Episode Transcript
Alan Helgeson:
“Reimagining Rural Health,” a podcast series brought to you by Sanford Health. In this series, we explore the challenges facing health care systems across the country, from improving access to equitable care, building a sustainable workforce, and discovering innovative ways to deliver high-quality, low-cost services in rural and underserved populations. Each episode examines how Sanford Health and other health systems are advancing care for the unique communities they serve.
In this episode, Courtney Collen with Sanford Health News talks with Dr. Jesse Ehrenfeld, president of the American Medical Association. Dr. Ehrenfeld joins as a keynote speaker at the 2023 Summit on the Future of Rural Health Care with the topic solving physician burnout – a prescription for a more resilient workforce.
Courtney Collen (host):
Dr. Jesse Ehrenfeld is here with us in Sioux Falls. Thank you for taking the time today. Glad to have you.
Dr. Jesse Ehrenfeld:
Thanks for having me. Appreciate it.
Courtney Collen (host):
What are the top three opportunities you see when it comes to building a stronger rural health care workforce?
Dr. Jesse Ehrenfeld:
Well, you know, we need to address the issue of burnout, and there’s growing awareness of physician burnout and its implication for health care over the long haul, but also the factors driving it. The solution to the workforce crisis, physician burnout, is complex. But there’s bipartisan support to do it. And, you know, we need to apply pressure on lawmakers, on Congress, to make sure that we can shore up the physician workforce, but particularly in rural areas we have the opportunity to make it easier for international medical graduates to practice in rural communities and in the U.S.
And you know, we support the Conrad 30 Physician Access Reauthorization Act, which would make the J-1 visa waiver program easier, make these people who want to come and work in rural areas. There’s also opportunities particularly to rethink medical education. The AMA has made grants to UC Davis in California, Oregon Health and Sciences out in Portland to recruit medical students from rural and Indigenous communities, train them in those communities with the goal that they practice in those communities. And we’ve seen some really wonderful early success. We’re learning more about the power of solving these issues upstream by recruiting students from rural communities to come to medical schools. And I’m optimistic that we can do that.
You know, it’s certainly encouraging to me to see the kinds of things that are also happening to support resilience and physicians who need help. And unfortunately, there are a lot of barriers. There’s a lot of stigma when a physician in burnout needs a confidential place to go to getting that assistance. We’ve supported legislative maneuvers in a variety of states to make sure that there are confidential physician wellness programs that mean that someone, people have a place to turn to. And I will say South Dakota is a leader in this area. A law passed in 2021 that protects physician confidentiality when someone is seeking help for career fatigue or wellness. We need to scale that to other states and certainly we’re seeing some movement.
Courtney Collen (host):
Dr. Ehrenfeld, where have we made progress when it comes to health care workforce issues?
Dr. Jesse Ehrenfeld:
Well, we’ve made a lot of strides in just sort of addressing the fact that we don’t have the people we need and that we need to better support physicians working in the system. The problem is with the system; the problem’s not with the individual physician.
You know, we have our AMA joy medicine recognition program, which recognizes health systems, hospitals, medical groups for their exemplary work in supporting physician well-being. And that program provides a roadmap for leaders to implement policies, to implement programs that can support physician well-being. Seventy-two health systems including 35 first time recipients were recognized in 2023 through our program including Sanford Health, which we’re very excited about, very proud to elevate. Sanford Health was among the systems that got the gold recognition, the program’s highest honor, because you all have demonstrated across a number of distinct areas, a commitment to supporting the practice environment and making it easier for physicians to do their jobs.
Courtney Collen (host):
Where do you think work remains? How will this shape strategy and policy moving forward?
Dr. Jesse Ehrenfeld:
Well, certainly, I think there are a lot of opportunities to make sure that as people are overwhelmed working in the system that we’re in today, that people see that there’s a place that they can turn to that has their back. And certainly as the largest, most influential physician organization, we try to be there. We try to make sure that when we see these challenges, when it’s so easy to be discouraged, that physicians recognize that there is a voice. And you know, I get to travel all over the country as AMA president. I see the heartache. I see the burden.
But I’m optimistic because I’m optimistic when I see physicians stepping up day in and day out, in spite of all of the challenges. I see physicians who step up to counter disinformation. I see young physicians, trainees that I work with who have a bottomless sense of curiosity, a commitment to making a difference. And I’ve seen so much happening in the country that in spite of the political division, the challenges in the world to make sure that patients have access to the care that they need, I know we can get there.
Courtney Collen (host):
If you could share one piece of advice with a new clinician or physician entering the workforce today, what would that be?
Dr. Jesse Ehrenfeld:
You know, it would be to hang in there. In spite of everything that we are facing, I know that we can pull it together. I know when I walk into my hospital and I see patients – I’m an anesthesiologist – I see people putting on their scrubs, putting on their white coat that in spite of what seemed like immense obstacles that there is joy in the profession. And we just need to create those social connections. We need to make sure that people have the tools to do their jobs more efficiently. We need to pull the system inefficiencies out. And I’m optimistic that we can get there.
Courtney Collen (host):
Thank you. And lastly, on that kind of high note, what excites you most about the future of rural health care?
Dr. Jesse Ehrenfeld:
Well, I think technology’s a real game changer when it comes to caring for patients, particularly in rural communities and medically underserved areas. The AMA has been a huge supporter of telemedicine before the pandemic because we saw how vital it can be for patients who have limited mobility, who don’t have direct access to a physician’s care because of geography. And so we have a lot of tools, a lot of resources for practices to integrate these tools and these technologies into what they’re doing.
I’m really excited about what AI can bring. I think we need to make sure that we think about it as augmenting the capability of our clinicians, not replacing it. So that’s why the AMA likes the term augmented intelligence. But I think that there are a lot of opportunities to rely on technologies, re-engineer our workflows, and I’m optimistic about what that’s going to mean for our rural communities.
Courtney Collen (host):
Dr. Jesse Ehrenfeld, thank you so much for your time today.
Dr. Jesse Ehrenfeld:
Thanks for having me.
Alan Helgeson:
You’ve been listening to “Reimagining Rural Health,” a podcast series brought to you by Sanford Health. Hear more episodes in this series or other Sanford Health Series on Apple, Spotify, and news.sanfordhealth.org.
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Posted In Leadership in Health Care, News, Rural Health, Virtual Care
