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Chief Wellness Officer Road MapImplement a Leadership Strategy for Professional Well-Being

Learning Objectives
1. Define your scope as a new Chief Wellness Officer (CWO)
2. Describe how to set an organizational strategy for wellness
3. Identify how to avoid common pitfalls as a new CWO
How Will This Toolkit Help Me?

This toolkit will help individuals develop and succeed in the chief wellness officer (CWO) position at their health care organization by providing a step-by-step guide for defining the scope, building a team, identifying resources, developing a strategy, establishing partnerships, setting performance metrics, and avoiding common pitfalls.


Leading organizations are creating a new C-level executive position called the chief wellness officer (CWO) to systematically improve well-being among physicians and other health care professionals. Once the organization has established the position and chosen a CWO, the CWO must implement specific and effective strategies for change. For individuals wanting to learn how to lay the foundation for such a position at their organization, visit the STEPS Forward® toolkit, Establishing a Chief Wellness Officer Position. For new CWOs, this toolkit is designed for you, outlining a step-by-step approach to executing and succeeding in your new role.

Nine STEPS for Leading Change as a New Chief Wellness Officer (CWO)

  1. Clearly Define Your Scope and Charge

  2. Study and Understand Your Organization

  3. Build Your Team

  4. Identify Existing Organizational Programs, Gaps, and Resources

  5. Define and Develop Your Team's Mission and Strategy

  6. Establish Partnerships, Thematic Task Forces, and Distributed Leadership

  7. Develop a Bidirectional Communication Strategy

  8. Set Performance Metrics for the Organization and the Team

  9. Avoid Common Pitfalls and Mistakes

STEP 1 Clearly Define Your Scope and Charge

When assuming your CWO leadership position, an important first step is to be clear about your scope and charge. Chief wellness officer roles in health care organizations fill a gap in an organization's efforts to build a practice environment that cultivates engagement, well-being, and esprit de corps.1 In industries like manufacturing or technology, the human resources department typically houses the CWO role; their primary purpose is to reduce health care expenditures by encouraging healthy lifestyles and individual approaches to foster stress reduction and personal resilience. CWOs in these organizations typically oversee all employees, including any number of what could be vastly different job descriptions, each with their own obstacles to reducing stress. The original focus of CWO roles in organizations like these, coupled with the need to reach all workers in dramatically different job types, generally results in efforts focusing on the individual (eg, personal resilience, mindfulness, exercise, self-care, etc.).

The health care CWO has a dramatically different role and function.1,2 While individual well-being resources are still important, the health care CWO's main focus is on addressing the unique needs of health care professionals by improving the efficiency of the practice environment, reducing unnecessary administrative burdens, supporting work life integration for clinicians, and improving organizational culture.3 Examples include4:

Your organization should have already decided whether the CWO position is responsible for physician well-being only or if it is responsible for the well-being of other members of the health care team, as well. Whatever your organization decides, keep your focus on the target group. Much of the CWO's work intersects with efforts of other functions within the health care organization; it is also necessary to coordinate efforts with these areas.


As CWO, you and your team will set the strategic vision of why and how the organization will improve the work environment to advance the well-being of health care professionals. This project will involve making the needs of physicians and other clinicians a fundamental consideration in all organizational decisions. CWOs must oversee the development and execution of the organization-wide strategy to advance professional well-being and lead the implementation of numerous targeted initiatives and tactics.1 There are many potential improvement opportunities, and no CWO or organization can take them all on at once, no matter how authentic their commitment. It is critical to identify and ensure the success of the most important strategies for organizational progress. To effectively drive forward those most critical, the CWO may be required to say “no” to other worthy endeavors.


