AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
Featured topic and speakers
What does a chief medical officer do? Should kids get vaccines? What's the hardest part about being a pediatrician? How to talk with patients about vaccines?
Our guest is Sapna Singh, MD, chief medical officer of Texas Children’s Pediatrics. Dr. Singh talks about her new role and how she’s addressing the top challenges that pediatricians are facing today. AMA Chief Experience Officer Todd Unger hosts.
**NOTE: This episode was filmed on June 30, 2025, prior to the passage of the budget reconciliation bill on July 3, 2025.
- Watch AMA Update for health care news for physicians, residents and medical students.
- Not a physician? Join the Patients Action Network.
- Learn more about the AMA Health System Program.
- Check out AMA's Joy in Medicine® Health System Recognition Program.
- AMA Joy in Medicine Roadmap
- Access the AMA Joy in Medicine Guidelines (PDF)
- Looking for the AMA Joy in Medicine application? Submit an Intent to Apply form for the 2026 Joy in Medicine Program.
- Wondering what specialties have the highest burnout rate? Read which physician specialties are seeing a drop in burnout.
- The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most—patients. We will meet this challenge together. Join us.
- Learn more about our AMA advocacy priorities, including:
- Reforming Medicare payment
- Fighting scope creep
- Fixing prior authorization
- Reducing physician burnout
- Making technology work for physicians
Speaker
- Sapna Singh, MD, chief medical officer, Texas Children’s Pediatrics
Transcript
Dr. Singh: We have power in our position as physicians. We have power in that relationship with our patients. And that trust that we build with them is how we continue to educate and inform them.
Unger: Hello, and welcome to the AM Update video and podcast. Today we're talking with the new chief medical officer of Texas Children's Pediatrics, Dr. Sapna Singh in Houston, Texas. We'll discuss her top priorities as CMO and some of the challenges facing pediatricians and their patients right now. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Singh, welcome back, and congratulations on your new role.
Dr. Singh: Thank you, Todd. Thank you for having me today.
Unger: Well, you officially took over as CMO back in October, so you've been in the role for some time now. I'm curious, how are things going?
Dr. Singh: Well, I'm happy to report I haven't broken anything yet, and I'm still here, so it's been great. It's been a wonderful transition. Certainly a challenge moving from primarily a clinical role as a general pediatrician to now being a part of leadership and really being at the table where decisions are made and trying to see how all the different moving parts in our organization work together. It's been intriguing. It's been really inspiring to me.
And I think I've really embraced not only the challenge, but also I think, the exhilaration of being able to be in a role like this and being able to help beyond what I was able to do in my clinical role alone.
Unger: If you were advising other physicians out there who might be considering stepping into a leadership role like the CMO role, what's the one piece of advice that you would give them?
Dr. Singh: I would tell them to be extremely open minded about what it takes to be able to run a large health care system successfully. I think that it's fascinating to me how many preconceived notions I may have had as a physician and my role in the system as a physician, what I viewed the role of other people and other different departments to be. And now that I've stepped into this role, I've found such clarity in spite of some of the things that I used to think. So being open minded and being extremely enthusiastic about jumping in with both feet, both hands, and willing to learn, I think that that's really important.
Because as I said, what we learn as physicians, we are natural leaders of our clinical teams. That's just part of the job. But the whole system and operations of an organization and what it takes to really run that successfully, there's a lot that goes into it. And I think that we don't always know that until we're really put in front of it. So that's been inspiring for me. But I think coming into the role with an open mind has been the most helpful piece of the puzzle.
Unger: Well, I'm curious how that mindset prepared you for what is a very interesting time of taking on this role. Obviously, there's been a large measles outbreak in your area, and other diseases like whooping cough are on the rise due to declining vaccination rates. What have you and your colleagues been seeing on the ground where you are?
Dr. Singh: It's been a mixed bag. It's really been interesting because this is unprecedented. These are diseases that we really felt like we had gotten a handle on with our vaccination rates having been adequate for herd immunity, the fact that many of these diseases have not been seen in decades, not even by myself. There's many practicing physicians out there who've never actually even seen these diseases themselves. It's just been a completely whole new world, trying to figure out now how do we identify and treat diseases that at one time, we felt we had under control.
And that all comes with the effort that we have to make now to build trust with our patients, trying to assure them and reassure them that the advice that we're giving them is really coming from a place of us wanting to do what they want, which is take the best care of their children. And prevention is one of the most amazing things that science has been able to innovate and implement when it comes to health care. And so for us, being able to vaccinate children against diseases that we know can be catastrophic is a really, really important message for us to get out there.
So we certainly weren't, I think, anticipating that we'd be back discussing some of these diseases again, but we're here. And I think that what I try to do every day is not allow that to make me feel, in any way, in despair or just frustrated. I try really hard to take that and lead with an idea of we have power in our position as physicians. We have power in that relationship with our patients, and that trust that we build with them is how we continue to educate and inform them of what's right and what they can do to help protect their children.
Unger: That is a great way to state that, and especially in the world of pediatrics, where that kind of trust for family is so important. I don't know if it's surprising to you, but our research found that pediatrics is one of the top six specialties for physician burnout. Why do you think that is?
Dr. Singh: That does make me sad. I try to be really optimistic. That does make me sad. It's one of the most beautiful positions. To me, being a pediatrician is a calling. It's a chance for us to be involved in someone's life from the moment they're born until they finally graduate and go out into the world. And I think that that's what draws many of us to the profession, is just that beautiful journey with our patients and knowing that we can help them grow and develop and stay healthy and safe.
