Joy in Medicine? What 100 Healthcare Professionals Have to Say about Job Satisfaction, Dissatisfaction, Burnout, and Joy

Contents

Dedication

Foreword

Preface

Acknowledgments

Introduction

Section 1 Introduction

1. Sebastian P., MD, primary care physician and instructor of medicine
2. Miguel G., MD, former military medicine primary care physician; surgical resident in obstetrics and gynecology
3. Theodore B., RN, BSN, insurance company healthcare consultant
4. Emily P., MD, FACP, retired internist, and medical school teacher and mentor
5. Derek Van Amerongen, MD, vice president and medical director of Humana of Ohio
6. Neal G., MD, emergency medicine physician; family practice-urgent care physician and entrepreneur; and chief medical officer for his state’s federal health insurance program, retired
7. Mary R., MSN, perioperative educator
8. Rachel M., MD, pediatric radiologist and professor of radiology
9. David L., MD, MPH, ophthalmologist
10. Owen R., BS, MS, city director of emergency and safety services
11. Rebecca L., MS, retired psychologist in private practice
12. Grace Y., RN, operating room nurse

Passion for Leadership

13. Gary Kaplan, MD, chairman and CEO of Virginia Mason Health System and practicing internal medicine physician
14. Gene Lindsey, MD, retired physician and CEO emeritus of Atrius Healthcare
15. Mark Huth, MD, president, CEO, and family physician at Group Health Cooperative of South Central Wisconsin
16. Tom Foels, MD, MMM, chief medical officer of a not-for-profit health plan
17. Donald Lappé, MD, FACC, FAHA, executive director of the cardiovascular clinical program; chairman, cardiovascular department; and chief of cardiology at Intermountain Healthcare
18. Chris DeRienzo, MD, MPP, neonatologist and chief quality officer for a large integrated health system
19. Virginia J., MSN, RN, chief population health officer for an integrated health plan
20. Charleen Tachibana, DNP, RN, FAAN, health system senior vice president for quality and safety and chief nursing officer
21. Carol M., MD, hospital internist specializing in allergy/asthma; hospital executive director; director of graduate medical education; and medical director for provider services
22. Peter R., MD, former president and CEO of an integrated healthcare system; strategic advisor/consultant

Passion for Treating the Underserved Globally and Domestically

23. Laura Spero, MSW
24. Myron Glick, MD, family physician; founder and CEO of Jericho Road Community Health Center
25. Mark K., MD, primary care internist for a rural integrated health system
26. Andrew M., MD, professor of family medicine and family physician
27. Ruth F., BSN, public health nurse/community health nurse at a rural integrated health system
28. Eliot D., MD, internal medicine officer for a rural integrated health system
29. Paula C., MD, orthopedic hand surgeon
30. Angela DeVanney, BA, executive director of the AMD3 Foundation

Autonomy and Control

31. Amir F., MD, FACP, internist and vice president of a small internal medicine group practice
32. Cathy U., MSN, administrative director of perioperative services for a large academic medical center
33. Elana G., MD, pulmonary and critical care physician; medical director of an adult medical specialties group in an integrated health system
34. Harlan Z., MD, total joint replacement surgeon
35. Edward B., MD, medical director of an alcohol and drug detoxification program
36. Meghan Pillow, MSN, critical care nurse
37. Sarah D., MD, physician and practice manager of a small group gynecologic private practice
38. Kevin S., MD, senior vice president and chief medical officer for an integrated health plan
39. Haley N., MA, music therapist
40. Marianne S., PhD, counseling psychologist in private practice and adjunct professor
41. Irene J., MD, OB/GYN hospitalist for a small community hospital
42. Francine J., MD, internist in a solo concierge practice

