Health system mergers can create uncertainty, workload burden and cultural strain. During its integration with Lehigh Valley Health Network, Jefferson Health worked to address these challenges and create space for dialogue.
“We combined two health systems with deep-rooted cultures, both internally and externally,” said Nicole Escobedo, senior director of clinician well-being for Jefferson Health
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For this reason, it was important to honor the differences of each legacy system while building a unified approach. This meant prioritizing the well-being of physicians and other health professionals to ensure their readiness and comfort with a newly merged ecosystem and culture, said Escobedo, who joined Amy Jibilian, MD, a pediatrician and well-being clinical lead for Jefferson Health’s Lehigh Valley Region, for an interview with the AMA.
Based in Philadelphia, Jefferson Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with reel designation in the AMA Joy in Medicine® Health System Recognition Program, which empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive
Well-being is woven in with cultural change
Combining two organizations with unique ecosystems is a work in progress.
“We’re evolving our legacy cultures to forge one cohesive culture and shared identity,” Escobedo explained.
A key priority is ensuring the process did not strip the decades of culture from each of the legacy systems. Well-being is being woven into that effort—not treated as a separate initiative. Feedback from across the organization has highlighted the impact on frontline physicians.
Based on AMA Organizational Biopsy® results, “one of the biggest concerns that we’re hearing is the effect that combining two very strong health systems has had on frontline physicians,” Escobedo said.
At the leadership level, she sees reason for optimism. Executives are “empathetic” and openly discussing “the moral and well-being impact that some of these tough decisions have on physicians.”
Importantly, Escobedo stressed that leaders are not dismissing those concerns. Instead, “they are creating space and honoring the unease that is caused when two systems come together,” while also working to bring voices from across regions into a more unified conversation
Dr. Jibilian framed the challenge in more universal terms. Mergers, she said, inevitably bring fear, uncertainty and concerns about maintaining that sense of respect and value. Supporting well-being during change means fostering psychological safety, balancing transparency with stability, and reinforcing a shared purpose
This is about merging two groups of people who have their history and their culture. The goal is to embrace cultures and differences while blending them into a stronger whole. That includes continually reinforcing that “you’re all valuable … we all respect one another” and are working together to build a stronger, more effective organization, Dr. Jibilian said.
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The AMA played a key role in the merger
Escobedo noted that the AMA played a key role as a neutral partner during the integration of the two distinguised well-being programs at Jefferson Health and Lehigh Valley Health Network. The AMA was a third party that both health systems had engaged with prior to the merger.
“The AMA was very knowledgeable about legacy Jefferson and legacy Lehigh Valley,” noted Escobedo. The organization helped identify areas of alignment and difference, and guided prioritization. The AMA helped the teams stay focused on “the right pieces of well-being” while navigating a complex transition
This meant pinpointing where differences in strategies existed, circling back to the principles of the AMA’s Organizational Biopsy and the Joy in Medicine Program
“They helped me stay calm and focused during the integration, reinforcing that we didn’t need to do everything at once, but could pause to build relationships and understand the organization,” said Escobedo.
Throughout this merger transaction, it was important to show that Jefferson Health was strong—its employees were going to be okay and make it through this, Dr. Jibilian stressed. “Those are human well-being concerns, as you’re going through change. So, I think that’s maintaining the sense of security.”
Ultimately, those concerns extend beyond physicians.
“It’s not just the physician—it’s every single person in that organization” navigating the uncertainty of change, she said.
Download the 2025 AMA Joy in Medicine® magazine (log into your AMA account to view) to see whether your organization is part of the prestigious group of 164 organizations across 40 states and the District of Columbia that are currently recognized for their dedication to physician well-being
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