As CWO, you perform an indispensable function as a physician advocate and organizational influencer that may be analogous to the chief quality officer, chief medical officer, or chief patient experience officer. The goal of these efforts is to serve as a catalyst to spur the evolution of the organizational culture toward more affirmational qualities, including:

  • Participatory leadership

  • Professionalism

  • Equity and fairness

  • Mutual respect

  • Service

  • Continuous learning

  • An attitude of caring for self and others


CWOs are also typically directly responsible for assessing professional fulfillment and distress, benchmarking the organizational experience relative to other medical centers, and tracking these measures over time.6 This data must be granular at the work-unit level (department, division, section, or clinic) and used to:

  • Engage the leadership of those work areas

  • Provide support and guidance on how to deploy tactics for improvement

  • Support local efforts to make progress

In addition to systematically engaging all units, you should also use this data to identify hot spots that require greater time, attention, and support from leaders outside the work unit to make progress.

Table 1 describes how 4 different organizations have defined the scope and responsibilities of the CWO and their location in the organization's leadership structure. Additional considerations regarding the CWO role and job description are provided in the STEPS Forward module, Establishing a Chief Wellness Officer Position.

Table 1. Four Examples of Organization Specifics and Features of the CWO Position

Contributing authors: Jonathan Ripp, MD, MPH, Mount Sinai Health System, Dean for Well-Being and Resilience, Professor, Medicine, Medical Education, and Geriatrics and Palliative Medicine; Stephen T. Keithahn, MD, FACP, FAAP, University of Missouri School of Medicine, Chief Wellness Officer, Associate Professor of Medicine, and Child Health; Heather Farley, MD, MHCDS, ChristianaCare, Chief Wellness Officer and Professor of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University; Elizabeth Lawrence, MD, University of New Mexico School of Medicine, Chief Wellness Officer, Assistant Dean for Professional Wellbeing and Professor, Department of Internal Medicine; Sharon C. Kiely, MD, MPM, Quinnipiac University Frank H Netter School of Medicine, Professor, Internal Medicine, Amy B. Locke, MD, FAAFP, University of Utah, Chief Wellness Officer, Executive Director, Resiliency Center, Professor of Family and Preventive Medicine, Adjunct Professor, Nutrition and Integrative Physiology, College of Health. Titles and affiliations current at time of publication.

Box Section Ref ID


  • Should a health care CWO focus first on personal resilience?

    Health care CWOs are not “personal resilience” officers. Providing resources to assist health care professionals with self-care is a component of the CWO's work. However, CWOs dedicate most of their time to creating a more efficient and supportive practice environment through workflow redesign and strengthening dimensions of organizational culture such as leadership, teamwork, professionalism, collegiality, and community.

STEP 2 Study and Understand Your Organization

Before you can start implementing and tracking new initiatives in your role as CWO, you must have a strong foundation of knowledge regarding the gaps and needs of the organization. The following areas of focus are fundamental:

  • Organizational structure in terms of size, geographic distribution, number of sites, and leadership hierarchy7

  • Relationship of the organization to its physician workforce—direct employment, an open staff model, an affiliated network, or some combination of these—and the reporting structure for overseeing these individuals

  • Key priorities outlined by the executive leadership team and typically articulated in the organization's strategic plan. Priorities may include expanding access, improving quality, market expansion, evolving toward new payment models, pursuing contracts with local employers, or preparing for value-based payments

  • Current financial health of the organization

  • Existing reputational strengths and risks

  • External landscape and competitiveness of the practice environment in which the organization functions

Once these broad organizational factors are understood, it is also crucial to obtain quantitative data. Such assessment typically involves an institution-wide survey of physicians and other professionals within the CWO's scope. Such surveys should include standardized and validated instruments for which there are national benchmarks and that holistically evaluate dimensions of professional fulfillment and occupational distress. Examples include the Well-Being Index by Mayo Clinic, the Stanford Model of Professional Fulfillment™, the Maslach Burnout Inventory, and the AMA Organizational Assessment.

Quantitative data can catalyze qualitative conversations throughout the organization. Deploy a Listening Campaign to further understand the data and how it intersects with physician perspectives and experiences at your organization. A Listening Campaign can involve sharing survey results with different work units, obtaining feedback on whether the results accurately reflect experiences, and soliciting input on the greatest system-wide and local opportunities for improvement.8,9

At this juncture, it is important to emphasize that the organization is at the data-gathering stage and will use this input to prioritize the issues it will address. Avoid setting the expectation that the CWO and institutional leaders will fix every problem articulated in these sessions. These conversations can also include discussing positive elements using the appreciative inquiry framework. Appreciative inquiry asks session participants to articulate 2 or 3 aspects of their work that are going well in addition to the 2 or 3 most frustrating things.

