SGO Wellness: Does Gynecologic Oncology Spark Joy? Takeaways from the AMA’s Joy in Medicine Health System Recognition Program | Connor C. Wang, MD
Physician burnout continues to be a pervasive challenge across the U.S., affecting a significant portion of physicians and creating a ripple effect on the healthcare system.1 In response, the AMA introduced the Joy in Medicine Health System Recognition Program, a comprehensive initiative aimed at addressing systemic drivers of burnout and fostering professional well-being.2 This program provides a roadmap to improve wellness and also celebrates organizations that meet evidence-based benchmarks with national recognition.
The field of gynecologic oncology is no exception to these challenges. A 2015 society survey revealed an unacceptably high rate of burnout among U.S. gynecologic oncologists.3 More recent surveys, including the 2020 State of the Society survey, confirm that the problem persists, affecting not only physicians but also APPs and trainees.4–6 As specialists, we face unique challenges, from performing complex surgeries to providing compassionate care for patients with life-altering cancer diagnoses. The solutions offered by the AMA’s Joy in Medicine framework provide one pathway for change, and when combined with the SGO’s specialty-specific system-level recommendations, we have an opportunity and guidance to tackle burnout on multiple fronts.2,6
The AMA’s approach is anchored in six pillars designed to foster sustainable joy in medicine: assessment, commitment, efficiency of practice environment, leadership, teamwork, and support. Assessment involves using validated tools to identify systemic drivers of burnout, which will allow for targeted interventions, such as workflow redesigns. Fostering leadership commitment is a crucial step, and initiatives like appointing a Chief Wellness Officer or creating an office of well-being show how organizations can make physician wellness a strategic priority. For example, the Permanente Medical Groups have demonstrated how leadership can drive change by encouraging open conversations about well-being and implementing actionable strategies to support physicians at every level.2
Efficiency of practice is one of the most tangible areas to intervene. Organizations like Kaiser Permanente’s use of AI-powered medical scribes and the “Pebbles in the Shoe” campaign, designed to identify and address workflow bottlenecks, further underscore how small but thoughtful adjustments can lead to significant improvements in well-being. Teamwork and support systems also enhance efficiency, such as demonstrated by Sutter Health’s models that incorporate medical assistants as chaperones, scribes, and procedure aids can allow doctors to spend more time on patient care. The AMA also highlighted several peer support programs that connect doctors facing adverse events or personal challenges with trained colleagues who offer guidance and emotional support. This approach reduces the stigma around seeking help and creates a sense of community.2
The SGO review’s system-level recommendations build on these principles by offering solutions to the unique demands of our specialty.6 Predictable schedules, adequate staffing, and manageable clinical workloads are critical factors. For example, the University of Colorado’s adjustment to medical assistant-to-physician ratios reduced burnout while improving productivity, demonstrating how targeted staffing changes can make a measurable impact. The review also advocates for regular tracking of burnout metrics. Using validated tools ensures that interventions are data-driven. An example is exit interviews, which provide valuable insights to systemic barriers that lead to attrition, offering another avenue for targeted improvements. Similar to AMA’s recommendations, the SGO review similarly embraces mental health support as another critical area. Normalizing mental health discussions and
implementing opt-out counseling programs can increase provider engagement. Expanding telehealth options for mental health services and providing flexible schedules for appointments are essential steps in breaking down stigma and ensuring physicians have access to the resources they need. Lastly, administrative burdens, including prior auth requirements and compliance tasks, are a shared frustration across all specialties and can be another major target to intervene. Both the AMA and SGO emphasize the need to streamline workflows and optimize EMR. Examples include implementing validated clinical decision tools to reduce prior authorization delays and standardizing (or leveraging AI into) EMR templates to save time on documentation. Tailored training and metrics to track EMR usage further enhance efficiency and reduce administrative burdens.
Both the AMA and SGO emphasize institutionalizing wellness as a core organizational value. Embedding well-being into leadership training ensures a sustained focus on physician health. DEI is also integral to these efforts. Attention should be paid to targeted strategies to address gender and racial disparities in burnout. Interventions may include mentorship programs to support underrepresented groups, enhance workforce diversity, and improve satisfaction across the board.
By integrating the AMA’s six pillars with SGO’s specialty-specific strategies,2,6 health systems and institutions can address the common and unique aspects of burnout in gynecologic oncology. These strategies provide a blueprint for change. The gynecologic oncology practice demands technical expertise, resilience, and dedication. Burnout threatens to erode these qualities, but solutions to create a path forward are within reach. As SGO members, we have the opportunity to lead and sponsor these initiatives, advocating for systemic changes that cultivate supportive workplaces where we can continue to deliver compassionate care and spark joy in our profession.
Connor C. Wang, MD, is a Gynecologic Oncology Fellow at Northwestern University.
References
1. Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of burnout among physicians a systematic review. JAMA – Journal of the American Medical Association. 2018;320(11):1131-1150. doi:10.1001/jama.2018.12777
2. Medical Association A. RECOGNIZED ORGANIZATIONS 2024.; 2024.
3. Rath KS, Huffman LB, Phillips GS, Carpenter KM, Fowler JM. Burnout and associated factors among members of the Society of Gynecologic Oncology Presented at the 45th Annual Meeting on Women’s Cancer, Society of Gynecology Oncology, Tampa, FL, March 22-25, 2014. In: American Journal of Obstetrics and Gynecology. Vol 213. Mosby Inc.; 2015:824.e1-824.e9. doi:10.1016/j.ajog.2015.07.036
4. Davidson BA, Turner TB, Kim KH, et al. SGO and the elephant that is still in the room: Wellness, burnout and gynecologic oncology. Gynecol Oncol. 2022;167(2):354-359. doi:10.1016/j.ygyno.2022.08.018
5. Wang CC, Godecker A, Rose SL. Adaptive and maladaptive humor styles are closely associated with burnout and professional fulfillment in members of the Society of Gynecologic Oncology. Gynecol Oncol Rep. 2022;42. doi:10.1016/j.gore.2022.101020
6. Williams-Brown MY, Summey RM, Newtson A, et al. System-level recommendations for improved wellness for gynecologic oncologists: A Society of Gynecologic Oncology Review. Gynecol Oncol. 2024;183:85-92. doi:10.1016/j.ygyno.2024.03.019