Year 4. October 6. Highlights From Our Recent Community Meetings
Each fall, I look forward to the opportunity to gather with faculty in groups across the region to share relevant department updates, provide a forum for discussion, and embrace the opportunity to directly address questions you may pose. With such a large department that spans a vast geography, it can be challenging to find time to get together to talk about the many crucial issues that affect us all, and I am thankful for your engagement in spite of your busy schedules.
We have completed community meetings for our clinical faculty in our five regions and a community meeting for our research faculty is scheduled for later this month. Thank you to all who came out to this year’s series of community meetings. Besides information and discussion, these meetings also provided an opportunity for all of us to connect socially and interact with other clinical colleagues with whom you collaborate but might not see on a regular basis. I use this week’s post to highlight some of the topics discussed in these meetings, which I hope will be useful for those who could not attend. They are shared with personal gratitude for the tremendous work and effort our faculty expend to advance our department’s strategic vision to lead in innovation, transform care and advance health for all.
Key Takeaways From DoM Community Meetings
As in prior community meetings, the complex issue of physician compensation represented many of the questions that were asked and discussed. As the clinicians in the DoM already know, we use national community benchmarks of clinical productivity and pay to determine specialty-specific and primary care physician clinical compensation. The rationale for this is to ensure that our clinical compensation can remain competitive with that of the marketplace to support our goal of attracting and retaining the best faculty. Compensation is based on national survey data that is obtained each year, and we strive to match our compensation to these data.
When productivity benchmarks increase, reflecting trends across the country — driven in part by increasing patient complexity and changes in coding, billing and documentation — many feel that this translates to more work for less pay. However, salaries for most specialties have continued to increase year over year, in part reflecting competitive pressures and the relative physician shortage across most specialties. The funding for faculty compensation derives from the reimbursement that we receive from insurance companies for the clinical work we do. These reimbursements have not kept pace with inflation, while many expenses to operate our clinical enterprise continue to increase. As an academic department of medicine, we also need to identify resources to support our other missions such as training and education. For these reasons, many academic institutions calculate faculty compensation by using another compensation benchmark derived from a survey by the American Association of Medical Colleges (AAMC), which results in compensation that is lower than the community benchmarks that we use.
This creates a tension in an environment where faculty are committed to the academic mission while working hard to maintain productivity expectations. This is a conundrum that the department works hard to manage as we balance these sometimes-competing demands. During the community meeting presentations I reviewed our rationale for using community-based benchmarks and compensation for clinical work, discussed some of the reasons why benchmarks have risen, and presented strategies we could use to ensure we are maximally reimbursed by third party payors for the work that we do. We also discussed what we need to do as a department and health system to optimize clinical functions at multiple levels so we can achieve this goal.
The department continuously evaluates and monitors productivity data of our faculty and national trends. We appreciate the feedback that we receive from faculty and remain committed to working collaboratively with division clinical leadership to support our faculty to optimize the balance between work and competitive pay. I look forward to reviewing this topic further during my presentation at the upcoming annual meeting of the Department of Medicine Professional Group (DMPG).
Expansion
Our community meetings also gave me the chance to report on clinical expansion projects that are underway across our region.
Let us start with the UCLA West Valley Medical Center (WVMC), where several DoM divisions have officially launched. Hospital medicine, oncology, nephrology, and pulmonary all started offering a full range of services this summer. Limited cardiology and digestive diseases coverage expanded to 24/7 on Oct. 1. Physical medicine and rehabilitation is launching services soon. Other subspecialty consult services including infectious diseases, endocrinology, rheumatology, palliative care and geriatrics are being planned and will launch as additional recruits are onboarded or coverage arrangements are finalized in relation to availability of consultants who practice at surrounding outpatient sites in the region. Dermatology consult requests at WVMC are being fielded by the dermatology inpatient attendings at Ronald Reagan and Santa Monica Medical Centers, with post-discharge follow-up arranged.
Although our presence at UCLA WVMC is still fresh, there is already good news. Patient satisfaction scores have jumped from the first percentile pre-move in to the 87th percentile since our hospitalists started caring for inpatients on July 1. This is a major testament to who we are and what we can do in the DoM. We anticipate that UCLA WVMC will become the healthcare hub for the San Fernando Valley community and greatly look forward to expanding our presence there.
