When health systems set out to improve physician well-being, there can be a natural urge to start with solutions. But before launching new programs or investing in new resources, leaders at Lee Health decided they first needed a clearer picture of what physicians were experiencing.
That meant measuring physician well-being.
“We really wanted to have someone, if we're going to be able to measure in the future, really follow through on that data,” said Jennifer Carrion, MD, a family physician and clinician experience liaison for Lee Health.
That decision became an important early step in Lee Health's journey to joy. It also led the health system to work with the AMA to measure physician well-being through the Organizational Biopsy®.
For health systems beginning similar work, Dr. Carrion said measurement can help leaders move beyond assumptions. It can identify what physicians need before organizations commit valuable time and resources to solutions.
Lee Health 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.
Put someone in charge
Lee Health's work began before the first survey was sent. For years, the health system had a well-being committee focused on supporting physicians. However, there had never been a dedicated organizational role responsible for tracking well-being over time.
About three years ago, that committee proposed creating a 0.5 full-time equivalent position devoted to the work. Lee Health ultimately approved the position, and Dr. Carrion became the organization's clinician experience liaison.
That ownership mattered because Lee Health did not want measurement to become an isolated exercise. Leaders wanted someone responsible for understanding the information, keeping the work moving and helping translate what physicians shared into future action.
Dr. Carrion also prepared for the new role by studying established approaches to physician well-being. She completed Stanford’s Physician Well-Being Director Course and the American Academy of Family Physicians' Leading Physician Well-being Certificate Program.
A consistent message emerged.
“All of these different programs were saying, ‘Hey, if you're going to do any well-being work, start with measuring,’” Dr. Carrion said.
Measure before acting
Instead of beginning with an intervention that had worked somewhere else, leaders at Lee Health wanted information about their own physicians and organization.
“Only then can you really see the health of the organization and really start to push those initiatives based on what the organization needs,” Dr. Carrion said, emphasizing that what works for one health system may not address the biggest pressures facing another.
“Just because an organization in another state or city is doing these initiatives doesn't mean that your organization will need it,” she said. “So please, please start by measuring with a validated burnout tool.”
That message resonated with Lee Health leaders.
Dr. Carrion said executive leaders supported the idea that measurement should come before major well-being initiatives. Nariman Heshmati, MD, chief clinical officer at Lee Health, also became a strong advocate for the effort and helped build support for moving ahead.
The next question was: How will Lee Health measure physician well-being?
Through conversations with other organizations, Dr. Carrion repeatedly heard about AMA well-being measurement tools, including the AMA Organizational Biopsy. Existing connections with the AMA helped make the Association a natural choice.
But Lee Health was looking for more than data.
“Not only would we get the data, but then what would we do with it?” Dr. Carrion said.
That was one reason the broader AMA Health System Member Program relationship appealed to Lee Health. The organization would have access to additional support as its well-being work developed.
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®.
Give every physician a voice
Informal conversations remain valuable when leaders want to understand physician experience. But those conversations have limits. Some physicians may feel comfortable raising concerns directly with a leader while others may hesitate to speak up about workflow problems, burnout or aspects of organizational culture.
“Informal conversations are really important,” Dr. Carrion said. “Anecdotes can be very valuable. But sometimes that doesn't level the playing field for those physicians who might not be comfortable speaking up.”
Formal measurement can provide another avenue for those voices.
“Measuring definitely gives a voice to those who simply just won't feel comfortable raising their hand or speaking up,” she said. “It creates this equal voice when you go ahead and launch something like this, and I really wanted to make sure that we all understood that.”
It can also challenge assumptions leaders may have developed through informal feedback.
“It allows us to move beyond assumptions,” Dr. Carrion said, and make sure “we know what we're trying to fix, not assume we know what we're trying to fix.”
That distinction is important when health systems face many competing priorities.
“If you're going to start investing in wellness or well-being in your organization, you want to make sure you're hitting those really important things that will matter to your physicians or your clinicians,” she said.
Her advice to other organizations is straightforward: “Get the data before you start any big initiatives so that you can actually prioritize what you need and what your clinicians need.”
Build trust before surveying
Getting meaningful information also required Lee Health to convince physicians that participating was worth their time. One concern was survey fatigue.
“We wanted to make sure that physicians understood that we're not just doing a survey to do a survey and then never follow through with it or make any changes,” Dr. Carrion said.
Leaders also wanted physicians to know the survey was not intended to assign blame if the results identified areas for improvement.
“We were really focusing on trying to listen and trying to act on the information,” she said.
Confidentiality was another major concern. Even before and during the survey, Dr. Carrion heard directly from physicians who wanted reassurance.
“I would still get those texts of, ‘Are you sure this is going to stay confidential? … I can speak my mind?’” she said. Her answer was yes, every time. Dr. Carrion repeatedly emphasized how the information would be protected and why Lee Health was gathering it.
“I wanted to make sure that they trusted us with the information they were going to give us,” she said.
The other half of that trust was accountability because “it's not just another survey,” Dr. Carrion said. “We actually want to do something about it.”
Make leadership visible
Executive support was also important in encouraging participation. Lee Health leaders communicated that physician well-being was an organizational priority and that the health system was investing in the work.
“Having executive leadership coming out with communication to say, ‘This is something we're prioritizing, this is something we're investing in,’ really helped to build that participation,” Dr. Carrion said.
But leadership involvement went beyond emails about the survey. At Lee Health's first CME well-being retreat, the organization's CEO recorded a video discussing his support for clinician well-being and his own experience with burnout in medicine. Lee Health later shared the video more widely.
The response from physicians stood out to Dr. Carrion.
“It was refreshing to see a leader openly speak about their burnout in medicine,” she said, describing the feedback Lee Health received. Seeing a senior leader speak openly about those experiences “allowed us to have more conversations and not feel that stigma attached to it.”
That presence sends an important signal about organizational culture. Health systems that want physicians to participate in well-being efforts should make sure executive leaders are not merely supporting the work behind the scenes, Dr. Carrion said. Physicians should be able to see and hear that commitment.
Plan for what comes next
Lee Health's decision to measure physician well-being was never intended to be the final destination. It was just the starting point.
The AMA relationship also gives Lee Health access to coaching and educational resources that can support the organization as its journey continues. For Dr. Carrion, knowing that support exists after measurement has been reassuring.
“What is making me feel reassured that we're going to get the work done is knowing there's that support from the AMA,” she said.
But the broader lesson for other health systems begins even earlier. Create ownership for well-being work, get leadership involved, explain why measurement matters, protect confidentiality, and make clear from the start that physicians' feedback will lead somewhere.
Most importantly, resist the urge to assume what physicians need.
“Starting with that data so you can really home in on what you need will help to prevent waste or funneling resources in an area that could have been funneled somewhere else,” Dr. Carrion said.
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.
