The pandemic challenged our clinical faculty with exhausting workloads and depleted resources. Leadership recognized early on the acute need to find better ways to support our clinicians and engaged faculty for input and advice. As a result, a restructuring workgroup was formed, and this committee aimed to create a new internal model that would deliver on all aspects of our mission, including better supporting the academic endeavors of our faculty.

Executive Vice Chair for Operations and Integration Juhan Paiste, M.D., MBA, FASA, CPE, and past Director of Regional Anesthesia Joel Feinstein, M.D., spearheaded the workgroup’s formation. To start the process, they took a grassroots approach to the process. Feinstein explained, "Specialties have overlap, but are not identical” in their needs. Therefore, each specialty was represented by an appointed committee member chosen by their peers and viewed as thought leaders in their respective areas.

Once the committee was formed, its members began the first phase of the redesign process, which included prepping and assessing the everyday needs of the clinical faculty. The committee asked questions such as “What do faculty members want from their careers?” and “Where do we want to go as a department?” After inquiring through an online poll, the committee compiled the answers and created a word cloud that was used as a compass for the committee to implement change. Faculty members expressed that they wanted the ability to practice what they wanted, where they wanted. They also voiced the need to have a better understanding of their workload and hours. Another concern revealed by the research was the want and need for more academic time to focus on continuing medical education and research within specialties. The committee worked with departmental leadership and scheduling staff to evaluate how they could answer this need.

“Our faculty starts every morning at 6:00 a.m., but previously, they were unaware of when their workday would end,” Feinstein says. “There is a lot of uncertainty in this profession with the workload. If their child has a soccer game, we want to make sure they can get to it.” Based on the feedback, the workgroup focused on three main areas: efficiency, productivity, and predictability. Paiste and Feinstein acted as liaisons between departmental leadership and the committee. They addressed the demands of a physician’s day-to-day job duties while taking into account the expectations the department and institution have for clinical care.

The solution to many of the concerns raised by the committee was to add more faculty members and support staff to our department. In 2023, more than 10 faculty are being onboarded to address personnel and academic time concerns. Additional staff members have also been hired to support onboarding and retention efforts, and various faculty members have been appointed to director-level positions to support the objectives laid forth by the committee. Moving forward, the committee will continue to implement new strategies, and although this is a work in progress, they have already seen improvements in faculty morale, wellness, and job satisfaction. In addition to the commitment to hiring additional faculty, the committee focused on addressing the uncertainty of afternoon coverage. A program was developed to value the afternoon coverage more highly while simultaneously setting the stage for future academic time to be available for all faculty. This system has now been in place for about six months and has been well received by the faculty.

“This workgroup’s high level of engagement combined with thoughtful analysis gave us the unique opportunity to discuss—honestly and transparently—challenges facing our department,” Paiste says. “I am extremely proud of the dedication this workgroup has shown to bettering the department and its people. The new model exemplifies our desire to make our physicians’ work-life balance attainable and shows our colleagues why UAB is an exceptional place to practice.”