As the threat of a doctor shortage continues in the U.S., Sutter Health has managed to drive down its physician turnover rate from 9% to 2–3% over three years while reducing burnout and saving clinical time hours. Its strategy? Creating an ecosystem that fosters a culture of learning, growing, education, leadership and curiosity-driven research.
Several of its programs seek to encourage physicians to be leaders, not just locally but also at the department, hospital and system levels, creating a leadership journey for them and supporting them throughout, said Todd Smith, MD, an orthopaedic surgeon in Modesto, California, and chief physician executive for Sutter Health, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
The nonprofit integrated health delivery system operates 28 acute care hospitals and more than 300 clinics and urgent care sites across Northern California.
Sutter Health focuses not only on its patients, but also on its people, looking for ways to support residents, fellows, physicians and other health professionals in their growth throughout their careers. Whether it's learning opportunities, or getting involved in graduate medical education, research or leadership, one of the things that sets Sutter Health apart is real commitment to physician leadership.
“It’s about creating leaders who help lead the organization, not just in theory but reality. What we're trying to do is create that lifelong home where you can grow, learn and expand in whatever line of service you’re interested in,” said Dr. Smith.
Adapting recruitment strategies
Sutter Health has been digging in deep on graduate medical education to become one of the leading trainers of residents and fellows in the state of California. The demand for physicians across specialties has gone up, especially those in acute care. In its quest to become the training program of choice, Sutter Health is focusing on how it can accelerate this over the long term to serve more patients across its integrated, community-based network.
“That’s across the specialties, and we're looking at the demands and the shortages as a focus for where and who we will train,” said Dr. Smith.
In fact, Sutter Health plans to train more than 200 residents a year in multiple physician specialties, increasing to almost 1,000 by 2030. The goal is to meet the needs and demands of its community and provide a growing and learning atmosphere that physicians and other health professionals can strive for as they continue to improve themselves and care for their patients, said Dr. Smith.
Sutter Health, which serves all 26 counties in Northern California, currently has residency programs across almost all its divisions and plans to expand offerings in the Central Valley and Oakland as well. The aim is to look across the organization and physician specialties that are needed, to provide training opportunities in multiple areas so more patients may benefit from care.
Remaining competitive in the market
Compensation and benefits play a role in every profession. It’s part of the entire package of professional development, said Dr. Smith.
Sutter Health keeps a very close eye on the market, using outside firms to assess fair market value and understand what the going rates are, which benefits it provides and what makes sense for the long term. This is to create a safety net so that physicians feel comfortable working at Sutter Health, are proud to be a member of the organization and are willing to recruit on behalf of the organization.
Recognizing well-being as a focus
In 2024, Sutter Health received recognition from the AMA Joy in Medicine® Health System Recognition Program, which empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive.
The Joy in Medicine recognition represents the hard work Sutter Health has done over the years to focus on well-being, which ties in with the recruitment and retention of physicians, said Dr. Smith.
In 2022, Sutter Health established an interdisciplinary well-being committee to assess and highlight all programs promoting well-being at the local, hospital or medical group level. Through this analysis, the health system developed a series of toolkits around retention to share best practices, said Dr. Smith.
As a result, physician burnout rates have declined from 33.9% in 2022 to 29.3% in 2023, which is “a pretty significant drop in a single year period and at a time when it's so valuable to really respect and retain everybody that's in the field,” he added.
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.
Using AI to drive job satisfaction
Technology is playing a growing role in improving job quality and supporting physician retention. Like other organizations, Sutter Health is exploring how augmented intelligence (AI)—also known as artificial intelligence—can be thoughtfully adopted to reduce administrative burden and allow physicians to focus more fully on patient care.
“We have leveraged and used AI predominantly around ambient listening, partnering with a company called Abridge to improve documentation and testing its use through research at Sutter,” he said.
Sutter Health started using Abridge’s ambient listening tool with a small pilot in early 2024 and more than 2,000 physicians and other health professionals have used the technology to date. Early pilot results showed about 78% of adoptees reported higher satisfaction in day-to-day work.
“With the technology itself, about 60% say that the notes are of better quality … and about 50% say that their cognitive load actually decreased, which allows them to really focus more on the patient and enjoy what they're doing,” said Dr. Smith.
Sutter Health also uses Epic’s automated response technology (ART), which pre-drafts responses to patient questions sent through Sutter’s online patient portal, allowing physicians and care teams to review and customize responses more efficiently. Deployed across the organization, ART has contributed to Sutter’s broader effort to improve efficiency—returning more than 1 million hours to physicians and staff in 2024 through a combination of automation, technology enhancements and streamlined workflows.
“It’s becoming key to how we practice every day and how we return some of the joy to medicine that the clinicians really deserve,” he said.
Keeping focus on the people
Ultimately, the goal of recruitment and retention is to “focus on the people,” said Dr. Smith. “If we provide the environment that allows the physicians to enjoy practicing at the top of their license, focus on what they do, provide them with the career path that allows them to continually grow and learn, you will provide that opportunity to have someone join and build a career.”
It’s also about developing an ecosystem where people want to keep improving in their clinical work. Give them a clear path forward on pursuing quality or people development work or moving into administration, he advised.
“Creating that ecosystem around which the physicians and clinicians can really continue to become better on a daily basis and know that they're supported—that's what I would focus on moving forward. We are in the people business after all,” said Dr. Smith.