Box Section Ref ID


  • Our organization already measures professional engagement. Isn't this enough?

    Although it is tempting to focus on and measure only positive elements such as engagement, numerous studies have demonstrated the strong relationship between aspects of occupational distress and critical organizational objectives (eg, quality of care, patient satisfaction, and turnover). Accordingly, the organization should evaluate dimensions of distress along with positive dimensions to obtain a holistic picture.

  • Should we measure employment statistics, such as trends in turnover and part-time status?

    Yes. Collecting institutional information from human resources on turnover, part-time status, the length of time that positions remain unfilled, the costs associated with open positions, and trends in these metrics can help estimate the overall costs of burnout to the organization. You can glean specific organizational costs in multiple dimensions, such as economic, quality, reputational, recruitment or retention, and malpractice risk.10

  • Are there non-financial costs associated with burnout that we should also consider?

    In addition to the core dimensions of burnout, work effort, and turnover, it is also valuable to recognize the non-financial costs to the organization resulting from the impact on professionalism, quality of care, teamwork, continuity of care, and patient experience.1117

STEP 3 Build Your Team

Building the team is an essential early step for a CWO who is founding a center or program. The optimal timing of your effort in the sequence of other activities can be somewhat flexible. After determining your position's scope, role, and structure, many of the specific functions and skills required for your center will become apparent. Your team should include:

  • Administrative or operational leaders

  • Administrative assistants

  • Project managers

  • Statistics and methodology experts

  • Event planners

  • Communications professionals to assist with both external and internal communication

While all centers will need to attend to some of these roles, such as communications, for many centers, the other roles are best contracted or outsourced (eg, survey administration and statistical analysis).

STEP 4 Identify Existing Organizational Programs, Gaps, and Resources

Quiz Ref IDBefore devising the organizational strategy, you and your team must identify what programs, resources, and activities are already in place to advance your efforts. Most organizations have existing training and activities to promote personal resilience. Others have formalized programs to advance professionalism, leadership development, teamwork, and diversity and inclusion. The goal for your team is not to take over all these activities or topic areas but to:

  1. Integrate support and increase utilization of programs and resources that already exist

  2. Identify notable gaps that new efforts could fill

It can also be informative for you and your team to understand what previous initiatives the organization has tried and discontinued due to lack of interest, low efficacy, unsustainable costs, or other factors.

To facilitate these efforts, you should meet with other relevant organization leaders, including the:

  • Chief quality officer (CQO)

  • Chief medical officer (CMO)

  • Chief experience officer (CXO)

  • Chief medical information officer (CMIO)

  • Chief diversity officer (CDO) or other leaders of diversity and inclusion

  • Chief human resources officer (CHRO)

  • Chief operations officer (COO) and other key members of the operational leadership team

These meetings can provide an understanding of what activities and efforts these leaders have in their respective portfolios and allow you, as CWO, to ensure that new initiatives are complementary and integrated into existing programs. As part of these meetings with the other executive leaders, you may also begin to discern which are natural allies and which may be more resistant to some well-being programs, plans, or initiatives.

STEP 5 Define and Develop Your Team's Mission and Strategy

Once your team is in place, the priority is to define and develop your team's mission and a strategy to achieve it.

While the mission for your center or program can typically be developed in a single brainstorming session or over a few days, developing a cogent strategy typically takes several months and requires extensive input and review from stakeholders both inside and outside the center. Your organization's unique opportunities, priorities, gaps, and resources will direct your strategy.

The strategy should specify a limited number (3 to 5) of long-term focus areas. A well-developed strategy will undergo minimal changes from year to year, even as the tactics to advance that dimension of the strategy change. Many physicians have limited experience with strategic thinking and strategic planning. They often mistake a collection of tactics or a conceptual framework for a strategy; this is a critical error. Deploying an array of tactics without considering a plan's core dimensions typically results in a fragmented and ineffective effort to make organizational progress, even if the tactics themselves are proven effective.