Other developments include the Oct. 1 launch of expanded ambulatory services at our Pasadena multi-specialty office, which encompass 8,300 additional square feet of space, 30 new exam rooms and four procedure rooms. The DoM divisions that will provide services in Pasadena are allergy-immunology, dermatology, endocrinology, nephrology, pulmonology, rheumatology and cardiology, including cardiac imaging. We also increased the complement of primary care physicians.
Our primary care and oncology clinics in Long Beach and primary care clinic in West Adams have opened as well. So too has the UCLA Atascadero Cancer Center, a much-needed oncology clinic that officially began welcoming patients on July 25. I am grateful to all of you who are helping us widen and deepen our connections across our local communities and look forward to seeing this momentum continue.
Strategic Plan Progress
Our conversations also included a synopsis of some of our progress on developments arising from our department’s strategic plan. We covered many of these in-depth in our Sept. 15 newsletter, but I would like to highlight some of them here.
First, to advance our Education pillar goal to develop and recognize our faculty educators, we are in the process of launching a second publication portal that will complement “Proceedings of the UCLA Department of Medicine,” the department’s journal for DoM faculty to showcase their creative work. The new outlet, “DoM Clinical Insights,” will give faculty an array of formats in which to showcase their work, including image and video vignettes, opinion pieces and narratives, summaries of completed quality improvement projects and clinical reasoning cases. It is slated to launch sometime this fall. Additional details about "DoM Clinical Insights" will be shared in the coming weeks.
Second, to advance our Research pillar goal to strengthen the research infrastructure and develop and retain research faculty and staff, we have added resources for DoM research faculty to the DoM website. This includes a summary of weekly updates on federal funding, resources for PIs and training webinars. We have also launched a formal onboarding process for newly recruited and existing research faculty, and as you know we actively worked to address the fallout of the recent suspension of federal grants — now paused under a court injunction — to support and keep our research faculty informed.
Additionally, we are making headway on our Patient Care pillar objective of strengthening clinical infrastructure and operational efficiencies through progress on the development of ambulatory operational standards for patient visits and InBasket management. A rough timeline for preliminary work on ambulatory operational standard implementation is below.
For InBasket management, a survey to assess our current protocols and needs is coming soon. More details on this program are summarized in the next section below.
We also recently held the inaugural DoM in LA Summit, a major development towards our Community Engagement and Investment pillar goal to strengthen engagement and collaboration with organizations caring for historically and contemporarily under-resourced communities. I will share more about this outstanding conference later this month, but for now, know that it was a fantastic kickoff that bodes well for the future of our community engagement efforts.
Despite the many headwinds our department faces, we continue to excel in our missions. As has been so apparent from the way we have weathered many crises this year, we also excel at supporting each other. We directly received feedback that collaboration and support from our colleagues are one of the main reasons why our faculty want to remain a part of the DoM. Thank you for building a community that makes the DoM a fantastic place to work. Please enjoy these photos and video recap of conversation and camaraderie at the DoM Community Meetings in Westlake Village, Westwood and the South Bay.
New Operational Standards for InBasket Management Will Help Streamline Clinicians’ Workload
New operational standards are on the way for InBasket management across our ambulatory practices. InBasket is the tool that physicians and staff at UCLA Health use to send messages to patients. In the early years of the COVID-19 pandemic, when clinic visits were mainly reserved for serious concerns or emergencies, InBasket correspondence became the default form of communication between patients and healthcare providers, with messages essentially tripling in a short amount of time. Yet the volume has not declined even after in-person visits resumed — and, in fact, has compounded as patients face longer wait times between appointments.
Thus, as you learned and will see from our latest wellness survey results, InBasket management continues to be the main driver of burnout for our faculty and staff who must respond to messages while also caring for ever-more patients in the clinic. In an effort to streamline and standardize message management among ambulatory facilities — each of which currently have their own InBasket protocol — the DoM will establish a set of best practices that all locations will follow.
“We’re trying to come up with a clear set of principles that help staff quickly decide how to handle different types of messages,” Cory M. Hedwall, project manager for the DoM Quality team and co-leader of the InBasket standard initiative, explained. “Just like with CICARE, it’s about making those behaviors feel second-nature — ultimately, the goal is to reduce burnout for providers, improve efficiency for staff, and give patients a smoother experience.”
