How Houston Methodist’s Joy in Medicine Initiative Is Redefining Physician Wellbeing

Physician burnout is now an urgent national issue. Leaders know the statistics: in 2024, U.S. physicians report some of the highest levels of professional exhaustion ever measured, threatening not just clinician health but also quality of care and the financial sustainability of provider organizations. Yet, too often, health systems struggle to move beyond superficial wellness programs and surveys. The Joy in Medicine Initiative at Houston Methodist is different. Led by Shlomit Schaal, MD, PhD, MHCM—Executive VP and Chief Physician Executive of Houston Methodist, and President & CEO of Houston Methodist Physician Organization—this program blends data, culture change, and frontline engagement to drive measurable impact.

Dr. Schaal shares an unusually candid, step-by-step playbook on how one of America’s most admired hospitals is closing the physician engagement gap and restoring joy to the practice of medicine.

Why Did Houston Methodist Launch the Joy in Medicine Initiative?

The Joy in Medicine Initiative began with a tough realization: Houston Methodist’s physicians were engaged but not thriving at the same level as the broader workforce. Employee engagement was stellar: “Our employee engagement scores here at Houston Methodist in 2023...were 4.46 out of five, which is the 96th percentile nationally,” Dr. Schaal explains—but the story for physicians was different. “Physician experience...was 4.18 out of five, which aligns with the 66th percentile. So, yes, there is a gap.”

This “physician-employee gap” is common across health systems. But at Houston Methodist, the leadership refused to treat it as inevitable. Instead, they saw it as a call to action. Dr. Schaal, newly arrived from UMass Memorial Health, brought a scientist’s mindset: “I always come with a question. The question was why, and how can we discover the reasons for it—and what can we do about it?” The stakes were high: physician wellbeing isn’t just a human resources problem—it’s a core driver of patient care, safety, and system performance.

Key drivers behind launching the initiative:

• Significant, measurable gap between employee and physician engagement.
• National crisis of physician burnout.
• Executive commitment to culture, driven by data and frontline voices.
• A belief that “joy in medicine” isn’t a luxury—it’s a strategic imperative.

What Makes Houston Methodist’s Approach Different?

Houston Methodist didn’t start with a ready-made solution—they started with humility and a rigorous process. Dr. Schaal and her team joined Healthcare PWAC, the Physician Wellness Academic Consortium (led by Stanford Department of Medicine), and adopted its three-part framework for physician wellbeing:

1. Culture of Wellness: Is wellbeing truly valued and visible in daily operations and leadership language?
2. Efficiency of Practice: How easy—or frustrating—is daily clinical work?
3. Personal Resilience: How are clinicians supported in maintaining their own wellbeing?

Instead of launching generic wellness workshops, the team undertook what Dr. Schaal calls the “JIMI Tour” (Joy in Medicine Initiative): a months-long roadshow meeting physicians where they practice, across a vast region. “Sometimes it took us two hours to drive to where our physicians are...we met our primary care physicians where they are.” They asked every group the same three open questions:

• Who are you?
• What’s good here?
• What could we do better? (the “pebbles in your shoes”)

Why does this approach matter?

• Direct, in-person engagement signals respect and builds trust.
• Open-ended questions generate richer, more actionable data than surveys alone.
• Leadership presence demonstrates authentic commitment.
• Solutions are grounded in the realities of daily clinical practice.

“You do not know how to help if you don’t hear what the problem is from the physicians...it’s not enough to fill surveys,” says Dr. Schaal.

What Did Houston Methodist Learn from the Front Lines?

Through in-person visits with nearly 200 of 250 primary care physicians, the executive team surfaced recurring pain points—each one a potential “joy thief.” Dr. Schaal shares: “There are three things that we heard in 100% of the rooms that we went to.”

1. Barriers to Social Services Referrals: Primary care physicians struggled to connect patients with needed social supports. This frustration stemmed not from a lack of empathy but from system barriers.
2. Clinic Inefficiency: “The most important thing for our providers...is to start on time and end on time.” Delays—whether from late starts, no-shows, or overrun clinics—eroded morale and made work-life balance impossible.
3. Administrative Burden: Documentation, EHR hassles, and 24/7 patient communications (“Dr. Google,” MyChart, constant emails and texts) left clinicians feeling overwhelmed and unable to focus on patient care.