The strategy of one organization cannot simply be wholesale adopted by another organization. Again, conceptual frameworks are not the same thing as a strategy.17,18 Conceptual frameworks are, by design, holistic overviews intended to provide a comprehensive view of the variables contributing to the challenge and/or the opportunities. No program, however, no matter how robustly staffed or resourced, can effectively advance all components of such models at one time. One of the most critical elements of a strategic plan is to help determine what the team will doandwhat it will not do. Developing a strategy is best done as a team, followed by vetting and input from multiple leaders and advisors. Published literature can provide design considerations for strategic plans for organizational well-being programs, and executive-level training courses for CWOs can assist with the strategic planning process.19,20

STEP 6 Establish Partnerships, Thematic Task Forces, and Distributed Leadership

To be effective as CWO, you will need to develop partnerships with other executive leaders, such as the CMO, chief clinical officer (CCO), CXO, CHRO, CMIO, and COO. If you work in an academic medical center, you will also need to collaborate closely with the deans of undergraduate and graduate medical education, the dean of faculty development, and the ombudsman.

In addition to these enterprise-level partnerships, a successful CWO must regularly interact with department chairs and hospital executives. It can also be helpful to build a network of local well-being leaders within each department or work unit. These department or work-unit-level leaders should receive basic leadership training before helping to implement local tactics and acting as a conduit for bidirectional communication between the CWO and the CWO's teams.

As CWO, you may periodically commission thematic, time-limited task forces to help the organization progress on specific issues spanning multiple organizational groups or departments. Such task forces may focus on the needs of physicians at different career stages, the needs of physician parents (such as breastfeeding mothers), or other topics. Quiz Ref IDEven though others will lead these task forces, you should not underestimate the logistical support and time demands such task forces require. You and your team may help craft the task force mission, charge, and timeline before appointing other institutional leaders to lead the task force. Generally, a CWO should not oversee or commission more than 1 task force per year. Accordingly, you should identify, prioritize, and commission potential focus areas for task forces in sequence.

Unless coordinated and commissioned together, you must also take care not to commission task forces on topics squarely in the leadership purview of other executives—particularly the CQO, CHRO, CMIO, or COO. Task forces that fall under this category of joint coordination and commission include those focused on:

Other broad task force topics, such as specific dimensions of organizational culture, should typically be launched by the dean or CEO rather than the CWO. In these cases, your role as CWO may be to chair, rather than commission, the task force. Other topics, such as efforts focused on practice efficiency, are typically best addressed at the work-unit level and not by an enterprise-level task force.

STEP 7 Develop a Bidirectional Communications Strategy

Physicians need to know what their organization's leaders are doing for professional well-being and that they have a voice in these efforts; this is the guiding principle of a bidirectional communications strategy. You can find examples of essential components in a successful communications strategy in Table 2.

Table 2. Components of a Communications Strategy to Promote Well-Being

A communications strategy that promotes well-being should address information needs, deliver informative messaging that reaches the intended audience, provide content related to organizational support, and use a tone that engenders a sense of caring. A leader (often the CWO) does not implement the strategy outlined here alone. Collaboration between the leader, the leader's team, and other groups in the organization, such as HR, divisions or departments, student affairs, or the well-being office, is instrumental for success. Contributed by Jonathan Ripp, MD, MPH; Chief Wellness Officer, Icahn School of Medicine, Mount Sinai, New York.

STEP 8 Set Performance Metrics for the Organization and the Team

As CWO, you should review and decide upon performance metrics for both your organization and your team.1,5These metrics are discussed in detail in the STEPS Forward toolkit,Establishing a Chief Wellness Officer Position. Remember the critical distinction between organizational metrics (Table 3) and metrics for you and your team (Table 4). CWOs cannot be held responsible for the burnout scores of their organization but can and should be responsible for providing education, advocacy, and leadership, as well as developing a strategy to guide the organization.

