In mid-2020, Duke University Medical Center's Internal Medicine residency program was facing a crisis. Emotional exhaustion was rising as physicians navigated fears about health risks and career impacts. Social isolation made an already demanding environment even harder. Leadership knew they needed to find new ways to keep people connected — and recognized.
Recognition that required too much effort
Before HeyTaco, the program's recognition system worked like this: if you wanted to acknowledge a colleague, you emailed the Program Director, who would then include the kudos in the weekly newsletter. It was well-intentioned, but the friction was real. As the team reflected, "less kudos were likely shared given the time and energy it takes to send an email to the Program Director."
The barrier wasn't will — it was workflow. Physicians were already stretched thin. A multi-step recognition process was easy to skip, even when gratitude was genuinely felt.
A community-first response to burnout
Leadership looked for a way to lower that barrier. Acknowledging the stress their trainees were facing and the reality of social isolation, they sought to increase feelings of accomplishment and foster community. HeyTaco offered instant, frictionless peer recognition — no email required, no waiting for the next newsletter.
"Acknowledging the stressful environment that our trainees were facing and the reality of social isolation, we sought to increase feelings of accomplishment and foster community."
Duke University Internal MedicineThe question was whether digital, real-time recognition could meaningfully change behavior among medical professionals. The answer came quickly in the data.
The results
Recognition messages increased 300% overall — from approximately 300 to over 900 messages annually. For established faculty, the increase was even more dramatic: a 600% jump compared to the previous year. The program also saw a tenfold increase in team-building messages. Physicians who rarely received public recognition were suddenly being seen — by their peers, in real time.
"Recognition went from a rare, effortful gesture to a daily habit woven into how the team works."
Duke University Internal MedicineThe lesson from Duke is straightforward: when recognition is hard, people do it less. When it's easy, the culture transforms. In one of the most demanding environments imaginable, a small change in workflow produced a massive change in how people experienced their work — and each other.