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Which physician has the highest burnout? How does gender affect burnout? Why is mental health important for health care workers?
Our guest, Mary Pan, MD, family medicine physician and chief wellness officer at the Washington Permanente Medical Group, discusses the ongoing issue of burnout among women physicians, the persistent gender gap in burnout rates and outlines innovative health care support systems like physician mentorship and peer support to improve the well-being of doctors. Dr. Pan shares insights from the AMA's Mini-Z Survey, which shows that while burnout rates are decreasing, women still experience higher levels of burnout compared to men—especially when it comes to work done outside of regular hours. AMA Chief Experience Officer Todd Unger hosts.
- The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most—patients. We will meet this challenge together. Join us.
- Find more physician burnout statistics in the AMA’s survey.
- Read more about the gender differences in burnout.
- Check out AMA's Joy in Medicine™ Health System Recognition Program.
- AMA Joy in Medicine™ Roadmap.
- Access the AMA Organizational Biopsy (PDF).
- AMA EHR burnout resources available.
- Learn more about the AMA Health System Program.
- Learn more about our AMA advocacy priorities, including:
- Reforming Medicare payment
- Fighting scope creep
- Fixing prior authorization
- Reducing physician burnout
- Making technology work for physicians
Speaker
- Mary Pan, MD, family medicine physician and chief wellness officer, Washington Permanente Medical Group
Transcript
Dr. Pan: Investing in clinician well-being, I realized early on, would really make the biggest difference to moving toward a health care culture that provides excellent care for patients, as well as focusing on the workforce sustainability.
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about ways to improve the well-being of women physicians to help close the gender gap in physician burnout. Our guest today is Dr. Mary Pan, a family medicine physician and chief wellness officer at the Washington Permanente Medical Group in Seattle, Washington. I'm Todd Unger, AMA's chief experience officer in Chicago. Welcome, Dr. Pan. Good to have you today.
Dr. Pan: Yeah, it's a pleasure to be here.
Unger: Well, despite the decrease in burnout that we saw last year, we continue to see a gap in the burnout rate between men and women. An AMA survey found that nearly 55% of women are feeling burnout, compared to 42% of men. I'm curious. For starters, are you seeing that same trend in your own organization?
Dr. Pan: Yes, we are. For three years, we've used the AMA's Mini Z survey, which is a validated measure of burnout and well-being in practicing clinicians. And we've seen a very similar trend. What we like about the survey is that it's actionable and really gives us the most effective interventions that we can do for different groups, such as our women physicians.
So we've seen year over year a gap between the women and men, rates of burnout. But we've also seen a decrease in that gap year over year, which is a positive thing to see, that our interventions are working.
Unger: Well, good. I'd like to understand more about what those innovations look like. It sounds like one way that you're hoping to close the gap is by taking steps to reduce what we call, the technical term, pajama time. Or that's work outside of work. And sometimes at night when you're getting the kids to bed, and then it's supposed to be your time, but no. Tell us about how you are helping to reduce that pajama time.
Dr. Pan: Yeah, so it's interesting. At our organization, we did actually find similar rates of work outside of work or that pajama time, as you mentioned, between men and women clinicians. But the burden of this is more acutely felt by our women. So we saw with both groups the number one thing that would keep them at their current hours was staffing. But for female physicians, number two was less work outside of work, and number three was less documentation.
So that really tells us that part of addressing this gap between men and women is taking a holistic approach to the disproportionately experienced burden of work outside of work on women. So that includes some long-term interventions of systems that reduce that burden, such as ambient AI, artificial intelligence assistance, adequate staffing and resources, and improved teamwork. But we've also built support around individuals and teams that are aimed directly at supporting our women clinicians. And that includes some coaching and peer support as well.
Unger: Tell us a little bit more about what that peer support and coaching looks like.
Dr. Pan: Yeah, so in addition to, right now, launching our fourth women's coaching cohort, that includes both individual and group coaching and a asynchronous professional development platform, which our previous cohorts have really benefited from. We've also established an internal individual coaching program for our local operational leaders, many of whom are our women leaders and newer to that operational leadership position.
