Table of Contents
Foreword xiii
Preface xix
Acknowledgments xxv
About the Author xxvii
Introduction xxix
Part I What Promotes Joy 1
Introduction to Part 1 1
Passion for the Work 2
1 Sebastian P., MD, Primary Care Physician and Instructor of Medicine 2
2 Miguel G., MD, Former Military Medicine Primary Care Physician; Surgical Resident in Obstetrics and Gynecology 8
3 Theodore B., RN, BSN, Insurance Company Healthcare Consultant 15
4 Emily P., MD, FACP, Retired Internist and Medical School Teacher and Mentor 19
5 Derek van Amerongen, MD, Vice President and Medical Director of Humana of Ohio 26
6 Neal G., MD, Emergency Medicine Physician; Family Practice and Urgent Care Physician and Entrepreneur; and Chief Medical Officer for His State's Federal Health Insurance Program, Retired 32
7 Mary R., MSN, Perioperative Educator 40
8 Rachel M., MD, Pediatric Radiologist and Professor of Radiology 48
9 David L., MD, MPH, Ophthalmologist 51
10 Owen R., BS, MS, City Director of Emergency and Safety Services 57
11 Rebecca L., MS in Clinical School Psychology, Retired Psychologist in Private Practice 60
12 Grace Y, RN, Operating Room Nurse at a Large Academic Medical Center 64
Passion for Leadership 70
13 Gary Kaplan, MD, Chairman and CEO of Virginia Mason Health System and Practicing Internal Medicine Physician 70
14 Gene Lindsey, MD, Retired Physician and CEO Emeritus of Atrius Healthcare 75
15 Mark Huth, MD, President, CEO, and Family Physician at Group Health Cooperative of South Central Wisconsin 82
16 Thomas Foels, MD, MMM, Chief Medical Officer of a Not-for-Profit Health Plan 88
17 Donald L. Lappe, MD, FACC, FAHA, Executive Director of the Cardiovascular Clinical Program; Chairman, Cardiovascular Department; and Chief of Cardiology at Intermountain Healthcare, Salt Lake City, Utah 94
18 Chris DeRienzo, MD, MPP, Neonatologist and Chief Quality Officer for a Large Integrated Health System 99
19 Virginia J., MSN, RN, Chief Population Health Officer for an Integrated Health Plan 102
20 Charleen Tachibana, DNP, RN, FAAN, Health System Senior Vice President for Quality and Safety and Chief Nursing Officer 107
21 Carol M., MD, Hospital Internist Specializing in Allergy/Asthma, Hospital Executive Director, Director of Graduate Medical Education, and Medical Director for Provider Services 113
22 Peter R., MD, Former President and CEO of an Integrated Healthcare System and Strategic Advisor/Consultant 116
Passion for Treating the Underserved Globally and Domestically 119
23 Laura Spero, MSW 119
24 Myron Glick, MD, Family Physician and Founder and CEO of Jericho Road Community Health Center 128
25 Mark K., MD, Primary Care Internist for a Rural Integrated Health System 134
26 Andrew M., MD, Professor of Family Medicine and Family Physician 141
27 Ruth E, BSN, Public Health Nurse/Community Health Nurse at a Rural Integrated Health System 146
28 Eliot D., MD, Internal Medicine Officer for a Rural Integrated Health System 150
29 Paula C, MD, Orthopedic Hand Surgeon 154
30 Angela DeVanney, BA, Executive Director of the AMD3 Foundation 158
Autonomy and Control 160
31 Amir F., MD, FACP, Internist and Vice President of a Small Internal Medicine Group Practice and Chair of a Group of 25 Practices Based on the Patient-Centered Medical Home 160
32 Cathy U., MSN, Adrninistrative Director of Perioperative Services for a Large Academic Medical Center 166
33 Elana G., MD, Pulmonary and Critical Care Physician and Medical Director of an Adult Medical Specialties Group in an Integrated Health System 170
34 Harlan Z., MD, Total Joint Replacement Surgeon 175
35 Edward B., MD, Medical Director of an Alcohol and Drug Detoxification Program 181
36 Meghan Pillow, MSN, Critical Care Nurse 184
37 Sarah D., MD, Physician and Practice Manager of a Small Group Gynecologic Private Practice 188
38 Kevin S., MD, Senior Vice President and Chief Medical Officer for an Integrated Health Plan 193
39 Haley N., MA, Musk Therapist 197
40 Marianne S., PhD, Counseling Psychologist in Private Practice and Adjunct Professor 200
41 Irene J., MD, OB/GYN Hospitalist for a Small Community Hospital 203
42 Francine J., MD, Internist in a Solo Concierge Practice 207
Working in Multiple Roles 210
43 Anthony M. DiGioia, MD, Practicing Orthopaedic Surgeon and Medical Director of the UPMC Magee-Womens Hospital and the UPMC Innovation Center 210
44 Connie E., DNP, Level 2 Staff Nurse at a Quaternary Care Pediatric Hospital and Assistant Professor of Nursing 215
45 Tyler M., MD, Chief Medical Officer for an Integrated Health System 219
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 223
47 Adam B., MD, Pediatric Pulrnonologist and Sleep Specialist at a Quaternary Care Children's Hospital 227