Working in Multiple Roles

43. Anthony M. DiGioia, MD, orthopaedic surgeon and medical director of the UPMC Magee-Womens Hospital and the UPMC Innovation Center
44. Connie E., DNP, Level 2 staff nurse at a quaternary care pediatric hospital and assistant professor of nursing
45. Tyler M., MD, chief medical officer for an integrated health system
46. Joseph B., MD, retired professor, researcher, and practicing gastroenterologist; president of a board review company in gastroenterology; and head of a monthly gastroenterology journal club
47. Adam B., MD, pediatric pulmonologist and sleep specialist at a quaternary care children’s hospital
48. Caitlin G., MSN, assistant clinical professor, hospital and home care nurse, and PhD student
49. Monica T., MD, Assistant Professor of Pediatrics and Attending Neonatologist at a Quaternary Care Pediatric Hospital
50. Walter G., MD, general surgeon
51. Nancy W., RN, PhD, nurse, clinical psychologist, faculty member, and clinical consultant
52. Nicole A., MD, MPH, medical director of a neonatal intensive care unit at a quaternary care pediatric hospital
53. Amy I., MD, pediatrician and chief of staff for an integrated health system

Being Part of a Team

54. Justine M. BS, retired nurse manager
55. Gail M., BSN, BS, labor and delivery nurse
56. Eric Cannon, PharmD, FAMCPP, assistant vice president of pharmacy benefits
57. Jennifer F., MSN, nurse practitioner for an integrated health system
58. Angela R., retired medical assistant/office manager
59. Dana D., LICSW, clinical social worker at a pediatric hospital

60. Karen L., MSN, board-certified family nurse practitioner at an academic medical center

61. Gloria K., MSW, hospital neonatal intensive care unit social worker

62. Sharon D., BSN, perioperative nurse and operating room educator

63. Vivian G., PhD, psychotherapist in private practice

Section 2 Introduction

64. Charles G., MD, radiologist

65. Jamie Cieplinski, RN, clinical unit leader and floor nurse at a community hospital

66. Carrie L., MD, emergency medicine physician

67. Paul T., MD, neurosurgery resident

68. Leonard R., MD, pediatric radiology resident

69. Ruby A., MSN, pediatric nurse practitioner at a federally qualified health center

70. Raymond J., MS, emergency medical technician, director of operations for an ambulance transportation company, and captain of an emergency medical services provider

71. Wayne K., MPH, part-time volunteer emergency medical services technician

72. Anthony F., MD, internist, associate medical director for the insurance division of an integrated health system, and adjunct associate professor of medicine

73. Margaret E., LCSW/PAC, physician assistant for an integrated health system

74. Melanie C., MD, pediatrician in private practice

75. Victoria N., DNP, MSN, FNP, nurse practitioner and director of a university health clinic

76. Stephan D., MSW, senior therapist, city department of health and community services

77. Alice H., MSN, nurse, surgical services educator

78. Craig M., Registered polysomnography technologist and manager of a pediatric hospital sleep laboratory

79. Lawrence W., MD, retired obstetrician/gynecologist and professor of obstetrics/gynecology at an academic medical center

80. Lisa W., MSN, family nurse practitioner in a small internal medicine group practice

81. Tina J., radiographer/assistant director of radiology at an academic medical center

82. Helen H., environmental services associate for an academic medical center

83. Judith S., MSW, retired clinical social worker

84. Bonnie M., RN, hospital neonatal intensive care bedside nurse

Section 3 Introduction

85. Diane L., MD, rheumatologist in solo private practice

86. Michael V., MD, endocrinologist, professor of medicine, and senior staff physician at an integrated health system

87. Natalie B., MD, obstetrician/gynecologist

88. Harold J., MD, surgeon in urology

89. Charlotte J., MD, internist in private practice

90. Jacqueline M., MD, internist, attending physician, and assistant professor of medicine

91. Gregory C., MD, vice chief of staff of a large suburban community medical center; hospital informaticist; and director of provider relations

