This story is one of more than 20 health system profiles featured in the 2025 AMA Joy in Medicine® magazine (log into your AMA account to view).
“Dumping phenomenon” is a common occurrence at some practices. This is when the hardest work will be deferred to someone else, knowing they’ll get paid the same for an easy or difficult consultation. Kaiser Permanente Northwest Cancer Center aims to avoid those scenarios, says Christine M. Barnett, MD. “We are very much a team,” and everyone is a team player, she said of the center’s multiple departments.
That is why department leaders only hire people who fit in with the culture of the organization.
“We’re very big here about supportive culture. We've turned people down because they just weren't the right fit, and we felt like they wouldn't necessarily support the other physicians,” says Dr. Barnett, medical director and chief of hematology and medical oncology at Kaiser Permanente Northwest Cancer Center.
The culture means team members have each other’s backs, and if someone needs coverage for a shift, “there's always somebody to switch with you,” she says.
Kaiser Permanente Northwest Cancer Center is part of Northwest Permanente, which is the largest independent interspecialty medical group in Oregon and Southwest Washington with over 1,500 physicians and other health professionals.
The cancer center has a peer support program and a wellness advisory committee that includes physicians from Northwest Permanente.
“Cancer is rewarding in the work that we do with patients, but it also can take a toll on all physicians and the teams that take care of patients,” says Tasha McDonald, MD, the cancer center’s chief of radiation oncology and associate medical director.
The department of radiation oncology fosters teamwork through daily huddles, potlucks and reflections on patients who have died. Teams also get together and do things outside of work.
“We have special meetings outside of our daily patient care to talk about hard issues and to support each other,” says Dr. McDonald.
Team structure is physician-led
Organizations often place the onus on physicians to address burnout. But burnout is not a physician problem, meaning they shouldn’t have to figure out how to solve it, according to Dr. Barnett.
Oncologists often spend a great deal of time in discussions with insurance companies to get an MRI or certain chemotherapy approved for their patient—tasks that don’t involve medicine and lead to job frustration and burnout.
Northwest Permanente is unique in that it takes care of these tasks for the physician, says Dr. Barnett. Other organizations are either led by hospital administration or venture capitalists.
“But we're physician led. Any decisions that are made that affect the work life of the physician are made by a physician,” she says.
The cancer center’s leadership is a collaborative effort between multiple department leads. This includes Drs. Barnett and McDonald and a surgical oncologist.
“We always take the consideration of multiple different teams into account when we're moving a project forward,” says Dr. Barnett.
Physicians are supported by a team of nurses and medical assistants (MA), which help with in-basket management and patient communication.
