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About practice transformation

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Physician well-being is essential for high-quality patient care. Through the AMA’s Practice Transformation framework, we provide guidance to health system leaders on how to create the conditions where joy, purpose and meaning are possible for physicians and care teams.

Through our five-step process (Research, Measure, Act, Recognize, Convene) our evidence-based, field-tested and targeted solutions help guide physicians, care teams and health system leaders on developing and implementing strategies to optimize practice efficiencies, reduce burnout and improve professional well-being.  

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For more information, please contact us.

Research

Practice Transformation: Research

As a respected thought leader and convener, the American Medical Association bases its work in practice transformation and professional satisfaction on rigorous research and practice science.

Physician burnout has economic costs as well as financial costs associated with staff turnover, lost revenue, decreased productivity and risks to the organization from lower quality of care and potential for more frequent medical errors.

AMA research has highlighted the system-level issues that drive burnout, and the steps organizations can take to coordinate solutions for effective changes.

Our seminal research on physician burnout has shaped other collective understanding of its underlying causes, drivers of burnout, and the impact burnout has on physicians, patients and health care organizations. In collaboration with health care systems, the AMA’s research efforts are aimed at delivering evidence-based, actionable solutions to increase professional well-being.

Electronic health records research

Research has illustrated that EHRs may largely contribute to physician burnout and frustration. The AMA has partnered with several research teams from around the country to further understand the impact of EHRs on professional satisfaction and to illuminate the promise of objective EHR use metrics to quantify elements of efficiency of practice and teamwork.

Metrics for assessing physician activity using EHR log data

Published in JAMIA in 2020, authors propose seven core measures of EHR use that reflect multiple dimensions of practice efficiency and use cases of these measures for multiple stakeholders. Authors argue that standardization of EHR use measures will foster cross-study synthesis and comparative research. Learn more.

EHR-use metric research 2021 grant awardees

The AMA has provided a second set of grants to several organizations to continue researching EHR-use metrics and their relationship to burnout, professional satisfaction, well-being, and other practice-related factors. Research partners who have collaborated with the AMA to expand understanding of the EHR and EHR-use metrics include:

     — Alliance Chicago
     — Stanford University
     — University of California San Francisco
     — University of Wisconsin Health
     — Yale University

Perceived EHR usability as a predictor of task load and burnout among U.S. physicians

Published in JMIR in 2020, authors conducted a secondary analysis of a cross-sectional survey of US physicians from all specialties from October 2017 to March 2018. This investigation found that physicians with higher levels of cognitive workload have higher rates of burnout. In an Emerging Topic presentation, Cognitive workload: A modifiable contributor to physician burnout?, authors Elizabeth Harry, MD and Christine Sinsky, MD, discuss study findings and approaches that health care organization leaders can take to address system issues to reduce burnout and promote physician well-being. Learn more.

Tethered to the EHR: Primary care physician workload assessment using EHR event log data

This retrospective cohort study, followed by direct observation, found that primary care physicians spend more than one-half of their workday, nearly six hours, interacting with the EHR during and after clinic hours. Learn more.

Association of perceived electronic health record usability with patient interactions and work-life integration among U.S. physicians

This cross-sectional study evaluated positive and negative perceptions of EHR use during patient encounters and at home after work hours. Higher physician-perceived EHR usability was associated with higher levels of perceived positive outcomes such as improved patient care, and lower levels of perceived negative outcomes such as worse patient interactions and work-life integration. The authors propose that EHR usability can be improved, thus improving patient care and physician well-being, if it is made a priority by those who design, implement and regulate EHRs. Learn more.

Characterizing physician EHR use with vendor derived data: A feasibility study and cross-sectional analysis

This study uses EHR audit-log data to determine that for every eight hours of scheduled patient time, ambulatory physicians spend more than five hours in the EHR. Differences in EHR use varied by specialty and physician gender. The analysis also demonstrates that while vendor-derived audit-log data are useful to some degree, their limitations do not allow for derivation of all proposed core EHR metrics and comparison of metrics across vendor products. Learn more.