To that end, Hedwall, initiative co-leads Kia Robinson, Arielle Bilek, MD and the rest of their team will start by distributing a survey to ambulatory clinic care providers, staff, and managers across the DoM to take stock of their current InBasket practices and pain points. They hope to have uniform standards ready for implementation in about 18 months.
“The more answers we get, the better understanding we’ll have of our current state, and the better we’ll be able to plan,” Cory said. He added that this work is very important to the project team, many of whom have firsthand experience with InBasket or innovations to improve it.
“Everyone is really driven to help the team spend less time on InBasket and more time on actual patient care,” Cory said.
Thank you to Cory, Kia, Arielle and the rest of their team for their excellent work on this important initiative. I look forward to seeing the results of your work!
Fourth Annual DoM Faculty Wellness Survey Shows Progress, With Room to Grow
I had the opportunity to share the results of our most recent wellness survey during our community meetings and am happy to share some of them here as well.
Let me thank you for your record-breaking participation in this important work. At nearly 90%, including 44 partial responses, the response rate was the highest in the four years we have conducted this survey (the response rate accounting for completed surveys only was 85% — still the highest so far!). This is a strong indication of the robust level of engagement of our faculty in the DoM, and the wellness team and I are grateful for your feedback.
“I was thrilled at the response — it’s hard enough to get half of a group of people to fill out a survey, let alone 90%,” Sun M. Yoo, MD, MPH, chief wellness officer for the DoM, said. “It’s a testament to the partnership we have with our faculty, and it’s really exciting for us because it means we have more people we can partner with as we brainstorm and work on making improvements.”
Survey responses were broadly representative of the demographics of our department, in terms of faculty track, duration of tenure in the DoM and site of practice.
The overall trend for our burnout rates continues to be positive — and for the first time, fewer than half of respondents reported feeling burned out. I should note that this survey opened in May and closed in June, so it may not completely capture the impact of some major federal research funding developments. Still, it does indicate significant progress year over year.
“We actually thought we might see an increase in burnout this year because of all the local stressors we experienced as a community here in Los Angeles and at UCLA, so we’re happy to see these results,” Dr. Yoo said. “But 46% is still much too high,” she added.
“That’s still almost one in two physicians who feels burned out,” she said. “It shows we have a lot of work to do to make improvements, decrease workload and improve the experience of faculty and staff in our department.”
I completely agree with Dr. Yoo’s perspective on these results.
The survey in previous years captured a sizable gender gap in burnout rates, with women — particularly women physician-scientists — reporting higher rates of burnout than men. While this trend persisted, burnout rates for both genders declined, though men reported a higher reduction in burnout than women (8.3 percentage points for men versus 2.5 percentage points for women), year over year. However, over the four years that we have conducted this survey there has been 30% reduction in burnout in women versus a 23% reduction in men.
“The gap is closing, but it still exists,” Dr. Yoo said. “We should do everything we can to continue to close it.”
Years of experience appear to play a role in burnout as well. As we have seen in previous years, early-career faculty report higher rates of burnout than those with more experience. There are many possible explanations for this: Early-career faculty may also have to balance career obligations with more demanding family responsibilities, such as having young children. Additionally, there is evidence that burnout might improve with job tenure as coping skills — such as being more likely and able to navigate and find necessary support — may improve with time. For physicians in academic settings specifically, data demonstrates that non-clinical time (i.e. education, administrative work, research), which typically increases with job tenure, may also help improve occupational wellbeing.
“This is certainly a consistent and interesting finding that we’re looking to explore further as we focus not just on drivers of burnout but factors that can help protect us from burnout and enhance wellbeing,” Associate Chief Wellness Director and Physician Wellness Director Joshua N. Khalili, MD said.
Survey respondents reported roughly the same average job satisfaction rating as in previous years, at 3.8 out of 5. In addition, our net promotor score, which indicates whether respondents would be willing to recommend the DoM as a workplace, has improved from -38% in 2022 to -6% in 2025.
“It’s our job to continue to move that figure to the right as much as possible,” Dr. Yoo said.
When asked to select external factors that affected well-being at work, 70% of respondents chose family responsibilities. The second-most common factor was political climate, which was chosen by 64%. Twenty percent of respondents chose the Los Angeles wildfires; the region was still in the early stages of recovery at the time of the survey.
