At The Permanente Medical Group (TPMG), the aim of helping physicians and other health professionals achieve joy and meaning in medicine is increasingly critical, especially amid the strains of the COVID-19 pandemic. That’s why it is part of their “total performance strategy,” which also includes the interconnected components of operational excellence and exceptional care experience.

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“When you talk about joy and meaning in medicine, it can often feel abstract and aspirational,” AMA member Amanjot Sethi, MD, said during an educational session at the American Conference on Physician Health 2021 in Scottsdale, Arizona. Dr. Sethi is a urologist who directs wellness operations at The Permanente Medical Group, a member of the AMA Health System Program

That is why it is so important to define and contextualize joy and meaning in medicine, said Dr. Sethi. Medicine has become “increasingly difficult, and we need concrete strategies to tackle some of the systemic barriers to enjoying the joy and meaning of our work,” he said.

Here is how The Permanente Medical Group is working to elevate joy and meaning in medicine.

Keeping joy and meaning in medicine front and center required developing a comprehensive strategy through input from all physicians and various thought leaders across the organization, said Dr. Sethi.

“We understood that if we had the narrow focus of mitigating burnout, we would fall short,” he added. “That is why our focus is to support our people across the whole spectrum of professional fulfillment, engagement and, when necessary, even distress.”

“The key here is that leaders at all levels of our organization can speak the same language when it comes to defining this important pillar” of what TPMG calls its “total performance strategy,” he said.

The pursuit of joy and meaning and medicine “is not a program or strategy living in a silo,” Dr. Sethi added. “This is something we all should want ownership of.”

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Such feedback from doctors includes “camaraderie, clerical burden, professional development, psychological safety, recognition, autonomy, workload and others.”

“This data can be used by leaders to facilitate conversations with physicians and co-design operational tests of change aimed at improving practice environment,” he said.

The Permanente Medical Group’s work on joy and meaning in medicine “is not about making individual physicians more resilient … it’s all of us working together to ensure that we have the systems and tools in place to help support thoughtful practice environments,” said Dr. Sethi.

“There are no simple solutions or quick fixes,” he said. “It’s about all of us—physicians, staff, leaders—rolling up our sleeves and really committing to understanding and removing the day-to-day barriers to professional fulfillment. It’s certainly a journey.” 

While the journey may have its challenges, Dr. Sethi feels that “if you commit to an improvement process in attending to these systemic challenges, it can positively impact the delivery and quality of your patient care.”

While the pandemic “has required us to be very adaptable in a fluid environment, we never moved from our commitment” to a strategy that makes joy and meaning in medicine a priority, said Dr. Sethi.

“From the start of the pandemic, many people were dealing with unprecedented personal and professional stressors,” he noted. That is why it is important to take a multidimensional approach during this time.

“We were very purposeful about quickly expanding pandemic-specific resources such as remote-care tools, child care grants and mental health resources,” said Dr. Sethi. “Additionally, across the organization, our teams rapidly transitioned robust wellness programming and proactive peer support to virtual platforms whenever possible.” 

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While the pandemic will continue to present health care organizations with difficult challenges, he noted that one key remains: “Hearing directly from our physicians.”

“It has never been more important to capture timely feedback about the factors that impact our physicians’ professional experience so that systems and support offerings can be evolved to meet their needs,” said Dr. Sethi.

Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face. By focusing on factors causing burnout at the system-level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction. 

The AMA’s Joy in Medicine Health System Recognition Program provides a roadmap for health system leaders to implement programs and policies that support physician well-being. Applications for the 2022 Joy in Medicine Program will open on January 14, 2022. Learn more by reading the program guidelines.

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