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Report from the Front Lines

Over the course of the year, we meet with residents, medical students, practicing physicians, and office staff in locations and facilities from Sacramento and Folsom to Anaheim and Moreno Valley, and from Cedars-Sinai Medical Center to Riverside University Health. The physicians we meet, wherever they are in the trajectory of their careers, share perspectives and concerns that are remarkably similar given the diversity of communities we have visited. Physicians, with all their gifts of remarkable intelligence and skill, are human too. They want to get things right, to promote good outcomes, to not just survive but thrive.

Physicians worry about not being able to practice their craft. They sometimes wonder what has happened to their dreams. Each physician has his or her own unique vision of what becoming a physician will mean to them and how they will live out their commitment to caring for the patients and families who come to them. This dream bumps up against the environment in which the physician practices. The current environment for healthcare delivery is uncertain and fluid, with competing and sometimes contradictory demands.

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Physicians worry about their ability to provide the best, most appropriate, safest patient care. The tension between their motivation and the practice environment prompts them to express frustration with the politics, legislation, and regulations that, in their view, pushes them to practice what they call “cookie cutter medicine.”  This perception is difficult to square with the goal of patient-centered care.

Physicians worry about being sued. The headline-making cases in the news often generate more heat than light, stoking physicians’ fears with dramatic descriptions of a physician’s or hospital’s failings. Most physicians say they know a colleague who was targeted unfairly or wrongly.

Physicians, especially those who are new to practice, worry about their own resilience. As their professional role evolves from novice to expert, meeting the challenge of the fourth element in the Quadruple Aim – caring for the caregiver – becomes a reality for them.  In the words of one physician, they “want to be strong” for their patients.

CAP physicians, leaders in their profession, organizations, and communities, know the worth of their leadership. When it comes to having a strategy for responding to the very real worries that confront them, CAP physicians can agree with Richard Corder, who, when he was at Massachusetts General Hospital, observed, “If the CEO [read physician] doesn’t get it, understand it, rally around it, speak to it, make it important among his or her team – then it’s not going to work.”

The good news for CAP members, and for the community beyond CAP, is that the components of CAP’s Residents Program and The Successful Physician have been designed and developed to offer information, tools, and strategies to support physicians and their staff as they deal with their concerns. The Residents Program and The Successful Physician provide guidance, leading physicians to their ultimate goal of getting things right — to becoming the physicians they want to be.

Working across departments and disciplines, the Residents Program and The Successful Physician mobilize teams composed of CAP and Schmid & Voiles staff to work with physicians and their staff in areas ranging from risk management fundamentals and professional development to specialty-specific risk management and enterprise risk management. Educational offerings such as: “The Impact of Physician Leadership on Quality and Safety”;  “Resilience – A New Take on Physician Wellness”; “Anatomy of a Lawsuit”; and “Payment Reform – How’s That Working for You?” are specifically designed to help physicians thrive.

The goal of the Residents Program and the Successful Physician is to meet CAP physicians and their staff, and their colleagues in the wider community, at the inflection point where we can be of most help in supporting their commitment to providing safe and effective patient care. 


Gwen C. Spence is Senior Account Manager, Membership Services for CAP. Carole A. Lambert is CAP’s Vice President, Practice Optimization. Questions or comments related to this article may be sent to