92. William C., MD, neurologist in private practice

93. Sydney G., MD, MPH, retired critical care pediatrician

94. Rose S., internal medicine physician, medical director of a subacute rehabilitation/skilled nursing facility

95. Theresa E., licensed physical therapist for a large integrated health system

96. Daniel M., MD, psychiatrist in private solo practice

97. Sophia L., MSW, clinical social work student

Section 4 Introduction

98. Paul DeChant, MD, MBA, author, speaker, and coach in reducing physician burnout

99. Bridget Duffy, MD, Chief Medical Officer, Vocera Communications, Inc.

100. Alan Frankel, MD, Managing Partner of Safe and Reliable Care

Biography

Eve Shapiro, Principal, Eve Shapiro Medical Writing, Inc. is a Bethesda, MD-based medical writer dedicated to improving healthcare delivery, patient safety, and the quality of care by focusing on the factors that put physicians at the "sharp end" of badly designed systems and put patients at risk for unintended consequences and adverse events that often result.

Ms. Shapiro has written and edited more than 150 journal articles, feature articles, reports, white papers, toolkits, books, fact sheets, and brochures for print and Web publication on medical issues for clinicians, health care leaders, administrators, researchers, policymakers, the media, and the general public. Topics include patient safety, medical ethics, medical errors, patient-centered care, systems improvement, transitions in care, physician-patient communication, preventive care, hand hygiene, alcohol and drug abuse, juvenile justice, and psychiatry.

Most recently, Ms. Shapiro has coauthored the book, The Patient Centered Value System: Transforming Healthcare Through Co-Design, published in September 2017 by CRC/Productivity Press.

"Eve Shapiro, in this important book, has contributed two very meaningful insights.　 First, she has relayed the stories of 100 health professionals in their own words and has given us all a framework within which we can make sense of their stories. Second, she has engaged two powerful currents—burnout within health care and the worst public health challenge in a century—and has given us a reason for hope.　This is a book all health professionals, as well as those in the public who care about their welfare, should read."

John R. Ball, MD, JD, MACP
Executive Vice President, Emeritus, American College of Physicians
Former Chair, Mission Health System, Asheville, NC
　

"In Joy in Medicine?, Eve Shapiro provides unique and valuable insights into understanding the challenge of clinician burnout. We will not fix the myriad problems in healthcare without a deep understanding of what contributes to both joy and burnout. Her in-depth interviews with clinicians provide insights that every healthcare leader needs to understand if they are serious about being part of the solution, rather than part of the problem."

Paul DeChant, MD, MBA
Author, Executive Coach, and Prior CEO, Sutter Gould Medical Foundation

"A growing body of research about the physician/caregiver experience identifies the causes, consequences, and remedies for physician burnout and the factors most highly related to physician joy and fulfillment. While this research is certainly informative, in my view, in Joy in Medicine? What 100 Healthcare Professionals Have to Say about Job Satisfaction, Dissatisfaction, Burnout, and Joy, Eve Shapiro’s narrative approach, using firsthand interviews that illuminate real people in real settings, yields rich, qualitative information that has a much greater potential to impact physicians, teams, and organizations.

"Those she interviewed share their stories—about highs and lows in their careers, their frustrations and stresses, their joys and satisfaction—and they offer advice to others who seek fulfillment in the practice of medicine. Stories are like pollen. They engage and persuade. They move people to action. They spark conversations with ourselves and others. The stories shared in Eve’s book have that power. Individuals and organizations can use this book to understand and support caregivers and to identify and pursue improvement initiatives in our quest to achieve human-centered care and a gratifying caregiver experience."

Wendy Leebov, Ed.D.
Author, Creator of Language of Caring
www.languageofcaring.org

"Eve’s Shapiro’s book, Joy in Medicine?, is a call to action to save lives: lives of patients and families, and lives of physicians, nurses, and all stakeholders inside (and outside) the traditional healthcare system. Eve interviews 100 men and women who work in the healthcare industry in our country today. She listens to understand, she reflects, and she shares their wisdom and insight (and her own) with the reader. Joy in Medicine? will teach healthcare leaders, people on the front lines of healthcare, patients and families, and communities what must be done to achieve betterment and bring joy back into medicine."

Thomas H.　Dahlborg, MSHSM
President, Dahlborg Healthcare Leadership Group (DHLG)
Director Health Care, Global Listening Centre　Board　(India)