Key research

Factors affecting physician professional satisfaction and their implications for patient care, health systems and health policy

This formative report identifies key drivers of professional satisfaction and provides recommendations to reducing burnout. Learn more.

National burnout survey

The most recent study in this series found that 43.9% of U.S. physicians exhibited at least one symptom of burnout in 2017, compared with 54.4% in 2014 and 45.5% in 2011. Learn more.

Physician task load and the risk of burnout among U.S. physicians in a national survey

Cognitive task load can affect providers' ability to perform their job well and may contribute to burnout. Learn more.

Resilience and burnout among physicians and the general us working population

Resilience is inversely associated with burnout symptoms, but burnout rates were substantial even among the most resilient physicians. Learn more.

Allocation of physician time in ambulatory practice: A time motion study in four specialties

For every hour physicians provide direct clinical face time to patients, nearly two additional hours are spent on EHRs and desk work in a clinic day. Learn more.

Estimating attributable cost of physician burnout

The organizational cost of physician burnout can range from $500,000 to more than $1 million per physician. Learn more.

Professional satisfaction and the career plans of U.S. physicians

This survey research demonstrated nearly 1 in 5 U.S. physicians intend to reduce clinical work hours in the next year, and roughly 1 in 50 intend to leave medicine altogether in the next 2 years to pursue a different career. Learn more.

Personal and professional factors associated with work-life integration (WLI) among us physicians

This cross-sectional study identified factors associated with work-life integration in physicians and found that lower WLI was reported by physicians who are women, single, aged 35 years or older and who work more hours and call nights. Learn more.

Disparities in burnout and satisfaction with work-life integration in us physicians by gender and practice setting

This article explores the interaction between academic practice, private practice and gender in relation to physician burnout and satisfaction with work-life integration and finds that gender differences in rates of burnout are related to practice setting and other differences in physicians' personal and professional lives. Learn more.

TEAM approach reduced wait time, improved “face” time

This article describes a study that evaluated the TEAM approach to clinical practice. Findings showed the model improved workflow, increased face time and decreased patient wait times. Learn more.

Advanced team based care: How we made it work

This case study, based on the experience at Bellin Health, describes the 3 components of the advanced team-based care model, identifies the barriers that existed in the minds of multiple stakeholders (from patients to clinicians and Bellin executives) and describes the strategies that enabled them to overcome these barriers. Learn more.

Preliminary report: U.S. physician stress during the early days of the COVID-19 pandemic

This quantitative research evaluated the impact of COVID-19 on physician stress and mental health using a 10-item survey that assessed stress, fear of exposure, perceived anxiety/depression due to COVID and work overload. Learn more.

Prevalance and correlates of stress and burnout among us healthcare workers during the COVID-19 pandemic: a national cross-sectional survey study

This study evaluates stress related to COVID-19, with a particular focus on work roles and race and gender. The findings suggest stress is higher among nursing assistants, medical assistants, social workers, inpatient workers, women and persons of color is related to workload and mental health, and is lower when feeling valued. Learn more.

Measure

Practice Transformation: Measure

Measuring physician burnout, organizational efficiency and team culture is a key first step for health systems to improve professional satisfaction and team well-being. To support health systems in identifying key drivers of organizational stress, the AMA provides complimentary assessment services to organizations nationwide.

Physician burnout is largely attributed to organizational and systemic factors. Therefore, solutions must be identified and developed at the systems level. By measuring, organizations can (1) understand unique challenges to physician and care team well-being in their system and (2) develop strategies and solutions that can be targeted to the distinctive needs of their organization, physicians and care teams.


 

Mini-Z Burnout Assessment

The validated Mini-Z assessment assists organizations of all sizes to assess burnout and professional well-being.

 

Learn more

From professional burnout assessments to targeted intervention strategies, the AMA is pleased to support health care systems across the country with guided and validated solutions.

