Marie meets with Dr. Paul DeChant, a former family medicine physician and CEO who now works as a health care management consultant. As a medical leader at the Sutter Gould Medical Foundation, Paul successfully led a system-wide transformation that enhanced clinician well-being and restored joy in caring for patients. Paul is the lead author of Preventing Physician Burnout which focuses on the use of Toyota Lean principles to improve the practice-level processes that have dehumanized the care experience for patients and doctors alike. In his conversation with Marie and Les, Paul focuses on removing the obstacles that come up in the course of everyday office practice. He emphasizes a process improvement approach that respects and embraces the opinions and insights of front-line office staff, stressing the importance of collaborative change initiatives. Paul underscores the importance of physician engagement. Without the buy-in of distressed physicians like Marie, turning around an oppressive practice situation may not be possible. Paul attempts to leverage his experience and track record to empower Marie, and others like her, in office-wide and system-wide transformation efforts. He stresses the importance of communication between front-line physicians and the medical and corporate leadership, and Marie is somewhat skeptical that her voice will be heard. Dr. DeChant explains that the when physicians and other members of the team are able to implement and sustain meaningful changes at the level of the practice, not only do people feel better about the care they deliver; the practice may even increase its capacity to accommodate more patients at the same time.