There's a lot of factors in pediatrics that work against us, though. We're human, and so the amount of work, especially unseen and unpaid work that now goes into primary care—not just pediatrics, but primary care in general—has just grown exponentially. When we're dealing with insurance companies and pharmacies and prior authorizations and trying to get services for our patients day to day, it can become really, really tough to manage that while also doing the work of taking care of our patients. That's really our first priority.
You've got costs that are rising across the board. That's for anything from supplies to staffing to just being able to support facilities. But reimbursements aren't changing. And when we start to hear things like the concerns around cuts to Medicaid, which a huge proportion of children do receive their services under Medicaid, it can be very scary for us as pediatricians to try to think through where will these kids go. How will they get the care that they need? Where will they go to be able to get preventative care, sick care?
And you add all that together now with some of the anti-science and some of the mistrust of the medical establishment that exists now, it's hard. It's hard. We're having tougher conversations with our families. We're having a much more difficult time trying to reassure people that we really are doing the right thing, and we want what's best for kids.
And so I can see how, as external factors push against us, and some things even internally, burnout, for sure, for pediatricians would be on the rise. I think what saves us most days is the kids. It's being able to interact with those children and their families. But that's not enough. We've got to get help for all the other things that are starting to really weigh down on us.
Unger: So you mentioned a number of different topics that really get in the way of both patient care and physician satisfaction. How do you see those really connecting in that world of patient care and physician well-being?
Dr. Singh: In terms of patient care and well-being, we have a mission to do our best to try to ensure that children are healthy and that they're taken care of. And that's not just going to be when they're sick. So a big part of our calling is to make sure that we keep children healthy and safe so that they don't need to come in and see us for being sick. And now there's the discussions around vaccines and vaccine safety and, obviously, the concerns that many parents have.
It's tough. I am in a clinic room with my patients for 15 to 20 minutes at a time, sometimes a bit longer, but that's the amount of time I have to also challenge the information that's thrown at them, hours and hours, day after day, that conflicts with what I'm trying to convey to them. So how do you do that? What is the strategy, the effective strategy for getting through, breaking through some of that misinformation? That's something that we're working on trying to do to support our physicians with, is how do you speak to families who have questions and are hesitant. How do you keep having those compassionate conversations, because the parents are worried, and they have true concerns. And they're hearing things that make them very, very worried about certain types of treatments. But it's our job then to have those conversations and get the truth out there, the real information out there, the facts out there.
Again, that can be wearing on you day in and day out. It's not something we used to have to do. We really had a relationship that was very much rooted in trust with families when you look back 20 years ago. And I think that trust still exists. It's just more effort now to work against some of the forces that we don't have a lot of control over.
Unger: Well, given all of this, from measles outbreak to lack of trust to physician burnout, how do you see your year two of being a CMO shaping up? What are going to be your top priorities?
Dr. Singh: My top priorities really are going to be supporting the physicians and the clinical teams to continue to face these challenges, but also to keep them positive and optimistic. I think it's very easy sometimes to really get bogged down by some of what we're hearing. And from one day to the next, things have changed so much. The health care authorities that we look to for much of our guidance, especially in pediatrics, have gone through a lot of change.
There's been many, many different changes that have occurred just in the last six months. And so we are now trying to redefine where do we find guidelines and policies, and how do we make sure that we continue to provide the highest quality and the highest standard of care to these patients. So it's me being able to find the resources to support our physicians and clinical teams, give them that education, give them those resources, and also leveraging things that we can do within the clinic walls that will help us be more efficient and make our work easier and much more, to make our work a little bit more back to what the fundamentals of what our calling is, back at the bedside.
So, for example, we've used AI as an ambient scribe technology in our clinical rooms with our physicians and patients. And in real time, it's recording our conversation. It helps to draft a note. I'm not behind the keyboard anymore. I'm speaking to my kids. I'm able to have a conversation with mom and dad. And as I leave the room, I can read through an AI-drafted note from our real conversation. And then I can close the note out and move on to the next patient.
It's a huge win. It's a huge win to take that work off the physician's plate and allow them to get back at the bedside. So support for the external factors we can't control and really trying to be innovative about how we continue to support our physicians in the work that they do day in and day out so that they feel more satisfied at the end of the day, that they've done what they really intended to. And that's taking care of kids.
Unger: Well, it sounds like there must be a lot of things going right, because you were recognized by the AMA Joy in Medicine Health System Recognition Program for your well-being efforts. I'm curious, just in closing, tell us more about that work and where it's headed.
Dr. Singh: So being able to use the Joy in Medicine roadmap, I think, is very helpful, because each step of the Joy in Medicine roadmap helps you build upon what you've already done. And so while we've had great strides in many of the endeavors that we've undertaken, there's still more work to do. And I think that that's something that we're going to continue to work at, we're going to continue to work towards—again, not with the focus of wanting to be awarded for this, but really for the focus that, are we doing right by the caregivers. Are we doing right by the people who provide care to our patients day in and day out.
Because I don't see how you can provide the highest level and quality of care to our families or children if those who are in charge of doing that care are just not well themselves. They've got to have the support. And I think that that is something that I take extremely seriously in my role.
Unger: Well, Dr. Singh, we wish you the best of luck with all that you're doing. And thank you so much for joining us today, and congrats again on your new role.
If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/joinnow. And to learn more about the AMA Joy in Medicine Recognition Program, visit ama-assn.org/joy. That wraps up today's episode. We'll be back soon with another am update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
Subscribe to AMA Update
Get videos with expert opinions from the AMA on the most important health care topics affecting physicians, residents, medical students and patients—delivered to your inbox.
