Leadership really sets the tone, the cultural norms, and the expectations for middle management, which then set the climate in the clinics or on the wards. So, it's crucial that it comes from the top of the organization. Increasingly, we're finding that's where requests for our services [are originating].

Schwartz Rounds offers the opportunity for empathy in community through communication. Some of it's through perspective-taking. Some of it is through personal sharing, recalling memories, recalling common experiences about things that happen in the everyday care of patients and their families.

To the extent that the information [shared by providers] is received by leaders and managers, it's going to co-construct a culture of caring and compassion. [It builds] authentic compassion and caring at a leadership level for the people they oversee. For leadership, having an understanding of who your people are outside of [the traditional] “town-hall"-style meeting, that goes a long way.

Extremely important. Burnout is a reflection of the interaction of personal and organizational resources, how a physician's support structures and personal resiliency intersect with their professional role.

There is starting to be a lot of pushback about burnout being perceived as an individual failure — like, “you're just not strong enough." If you really want to support clinicians, providers, and staff, you need to create an environment in which they feel connected, in which they have a sense of purpose. That's very different than saying, “Go take a yoga class or meditate." Burnout is really an occupational syndrome.

Not at all. We have looked at the impact of our Schwartz Rounds program on several domains of care and physician well-being. One was isolation, a sense of stress, feeling alone in your work. We found a dose-effect response among caregivers who attended the rounds. The more frequently they attended, particularly with teammates, the less they endorsed the concept that they felt isolated.

We find that caregivers draw a tremendous amount of fulfillment and resilience in hard times from their relationships with colleagues. That is so important. If you have someone you can turn to, someone you can trust, someone who understands, that is huge, no matter how hard things get. I can't say enough about that.

Definitely. The more wraparound care and support you can have, the better off patients are going to be, and the happier doctors are going to be. They're happier when they have the time and the flexibility in their schedule to spend however much time they think they should with their patients. And they feel more connected.

The best primary care physicians are those who know what's going on with patients' personal and family lives. You know, their angst, their happiness, their joys, the generations. We're not technicians.

Any organization that facilitates true relationship-based care is a capable organization in my book.