48 Caitlin G., MSN, Assistant Clinical Professor and Hospital and Home Care Nurse, and PhD Student 232
49 Monica T., MD, Assistant Professor of Pediatrics and Attending Neonatologist at a Quaternary Care Pediatric Hospital 235
50 Walter G., MD, General Surgeon 239
51 Nancy W., RN, PhD, Nurse, Clinical Psychologist, Faculty Member, and Clinical Consultant 242
52 Nicole A., MD, MPH, Medical Director of a Neonatal Intensive Care Unit at a Quaternary Care Pediatric Hospital 248
53 Amy I., MD, Pediatrician and Chief of Staff at an Integrated Health System 254
Being Part of a Team 262
54 Justine M., BSN, Retired Hospital Nurse Manager 262
55 Gail M., BSN, BS, Hospital Labor and Delivery Nurse 267
56 Eric Cannon, PharmD, FAMCPP, Assistant Vice President of Pharmacy Benefits for an Integrated Health System 270
57 Jennifer E, MSN, Nurse Practitioner for an Integrated Health System 275
58 Angela R., Retired Medical Assistant/Office Manager 280
59 Dana D., LICSW, Clinical Social Worker at a Pediatric Hospital 284
60 Karen L., MSN, Board-Certified Family Nurse Practitioner at an Academic Medical Center 287
61 Gloria K., MSW, Hospital Neonatal Intensive Care Unit Social Worker 289
Finding Work-Life Balance 294
62 Sharon D., BSN, Perioperative Nurse and Operating Room Educator 294
63 Vivian G., PhD, Psychotherapist in Private Practice 299
Part 2 What Diminishes Joy 303
Introduction to Part 2 303
Pressure, Stress, and Fatigue 304
64 Charles G., MD, Radiologist 304
65 Jamie Cieplinski, RN, Clinical Unit Leader and Floor Nurse at a Community Hospital 308
66 Carrie L., MD, Emergency Medicine Physician 312
67 Paul X, MD, Neurosurgery Resident 316
68 Leonard R., MD, Pediatric Radiology Resident 318
69 Ruby A., MSN, Pediatric Nurse Practitioner at a Federally Qualified Health Center 322
70 Raymond J., MS, Emergency Medical Technician, Director of Operations for an Ambulance Transportation Company, and Captain for an Emergency Medical Services Provider 327
71 Wayne K., MPH, Part-Time Volunteer Emergency Medical Services Technician 335
72 Anthony F., MD, Internist, Associate Medical Director for the Insurance Division of an Integrated Health System and Adjunct Associate Professor of Medicine 340
73 Margaret E., LCSW/PAC, Physician Assistant for an Integrated Health System 348
74 Melanie C, MD, Pediatrician in Private Practice 352
75 Victoria N., DNP, MSN, FNP, Nurse Practitioner and Director of a University Health Clinic 356
Administrator-Clinician Disconnect 360
76 Stephan D., MSW, Senior Therapist, City Department of Health and Community Services 360
77 Alice H., MSN, Nurse and Surgical Services Educator 364
78 Craig M., Registered Polysomnography Technologist and Manager of a Pediatric Hospital Sleep Laboratory 370
79 Lawrence W., MD, Retired Obstetrician/Gynecologist and Professor of Obstetrics/Gynecology in an Academic Medical Center 375
80 Lisa W., MSN, Family Nurse Practitioner in a Small Internal Medicine Group Practice 378
Disrespect 384
81 Tina J., Radiographer and Assistant Director of Radiology at an Academic Medical Center 384
82 Helen H., Environmental Services Associate for an Academic Medical Center 389
83 Ludith S., MSW, Retired Clinical Social Worker 392
84 Bonnie M., RN, Hospital Neonatal Intensive Care Bedside Nurse 397
Part 3 What Destroys Joy 403
Introduction to Part 3 403
Lack of Autonomy and Control 404
85 Diane L., MD, Rheumatologist in Solo Private Practice 404
86 Michael V., MD, Endocrinologist, Professor of Medicine, and Senior Staff Physician at an Integrated Health System 409
87 Natalie B., MD, Obstetrician/Gynecologist 415
88 Harold J., MD, Surgeon in Urology 419
89 Charlotte J., MD, Internist in Private Practice 423
Lawsuits 424
90 Jacqueline M., MD, Internist, Attending Physician, and Assistant Professor of Medicine 424
91 Gregory C, MD, Vice Chief of Staff of a Large Suburban Community Medical Center, Hospital Informaticist, and Director of Provider Relations 431
92 William C, MD, Neurologist in Private Practice 439
Moral Distress 445
93 Sydney G., MD, MPH, Retired Critical Care Pediatrician 445
94 Rose S., MD, Internal Medicine Physician and Medical Director of a Subacute Rehabilitation/Skilled Nursing Facility 450
95 Theresa E., Licensed Physical Therapist for a Large Integrated Health System 455
96 Daniel M-, MD, Psychiatrist in a Private Solo Practice 461
97 Sophia L., MSW, Clinical Social Work Student 468
Part 4 What the Experts Have to Say 477
Introduction to Part 4 477
Lessons From the Field 478
98 Paul DeChant, MD, MBA, Author, Speaker, and Coach in Reducing Physician Burnout 478
99 Bridget Duffy, MD, Chief Medical Officer, Vocera Communications, Inc 480
100 Allan Frankel, MD, Managing Partner of Safe and Reliable Care 483
