CCO: UW Health Following Best Practices for Physician Well-Being

The Wisconsin-based health system is using Stanford Medicine's well-being survey and following the Stanford Medicine Model of Professional Fulfillment.

UW Health is following clinician well-being best practices established by Stanford Medicine, the chief clinical officer of the Madison, Wisconsin-based health system says.

With a nation-wide shortage of physicians worsening, physician well-being programs are essential for retention and recruitment. In addition, physician burnout remains a concern across the country, and it spiked during the coronavirus pandemic. In a 2021 survey of physicians conducted by the American Medical Association, Mayo Clinic, and Stanford Medicine, 62.8% of physicians reported experiencing burnout symptoms, which was up from 38% the previous year.

When a physician's well-being is compromised, there are several negative effects, says Aimee Becker, MD, chief clinical officer at UW Health.

"When we look deeply at physicians in particular, certainly we know there is a financial impact to a lack of well-being and the presence of burnout," Becker says. "There is fluidity with physicians leaving the organization as well as recruitment and retention issues. There is also a lost opportunity when physicians are not well or burned out—their work is impacted. For example, there can be productivity and quality issues."

UW Health stepped up efforts to promote physician and advanced practice provider well-being in 2017, when the health system conducted its first physician and APP well-being survey as part of Stanford Medicine's Physician Wellness Academic Consortium. UW Health has repeated the survey every two years since 2017, Becker says. "It is challenging to make meaningful change without having data and metrics."

The Stanford Medicine well-being survey includes annual benchmarks for burnout and professional fulfillment. "The benchmark for burnout has risen since before the pandemic, and the benchmark for professional fulfillment is slightly lower than since before the pandemic," Becker says.

UW Health is using the well-being survey to monitor well-being trends in its physician and APP workforce.

"In our most recent survey, which was conducted in 2022, we rated at approximately the benchmark for the country," Becker says. "In general, our female physicians experience slightly more burnout than our male physicians, and female physicians experience slightly lower professional fulfillment than male physicians. In our APP group, those findings have been reversed, with our male APPs experiencing slightly more burnout and slightly lower professional fulfillment."

Programs that support physician and APP well-being

After UW Health started conducting the well-being survey, the health system committed to not only measuring wellness among physicians and APPs but also to acting on the measurements. UW Health developed a well-being committee that included physician and APP representation from all clinical departments. "They were tasked with helping us as an organization to identify initiatives to improve physician and APP well-being," Becker says.

Most of UW Health's well-being improvement initiatives for physicians and APPs have been consistent with the Stanford Medicine Model of Professional Fulfillment, Becker says. The model has three domains: culture of wellness, efficiency of practice, and personal resilience.

An example of promoting a culture of wellness in recent years is the health system's revamping of its Physician Leadership Development Program, which had been in place for more than a decade. UW Health partnered with the American Association for Physician Leadership to have a robust curriculum that offered a Certified Physician Executive pathway and credits for a Master's in Medical Management. The revamped Physician Leadership Development Program was implemented in 2020.

Examples of the leadership program's curriculum include conflict negotiations, constructive feedback, healthcare finance, emotional intelligence, and leading by influence.

"On average, we have had 25 physician leaders in each Physician Leadership Development Program cohort," Becker says. "As physicians have graduated from the program, they have advanced in the organization, whether that is in their clinical department or stepping into new roles at the health system."

Another example of promoting a culture of wellness at UW Health is an organization-wide peer support program that is a holdover initiative from the pandemic.

"We have physicians and APPs trained to provide peer support," Becker says. "The people who provide peer support are activated when there is a challenging work situation or when there is individual stressor burnout. There is comfort in being able to reach out to a peer to have a conversation when you are struggling with something."

An example of efficiency of practice initiatives at UW Health includes addressing burdens associated with the health system's electronic health record such as documentation and extra regulatory clicks in the EHR, which is Epic.

"This is a pain point for physicians and APPs," Becker says. "So, we have had some initiatives aimed at these burdens. One was implementing a remote scribe program for clinic-based physicians to ease documentation burdens, which improve efficiency of practice for these physicians."

To educate care teams about Epic and get feedback from care teams about using Epic, UW Health expanded the health system's physician informatics team to ensure that each clinical department had representation. "That was a big addition to support efficiency of practice," Becker says.

In the domain of personal resilience, UW Health is supporting staff members individually and helping them grow and develop.

"Emotional well-being resources are foundational for personal resilience," Becker says. "We are not relying on individuals to solve our well-being stressors and things that make healthcare challenging. For physicians, APPs, and other staff members, there is access to financial counseling. There are well-being initiatives for physical well-being. We are also supporting initiatives to promote connectedness and having fun. We also shine a light on mental health, including destigmatizing mental health challenges."