pilot of an AI tool—engagement improves and skepticism is lessened.
Maintain open communication
“We ask chiefs to approach the discussion with authenticity, curiosity. You don't have to have all the solutions as the chief. You do need to provide the forum and psychological safety for the discussion,” Dr. Sethi said.
That simple guidance—prioritize conversation over instant fixes—may be one of the most important operational shifts a system can make.
Dr. Sethi was candid about limits and ongoing challenges. No single program will erase macroeconomic pressures, regulatory complexity or every source of clinician distress. Yet TPMG’s progress shows how consistent, integrated work can move the needle over time.
“We don't have it all figured out,” he said. “There's still plenty of work to do, but I think it is good to take a look back, reflect and think about why we are making the progress that we're making.”
And for TPMG, that reflection leads not to complacency but to iteration with better tools, more refined measures, deeper leader training and more rigorous closure of the feedback loop.
“If we can continue to do that—measure, act, and close the loop—we’ll have a tangible way to transform physician well-being from a lofty aspiration into an operational reality,” Dr. Sethi said.
AMA STEPS Forward® open-access resources offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These resources can help you prevent burnout, create the organizational foundation for joy in medicine and improve practice efficiency.