Many other factors that are dominant determinants of well-being are not under a CWO's control. These factors can include:

  • Productivity expectations

  • Adequacy of staffing

  • Compensation models

  • Organizational leadership

  • Teamwork characteristics

  • Transitions to new facilities

  • EHR characteristics or features

You and your team cannot fix many of the local department-specific or work-unit-specific issues that frustrate care team members. Although you and your team can help identify these issues and support work-unit-level efforts, addressing these issues is the responsibility of the local work unit leaders. Accordingly, the high-level outcome metrics of the well-being and professional satisfaction of the organization's physicians and other clinicians are a shared responsibility of all organizational leaders. Such a framework is consistent with the shared responsibility of corporate leaders for quality outcomes, financial performance, and other measures.

Table 3. Organization-Level Metrics
Table 4. Responsibilities of the CWO and Their Team
STEP 9 Avoid Common Pitfalls and Mistakes

Common pitfalls and mistakes for a new CWO include:

  • Conflating metrics of organizational progress with the metrics of CWO efficacy

    As discussed, you and your team do not have direct authority over many organizational decisions and factors that impact professional fulfillment (eg, productivity expectations, leadership, staffing, workflows, the EHR, and the efficiency of the practice environment). Therefore, it is critical to distinguish organizational metrics and goals from the measures by which the organization will assess the efficacy of you and your team.

  • Failing to develop a strategy

    Another common pitfall is failing to invest the appropriate amount of time in developing an organizational strategy. Deploying an array of tactics, even if they are proven effective, is unlikely to lead to organization-level improvement. A well-thought-out organizational strategy is necessary for the team to identify and prioritize critical focus areas and the worthwhile alternative opportunities that you will pursue later.

  • Rushing to build your team

    Selecting the right team members, hiring, and onboarding these individuals, and deploying them in alignment with the strategy all take time. This process takes 6 to 12 months, even in optimal circumstances. Although you can move some of the elements described in this toolkit in parallel with team building, fulfilling many of your center's initiatives and actions will require you to complete this process first.

  • Trying to directly oversee too many initiatives

    Although you and your team will need to develop and implement a number of your own initiatives, other efforts require partnering with other leaders and groups in a supporting or advisory role instead. Trying to oversee or execute too much puts your team's well-being at risk and is a recipe for failure.

  • Trying to do too much too fast

    The natural tendency for a new CWO is to hit the ground running. However, CWOs must be careful not to launch too many initiatives too quickly. Doing so often decreases the effectiveness of all endeavors. It is more important to start with a limited number of projects and activities to gain traction before expanding the portfolio. Given the extent of the need and the breadth of the opportunities you might pursue, adhering to this principle requires substantial discipline—even with a well-devised strategy.

  • Becoming the complaint department

    Distress and frustration among physicians are widespread and substantial. Once a CWO is appointed and a center created, these individuals can finally express their dissatisfaction, concerns, and ideas. This often results in individuals directing all types of complaints to CWOs and their teams. An influx of complaints presents a dizzying array of challenges, including many far beyond a CWO's scope and responsibility. CWOs have received complaints or requests about:

    • Policy changes to allow physicians to bring their pets to work

    • Length of commute

    • Lack of parking

    • Lack of on-site childcare

    • Cost of living in the community

    • Cleanliness of the call rooms

    • Firing certain physicians

    • Terminating all the administrators

    • Invalidating efforts to uphold professional standards

Although you and your team can listen respectfully and acknowledge the concern/complaint, you should avoid becoming the clearing house for all complaints about the organization. Doing so will distract you from pursuing your strategic priorities.

  • Trying to please everyone

    Much like thinking the CWO's center is the complaint department, people tend to believe their pet project or activity should be and will be prioritized for implementation by the CWO's team. This is not feasible given the limited time, attention, and resources available; it is not a successful path to organizational change, either. You will inevitably face criticism as a result of this, and it is helpful to have “thick skin” in this regard.

  • Becoming a personal resilience officer rather than the CWO

    Your primary function as CWO is not to develop a portfolio of personal resilience and self-care offerings. However, because such individual offerings are relatively easy to make and give the illusion of progress, many CWOs initially devote attention to such activities. Although systematic efforts focused on improving the efficiency of practice, optimizing workflows, evolving leadership behavior, and addressing problems with the organizational culture take more time, they are the initiatives that will ultimately result in a more significant impact. It is thus imperative to invest the energy necessary to launch such efforts rather than focusing exclusively on personal resilience offerings or devoting the majority of your energy to initiatives targeted to individuals.

