Q&A: Kathleen Creason, CEO of Well Physician California

The California Medical Association, in collaboration with Stanford University, recently began a new initiative to target physician wellness and reduce burnout and attrition from the profession. Well Physician California aims to be the most comprehensive program in the country to increase physician wellness and ultimately improve the quality of care for patients.

State of Reform spoke with CEO Kathleen Creason about the initiative’s roots, programs, and goals.

Marjie High: Can you tell me a little bit more about the Well Physician California program?

Kathleen Creason: The program is a collaboration between the California Medical Association (CMA) and Stanford University to focus on the area of physician wellness. The issue had been identified as something that is significant in health care impacting physician levels of fulfillment, engagement, interactions with patients, etc.  So, CMA put forth a commitment of resources to support this endeavor which is very broad-based, comprehensive, and very multi-leveled, to address the issue of physician burnout.

There are a lot of statistics that demonstrate that physicians are experiencing challenges with burnout that are attributable to a number of different factors.  Primarily the administrative burdens that physicians are facing are at a much higher level than ever before. There is a disconnect between the desire to provide strong, appropriate, and relevant care to patients, which can be conflict with some profit motives or pressures from organizations. Also, the addition of electronic health records has added another twist to the patient interaction.

Our organization, Well Physician California, is a subsidiary of the California Medical Association and we’re working with key individuals at Stanford because they have done a great deal of research and work with data and analytics on the issue. They have developed a very large, comprehensive program that we are in the process of implementing.

The program is really two pronged. One, is supporting physicians, who can be anywhere along the spectrum of burn-out from the physician who is just really not excited to go to work today, to the physician who is in severe distress and thinking of leaving the practice of medicine. We have some individual programs and services that we will provide support to them to enhance their level of fulfillment and engagement.

The other aspect of the program addresses an organizational perspective. Acknowledging that there may be leadership influences, technology issues, and other situational aspects that are systemic factors contributing to the levels of physician burnout. For this, we will be working with organizations to submit surveys to physicians throughout the State of California to measure levels of burnout and identify systemic issues that are contributing factors.

This is all geared toward supporting physicians so that they can provide the best patient care possible.

MH: How can physicians go about accessing your programs or how would they get involved with the services?

KC: Well they can contact us – Well Physician California. The primary bulk of the resources will be available to physician members of the California Medical Association, but there will be a number of services that will be available to any physician that contacts us.

As an example we’ll have a peer support line. So if a physician is experiencing a situation, for example a medical malpractice lawsuit, and they just want to talk to somebody who has been through that, we are going to be agnostic on the membership requirement for that so any physician can call the peer support line and find engagement in that way. We’ll also have some on-line programs that are available – self-assessments, that type of thing – and information on resources that are available to physicians.

MH: Do you have any statistics on how physician burn-out is impacting the overall workforce – in terms of how many physicians does the profession lose to burn-out or to switching careers?

KC: I know that there have been some studies that have been done on that. The one that pops to mind as far as levels of burnout is a 2017 study that showed more than 50% of physicians self-identify as having at least one aspect of burnout. There is a very distinct trend that is seen between 1) levels of burnout and reduction of clinic hours and 2) leaving practice.

MH: Anecdotally you hear stories of this being a problem, but it is interesting to hear how specifically this may impact the workforce.

KC: Yes, I took this position about 6 months ago, before that I was the Executive Director of the Osteopathic Association here in California and I had a leader, a very well respected physician, who ended up leaving clinical practice. In retrospect, I realized it was because he was burned out. He was facing just oppressive administrative burdens and it conflicted with his concept of how he wanted to practice medicine and how he felt he was able to or not provide the best patient care. So that was a very specific example to me of someone who was just beloved by patients and well-respected by his peers. He was under 60 years old and had many clinical years in front of him. So yes – you say anecdotally – that was the perfect example.

MH: You hate to hear stories like that because it not only impacts the physician, but it impacts other physicians and other members of the workforce. Are there any other aspects of the program that you would like to highlight?

KC: The program is currently in development.  It is just a really exciting time because we are ramping up aggressively. Later this year we should have some good data to share.

MH: What types of outcomes are you looking to measure with the evaluation and data piece of the project?

KC: Well the survey that we are sending out is going to be focusing on several different areas to establish a base line within which the physicians indicate their level of fulfillment or burnout. It will look at some of the contributing factors: How is the quality of leadership within their organization? How is the level of work, the hours of work, the administrative burden? How are sleep issues affecting them? We will try to judge a variety of aspects from work scenarios to personal issues.

MH: So, is the idea that they will take advantage of some of Well Physician California’s services and then complete the survey again so you will be able to measure a beginning to an end?

KC: Yes – exactly. We are going to be conducting the survey on an annual basis so the goal is to measure and set baseline. Then we will introduce these various programs and services and roll out the survey again to measure whether and which of the programs had a measurable level of impact on burnout. Ultimately, we hope to show the program will help physicians conquer these issues, so they can do what they do best – care for patients.