Having a pebble in your shoe can be painful. Having 163 pebbles would be downright debilitating. Yet that was the reality faced by physicians, other health professionals and administrative staff at The Southeast Permanente Medical Group (TSPMG).
The medical group implemented a campaign in 2022 called "Pebbles in the Shoe." The goal was to garner feedback from employees about inefficiencies at work that could be leading to burnout, including any caused directly by the medical group's IT system.
That first year, 163 "pebbles" were submitted.
“It was eye-opening for us to see how many pebbles were frustrating our clinicians and admin staff day to day," said Ah Rim Shin, MD, a family doctor and physician lead of the medical group’s wellness committee. “We used those pebbles to share our well-being efforts that year as we composed a cross-departmental team of clinicians and admin staff to tackle the pebbles submitted."
The Southeast Permanente Medical Group is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine. TSPMG employs over 700 physicians to offer medical care to 300,000 patients in metropolitan Atlanta and Athens, Georgia.
Dr. Shin spoke about the pebbles campaign and how The Southeast Permanente Medical Group is using augmented intelligence (AI)— often called artificial intelligence—to help further reduce physician burnout in a recent episode of “AMA Update.”
Removing “pebbles” to reduce burnout
Dr. Shin understands the realities of physician burnout, having experienced it herself. She and her colleagues knew they wanted to get at the root of what was causing burnout at The Southeast Permanente Medical Group. That is why, in engagement surveys, they used specific questions about physician burnout to begin actively measuring it across the medical group.
The pebbles campaign provided a number of qualitative instances of how small burdens can create bigger problems. By beginning to address some of the pebbles, such as charting processes or staff shortages, the medical group was able to get physicians and other health professionals back to doing what they like most: being with their patients.
“One of the foundational aspects of quality care comes from that basic interaction between the patient and their physician," Dr. Shin said. “Patients don't come to the doctor just to have labs done or tests ordered. They come to the doctor to be listened to, to be treated as a unique individual, and to have a relationship with their physician."
More than 210 pebbles have been identified since the campaign began. Of that number, more than 35% of pebbles were related to an IT issue in one way or another. To help offset that percentage, Dr. Shin and her colleagues invited a member from the IT department to join the larger well-being committee.
Since joining the committee, the IT member has listened to different technology-related issues and provided suggestions for potential next steps to resolve the issue as quickly and effectively as possible.
From AI implementation to EHR adoption and usability, the AMA is making technology work for physicians, ensuring that it is an asset to doctors—not a burden.
The standard of care in physician well-being recognition
Institutions in this article have been honored by the Joy in Medicine™ Health System Recognition Program.
Bringing AI to the doctor's office
One tool the IT member helped with was an AI-driven ambient-listening tool that helped reduce charting time for physicians and their care teams.
The inspiration for the project came from The Permanente Medical Group's deployment of a similar AI tool for all physicians in Northern California. In that instance, an AI device listened to patients and physicians as they talked and summarized the transcript.
Physician leaders were excited to implement a similar tool at The Southeast Permanente Medical Group. The results, Dr. Shin said, have been overwhelming.
"What we saw were improvements of our clinicians' ability to juggle their workload," Dr. Shin said. "We also saw improvements in their ability to successfully balance work and personal life, and we also saw a reduction in our physicians who felt burned out on a daily basis."
One surprising line of responses related to how the AI tool aided human connection.
"Many of the clinicians actually said that the tool helped them to focus more on the patients in front of them rather than on the computer screen," Dr. Shin said. "And so, they stated that it helped increase enjoyment of their patient encounters."
Learn more about why The Southeast Permanente Medical Group says IT must be at the table to help reduce burnout.
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