Learn more in the practice transformation toolkit (PDF) or contact us for additional information.

Act

Practice Transformation: Act

The AMA provides intervention support to health systems ready and able to test and share strategies that drive measurable progress and meaningful impact to improve satisfaction and efficiency in their workforce.

Support includes providing resources through STEPS Forward™, access to physician and subject matter experts, webinars, podcasts and on-line coaching and a platform to engage with other health systems implementing similar efforts.

AMA STEPS FORWARD™: Transform you practice

Nearly 60 modules⁠—expert-driven, field-tested strategies to help implement change in your practice.

Not sure where to start? Take a brief 12-question practice assessment to determine suggested modules to best optimize your practice.

Webinar series

The American Medical Association invites you to join our 2021 webinar series focusing on physician well-being, practice redesign and implementing telehealth during COVID-19. Programming will focus on resources and solutions to help alleviate stress on health care systems, teams and staff during the pandemic and guide systems through telehealth integration.

Register today or watch past webinar recordings.

Recognize

Practice Transformation: Recognize

Representing the AMA’s steadfast commitment to advancing the science of physician burnout, AMA’s recognition opportunities can propel and empower health systems to reduce burnout so that physicians—and their patients—thrive.

The AMA recognizes organizations and practices that have demonstrated strong commitment to improving physician satisfaction and reducing burnout.  

 

The Joy in Medicine™ Health System Recognition Program

Launched in 2019, the Joy in Medicine Health System Recognition Program provides a roadmap for health system leaders to implement programs, policies, and workflow efficiencies that support physician well-being and enhance joy in medicine. This program is designed to empower health systems to strategically and systematically reduce burnout so that physicians—and their patients—can thrive.

To learn more about the program guidelines and application cycles, visit the Joy in Medicine Health System Recognition Program.

Convene

Practice Transformation: Convene

By organizing virtual and in-person national conferences and events, the AMA brings together thought leaders and health systems for dialogue, consensus-building and collaborative sharing of best practices for improving physician professional satisfaction.

These immersive, educational opportunities are intended for physician and system leaders, practicing physicians and clinical staff, and academic researchers to assist in their transformation journey.

Webinars

AMA STEPS Forward™ webinar series

STEPS Forward webinar series

The AMA STEPS Forward™ webinar series provides interactive instruction from experts who address practical, actionable strategies to transform the medical field and your practice within it.

The webinar series is part of the AMA STEPS Forward™ Innovation Academy, designed to help physicians, care teams and health care leaders implement time-saving practice innovation strategies that promote joy in medicine, efficient use of technology, practice sustainability and quality patient care.

Visit AMA STEPS Forward™ for more information.

Conferences

International Conference on Physician Health

Oct. 13-15 | Hyatt Regency - Orlando, Florida

The International Conference on Physician Health™ (ICPH) is a collaborative meeting of the AMA, Canadian Medical Association (CMA) and British Medical Association (BMA).

The conference provides a forum for practitioners and researchers to present innovative methods and support systems, educational programs and recent research findings in the area of physician health. 

ICPH promotes an overall healthier culture for physicians by offering practical evidence-based solutions, practice skills and resources and tools for attendees to take back to their workplace and readily implement.

Please visit ICPH 2022 for more information on the conference or contact us at [email protected] with any questions.

American Conference on Physician Health

Oct. 7-9

The 2021 American Conference on Physician Health (ACPH) is a scientific conference sponsored jointly by the American Medical Association, Mayo Clinic and Stanford University. This event will elevate scientific research and discourse on health care system infrastructure and how organizations can help combat burnout and promote physician well-being. The conference agenda is determined by the abstract submissions for the conference.

Visit the ACPH conference for more detailed information on call for abstracts, registration, travel, agenda and speakers.

Practice transformation faculty speakers

Interested in having a speaker at your event? View the biographies (PDF) of AMA physician experts and contact us with required information.