We also have a senior women's leadership group that meets quarterly. So all of our board members, our executive women leaders. We meet in person quarterly, as well as our broader women clinicians group, called the Yin of Medicine. And that is establishing a yearly conference and monthly podcast discussion groups to build connection and collegiality, mentoring, and sponsorship among our women clinicians.
Unger: Oh, really interesting. Well, it sounds like a lot of the things that you're putting in place are working. Probably one of the reasons why your organization was recognized by the AMA Joy in Medicine™ Health System Recognition Program for your well-being efforts. Have you seen those efforts impact your female physicians in any kind of different way?
Dr. Pan: Yes, we have. I think, you know, we really appreciate the Joy in Medicine™ Health System Recognition Program because it provides an evidence-based roadmap for organizations to really make an impact in a comprehensive approach to clinician well-being. So, it's kind of a scaffolding for organizations.
And we've used that approach to identify particular needs of different groups, including our women clinicians. And as I mentioned earlier, seeing that decrease in gap between the burnout rates between men and women clinicians year over year has really shown that those interventions that we've enacted have made the difference.
Unger: Dr, Pan, I'm just curious. After listening to this conversation, you know, what is it that inspired you personally to take on a leadership role like this in increasing physician well-being, and in particular, what we're talking about today among women?
Dr. Pan: That's a great question. When I was going through my training, my medical training, there was no such type of position in existence. And I'm 15 years into my career now, so a little bit mid-career. But even early on, I'd say I noticed rapid changes and challenges in healthcare that were affecting all of us.
I'm in primary care. But even my, you know, surgeon colleagues, we really saw a lot of changes. When I started my training, there were paper charts, no electronic health record, no email messages or inbox messages. And now, a huge portion of our work is through the electronic health record and virtual care.
So for all of us in medicine, you know, we've really seen the competing demands and inequities, especially for women, in and outside of the workplace. So I also have three children and elderly parents, and part of that sort of sandwich generation of working women. And investing in clinician well-being, I realized early on, would really make the biggest difference to moving toward a health care culture that provides excellent care for patients, as well as focusing on the workforce sustainability.
Unger: It's kind of interesting perspective for you to have seen the kind of the before and after. Because we know a lot of these technological advances maybe weren't developed necessarily with physicians in mind and have led to a lot of that burnout. I mean, how do you kind of factor in your experience of the before and after into your approach now?
Dr. Pan: So it's interesting that you asked that question. You know, right now, ambient AI is a big thing that a lot of organizations are implementing, including my own. And I think seeing those changes and very different than when the electronic health record was first developed. I think not taking that clinician viewpoint into mind, but now with ambient AI, they really are.
They're thinking about, OK, what user ability for our clinicians, for our what we call the individual contributors, or people who are front and center with the patient and providing patient care, what is this experience like? And how can we make that more streamlined and more efficient for the user? So, I think that, that approach has changed in recent years.
Unger: Absolutely. Speaking of the new year, now that we're into 2025, what are you most looking forward to?
Dr. Pan: We have a lot coming in 2025, a lot of our programs and tactics that we're rolling out. But one of the things that I'm most excited about is the Wellness Dashboard that we're developing to use across multiple Kaiser Permanente regions. And that's really exciting because it's having a way to bring clinician and staff well-being front and center for our leaders, both our executive leaders and our operational leaders. And it's important to really ensure that the interventions that we are enacting are meaningful and to guide our work to address the most pressing areas of need.
Unger: That does sound like something to look forward to seeing in the coming year. Dr. Pan, thank you so much for joining us today. And we're going to look forward to seeing what you accomplish in 2025. If you're a health system leader, you can learn more about the AMA Joy in Medicine™ and how it can help you improve physician well-being. Visit ama-assn.org/joy and join the 130 other health systems that we've recognized for their well-being efforts.
That wraps up today's episode. And we'll be back soon with another AMA Update. Be sure to subscribe for new episodes. And find all our videos and podcasts at ama-assa.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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