These pain points, once mapped to the PWAC framework, provided a roadmap for real change. “We devised a strategy—very meticulous—to address all the things that we heard.”

What was not the solution?

• Quick fixes or one-size-fits-all wellness programs.
• Relying solely on surveys or digital tools.
• Top-down mandates.

Instead, Houston Methodist combined qualitative (“JIMI Tour” feedback) and quantitative (surveys, crowdsourcing via Press Ganey’s platform, EHR satisfaction data) methods to prioritize and structure action.

How Was the Strategy Developed and Deployed?

Strategy development at Houston Methodist unfolded in three phases:

Listening and Data Collection:

• In-person JIMI Tour.
• Crowdsourcing of physician ideas and upvoting priorities.
• Two focused surveys: the JIMI Survey (rebranded from PWAC), and the CLASS survey (EHR satisfaction).

Prioritization and Strategic Planning:

• Leadership grouped feedback into the three PWAC domains.
• Specific strategies were created for each area, Three for culture of wellness, Four for efficiency of practice, Two for personal resilience.

Transparent Communication and Implementation:

• All strategies were unveiled at a Joy in Medicine Symposium.
• Direct communication to physicians: “We heard you. You told us what’s important, and we devised strategies and priorities to address the things that are most important to you.”

Implementation included:

• Investment in social work infrastructure for referrals.
• Clinic scheduling reforms to ensure on-time starts and ends.
• Efforts to reduce administrative burden, especially around EHR support.

Dr. Schaal notes, “If the people do not know what you’re doing, it’s completely worthless.” Communication, transparency, and a feedback loop were central.

What Are the Early Results and Impact?

Dr. Schaal is clear: “There is no quick solution unless you really understand the problem and then you have to prioritize what you’re going to do.” But Houston Methodist is already seeing tangible results:

• 100% Attendance Among Primary Care Physicians: When the organization invited physicians to attend its flagship Pathway to Unparalleled event—a first for clinicians—every single primary care doctor showed up. Previously, only 2% had attended. Overall physician attendance jumped from 2% to 70%.
• Increased Trust and Engagement: “If you go as an administrator, as an executive leader, you take the time, you really give attention to physicians and give weight to what they have to say—then when you ask them to participate in something, they respond, and they’re all in.”
• Early Cultural Shift: Anecdotally and through early metrics, the organization is seeing greater physician pride, willingness to voice concerns, and a sense of shared mission. As Dr. Schaal puts it, “Something special is happening here in terms of what it means to be employed by Houston Methodist Physician Organization.”

What Lessons Can Other Health Systems Apply?

Houston Methodist’s Joy in Medicine Initiative offers a replicable, step-by-step playbook for executive leaders and physician organizations nationwide.

Key Takeaways for Executives and Administrators:

• Engage in Person: Go where your physicians are. Surveys aren’t enough.
• Ask Open Questions: Begin with “What’s good?” before “What’s wrong?” Build trust.
• Prioritize by Data: Use frameworks like PWAC to sort issues and focus resources.
• Communicate Transparently: Close the feedback loop—show that you’re acting on what you hear.
• Tailor Interventions: Recognize that primary care, specialty care, and non-clinical roles have different challenges.
• Measure and Share Results: Track engagement, attendance, and culture change over time.

As Dr. Schaal reminds us, “It shows enormous respect to our physicians and providers, which I strongly feel that without physicians, without people who deliver the care—what are we doing here?”

What’s Next for the Joy in Medicine Initiative?

Houston Methodist isn’t stopping at primary care. The next phase will address specialty care physicians—expected to take two years, given the larger group and unique specialty-specific challenges. The organization recognizes that sustainable change isn’t a one-time intervention but a continuous process of listening, measuring, and iterating.

Takeaway: Real Physician Wellbeing Requires Relentless Curiosity, Courage, and Follow-Through

The Joy in Medicine Initiative at Houston Methodist stands out because it fuses scientific rigor, leadership humility, and relentless follow-through. For U.S. healthcare leaders searching for more than “wellness theater,” Houston Methodist’s example is clear: transformative change starts with showing up, listening deeply, and treating physicians not as a problem to be managed, but as the most vital asset in healthcare’s future. The lesson? If you want to move the needle on physician engagement and wellbeing, start by respecting their voice—and back it with visible, persistent action.