  • Failing to develop a robust communication arm

    Failure to build the infrastructure to facilitate bidirectional communication between the CWO's program and the physicians in the organization can be consequential. Even when a CWO and their team are effectively executing their strategic plan and making progress on multiple fronts, it is challenging to keep physicians across the organization informed of these efforts. Poor communication could lead physicians and the organization to perceive the CWO as ineffectual, and the CWO may miss valuable opportunities to foster organization-wide well-being.


A CWO is a unique and vital leadership position within a health care organization. Using an established road map to success can help recently-appointed CWOs navigate this new territory.

Box Section Ref ID
Graphic Jump Location
AMA Pearls

AMA Pearls

  • Concentrate efforts on improving the practice environment rather than on improving the personal resilience of the workforce.

  • Establish a strong internal team as well as liaisons within the organization.

  • Do not hold the CWO responsible for the burnout scores of the organization. Instead, the CWO should be responsible for providing education, advocacy, and leadership, and for developing a strategy to guide the organization toward improved well-being.

Further Reading

Journal Articles and Other Publications

Chief wellness officer

Well-being and burnout

Workplace and workstreams

  • Swensen S, Shanafelt T. Mayo Clinic Strategies To Reduce Burnout: 12 Actions to Create the Ideal Workplace. Oxford University Press; 2020. https://academic.oup.com/book/36545

  • Shanafelt T, Stolz S, Springer J, Murphey D, Bohman B, Trockel M. A blueprint for organizational strategies to promote the well-being of health care professionals. NEJM Catal Innov Care Deliv. 2020;1(6). doi:10.1056/CAT.20.0266

  • Sieja A, Markley K, Pell J, et al. Optimization sprints: improving clinician satisfaction and teamwork by rapidly reducing electronic health record burden. Mayo Clin Proc. 2019;94(5):793-802. doi:10.1016/j.mayocp.2018.08.036

  • Sinsky CA, Panzer J. The solution shop and the production line - the case for a frameshift for physician practices. N Engl J Med. 2022;386(26):2452-2453. doi:10.1056/NEJMp2202511

  • Sinsky CA. Riding the wave: seven steps to scheduling success. Fam Pract Manag. 2022;29(6):19-24. https://www.aafp.org/pubs/fpm/issues/2022/1100/wave-scheduling-tips.html

  • Singh N, Lawrence K, Sinsky C, Mann DM. Digital minimalism - an Rx for clinician burnout. N Engl J Med. 2023;388(13):1158-1159. doi:10.1056/NEJMp2215297


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Disclaimer: AMA STEPS Forward® content is provided for informational purposes only, is believed to be current and accurate at the time of posting, and is not intended as, and should not be construed to be, legal, financial, medical, or consulting advice. Physicians and other users should seek competent legal, financial, medical, and consulting advice. AMA STEPS Forward® content provides information on commercial products, processes, and services for informational purposes only. The AMA does not endorse or recommend any commercial products, processes, or services and mention of the same in AMA STEPS Forward® content is not an endorsement or recommendation. The AMA hereby disclaims all express and implied warranties of any kind related to any third-party content or offering. The AMA expressly disclaims all liability for damages of any kind arising out of use, reference to, or reliance on AMA STEPS Forward® content.

About the AMA Professional Satisfaction and Practice Sustainability Group

The AMA Professional Satisfaction and Practice Sustainability group is committed to making the patient–physician relationship more valued than paperwork, technology an asset and not a burden, and physician burnout a thing of the past. We are focused on improving—and setting a positive future path for—the operational, financial, and technological aspects of a physician's practice. Learn more.

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 Chief wellness officer course . Stanford Medicine WellMD & WellPhD. Accessed July 31, 2023. https://wellmd.stanford.edu/knowledge-hub/courses-conferences/cwo-course.html

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