“Whatever the nature of our wounds, we heal to be healed.”
Anthony Suchman and Dale Matthews

Earlier this year, the Editor’s Clipboard featured a look at physician satisfaction and burnout, a topic that is gaining national attention and momentum.
 
Many experts link professional burnout with those activities that interfere with the “why” we became physicians, isolating us from our colleagues and an empathic relationship with our patients. These two recent articles (Evolutionary Pressures on the Electronic Health Record and Five People) in JAMA highlight these barriers and the importance of the physician-patient relationship.
 
We spoke to the difficulty in sustaining both individual and organizational purpose that TOMS: One for One experienced as the company worked to better deliver its product -- shoes and now glasses -- or the “what.” These two, the why and the what, are not mutually exclusive.
 
Daniel Pink, in “Drive,” writes about autonomy and mastery as prime motivating and sustaining factors in complex tasks. Amabile and Kramer, in “The Progress Principle,” speak to the nourishment factor of accomplishment (clear goals, autonomy and adequate resources) with interpersonal support, respect and collegiality. Atul Gwande, in “Better,” illustrates the importance of data to quantify opportunity and progress, in describing Dr. Virginia Apgar’s scoring system for at-risk newborns. He challenges us to embrace a bias for action and to begin by “counting something” as a first step of making the “what” better, a tenet shared by our continuous improvement efforts.
 
Last month, our most popular article featured Drs. Kristina Newport and Shanthi Sivendran, and the organic growth of a young physicians’ social group. Using social media, this group connects and frequently meets, without the burden of agendas, administration oversight or excessive cost. It is flexible enough to accommodate diverse and challenging schedules, and available to physicians regardless of where they deliver care. The collegial environment is an opportunity to share and connect outside of our professional responsibilities. I understand you are only excluded if you have a phone with big numbers. Kudos for a “what” well done.
 
This month’s issue features articles on two physician leaders, Dr. Rick Donze, CMO of Chester County Hospital, and Dr. P.J. Brennan, CMO for the Penn Medicine system. The med staff at CCH is similar to LGH, with a large number of non-employed physicians. While Rick has an unassuming demeanor, the system’s operational and clinical quality belie his passion for better care delivery. Dr. Brennan, whose background is in ID and quality, has many interests outside the hospital setting, including baseball and history. He has facilitated Rick’s and my entry into the Penn system.
 
Enjoy this month’s Progress Notes!

Monty

Lee M. Duke II, M.D.
Chief Physician Executive
Progress Notes' Editor-in-Chief
LMDuke@lghealth.org

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