Joy in Medicine Initiative: Bridging Physicians' Engagement Gap.

Abstract

A 2023 workforce engagement survey of employees at the Houston Methodist Physician Organization (HMPO) identified a widening engagement gap between physician and nonphysician staff members. A greater number of physicians reported disengagement, mirroring a national trend in declining engagement scores, than other employees. Recognizing that low levels of physician engagement can negatively impact physician retention, patient care, and organizational success, in 2024, HMPO launched a focused Joy in Medicine Initiative (JIMI) aimed at bridging the engagement gap. The JIMI workplan, led by the Office of Professional Fulfillment and Experience (ProFEx), incorporated several components, including a listening and learning (L&L) tour facilitated by the Chief Executive Officer, and applied qualitative and quantitative methods to gather insights directly from physicians and other nonphysician clinicians in the primary care group. This intentional approach to planning and executing the L&L sessions yielded an overall participation rate of 76% among 232 eligible patient care clinicians. Feedback revealed key drivers of engagement and joy, including timely schedules, organizational pride, strong team relationships, and institutional electronic health record support. A second method to gather feedback involved the use of a crowdsourcing approach that yielded 66 unique improvement ideas. A thematic analysis of the feedback gathered from both approaches provided a holistic picture of the factors driving physician disengagement, including administrative burden, in-network referral difficulties, and a lack of mental health support for patients. To assess fulfillment and burnout, ProFEx deployed a well-being survey for clinicians, which revealed high professional fulfillment for physicians, with burnout rates below, but near, benchmarks representing concerning levels for national academic health centers as established by the Healthcare Professional Well-being Academic Consortium (PWAC). ProFEx's findings underscored the need for a multifaceted approach to improve engagement while addressing burnout. ProFEx and HMPO leadership developed a strategy informed solely by input from physicians and nonphysician clinicians using the Stanford Professional Fulfillment Index, which considers three domains: culture of wellness, efficiency of practice, and personal resilience. In the first year of the strategy's execution, HMPO accelerated the deployment of ambient listening technology to reduce documentation burden and fostered personal and community resilience through the Houston Methodist (HM) network-wide JIMI events, such as commensality dinners. HMPO also launched a philanthropic mini grant program, daily team check-ins with leadership escalation (i.e., daily management system and tiered huddles) to enhance communication, and a peer support program to further strengthen the culture of well-being for HMPO clinicians. In 2025, HM secured bronze-level recognition in the American Medical Association's Joy in Medicine Health System Recognition Program. In the fall of 2025, ProFEx administered a second workforce engagement survey. Amongst primary care physicians who experienced a year of the JIMI strategy, survey results indicated improvements in engagement, alignment, safety culture, and safety. The JIMI offers actionable insights for other health care organizations.