Consistent with what we have heard in prior years, roughly half of faculty reported feeling dissatisfied with the amount of time they spend working on electronic health/medical records (EHR or EMR) at home. EMR and Inbasket were also the most frequently cited terms in the qualitative portion of the survey, which asked respondents to name two things they would change about their work environment. These words came up more than three times as frequently as the next most common terms — staffing and support team quality, followed by administrative and clerical overload. Taken together, these responses point to a need to improve clinical operation efficiency.
“That’s why it’s going to be so important to partner with ambulatory operations to make improvements, because those are the biggest pain points,” Dr. Yoo said.
This work is already underway through several of our initiatives under the strategic plan, such as the development of new ambulatory operational standards and protocols for InBasket management as described above. Another program, the IMPACT-REST Program, a new departmental pilot program co-led by the DoM Quality team and DoM operational leadership, is designed to further support InBasket management in the ambulatory setting. Launched as a pilot in July 2025 in the South Bay / DTLA region, it currently includes 1 RN and 1 MD “InBasketologist” covering half of a region, with expansion to the entire region planned for January 2026. At full scale, the model will include 2 RNs and 1.5–2 MD InBasketologists supporting the InBaskets of 30–40 primary care physicians (PCPs) across the region.
In the IMPACT-REST pilot, participating PCPs covered are actively present in clinic, seeing patients, while the inbasket team manages calls and messages. PCPs remain responsible for results, cc’d charts, admissions, discharges, transfers, and prescription requests, while RNs screen all calls and messages, escalating those beyond their scope to MD inbasketologists.
Early results are promising. Since July 2025, only 8% of items escalated to theInBasketologist ultimately required the PCPs attention. 16% bypassed the InBasketologist and were routed directly to PCPs, often related to patient insistence or PCP-driven follow-up from contact initiated by the PCP to address results. Our goal is to expand this program after we have analyzed the full impact of this pilot study.
Another innovation that is addressing physician burnout is the recent adoption of AI-assisted ambient scribes. The DoM took part in the UCLA Health ambient listening pilot, which ultimately led to UCLA Health’s partnership with Nabla, one of the leading ambient AI assistants. Nabla is an AI-powered ambient listening tool available in CareConnect and Haiku for UCLA Health outpatient physicians, designed to streamline clinical documentation by automatically generating medical notes from patient-provider conversations. This helps clinicians save time and reduce administrative burden. The feedback that we have solicited, including informal surveys during our community meetings, indicates that faculty who have adopted this technology have found it transformative in increasing their ability to spend less time on administrative tasks, such as after-hours documentation of patient encounters. On a personal note, I saw my PCP recently and witnessed firsthand the impact of the ambient scribe on the encounter. I had a chance to review the note that we produced in real-time, which was pretty impressive and comprehensive.
All eligible outpatient ambulatory physicians can request a Nabla license. Find out more about requirements and request access here. I encourage you to adopt this technology!
I was also pleased to provide an update on the positive impact of our professional coaching program. The lessons learned by participants in the UCLA Department of Medicine professional coaching program — led by Dr. Khalili — appear to be a scalable solution for burnout. Results of an analysis of the efficacy of this program, comparing participants and non-participants, were recently published. They convincingly demonstrated the efficacy of this intervention individually or in a group setting to reduce burnout.
“Coaching is focused on helping you develop boundaries around work and on finding what brings meaning to you, both in work and in life,” Dr. Khalili said. “Burnout is very complicated, but coaching is one thing in our toolkit that can help us continue to keep it trending down.”
Other initiatives focus on building community, improving work-life balance and remaining resilient in the face of crisis, such as the LA wildfires and federal research and healthcare budget cuts. The wellness office has begun holding quarterly listening circles to give faculty and staff space to talk candidly about the challenges they face.
Thank you to Dr. Yoo; Dr. Khalili; our division wellness champions; Office of the Chair of Medicine Executive Director Libby Shin; Project Manager Nicole Suarez; and Dennis Ruenger, PhD, principal statistician in the UCLA Division of General Internal Medicine and Health Services Research, for your outstanding work, as well as to all of you who participated in the annual wellness survey. If you have thoughts on how we can improve or ideas for wellness initiatives, I invite you to reach out to Dr. Yoo, Dr. Khalili, your division wellness champion, or myself at any time.
Dale
P.S.
During the South Bay community meeting, I had a conversation with one of our outstanding PCPs in Palos Verdes, Robert Reiss, MD, who shared with me that he was going to run the Manhattan Beach 10K, this past Saturday. The results are in! Way to go Robert!!!
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