Moral injury is also coming to the forefront as physicians consider rationing scarce resources with too little guidance. Which surgeries truly justify use of increasingly scarce PPE? A cardiac valve replacement? A lumpectomy? Repairing a torn ligament? Dr. Dean explores these questions in the latest piece for Medscape entitled: COVID-19 Is Making Moral Injury to Physicians Much Worse.
Dr. Wendy Dean discusses why the term “burnout” does not encompass the full scope of the problem of physician distress with the team at Medscape, and what can be done to address physician career dissatisfaction. It starts with accurate terminology. Watch below or the transcription can be found here.
MD Says: How Doctors Can Stop Burnout and Moral Injury: Wendy and her coauthors have recently written articles describing the difficulties, frustrations, and some of the burnout that physicians have been experiencing lately. According to Wendy, this is not burnout. It’s much, much worse. This is moral injury that’s being inflicted upon physicians. Read the transcript and watch the video at the link below.
For more than a decade, the term burnout has been used to describe clinician distress. Although some clinicians in federal health care systems may be protected from some of the drivers of burnout, other federal practitioners suffer from rule-driven health care practices and distant, top-down administration. Reframing Clinician Distress: Moral Injury Not Burnout – our thoughts in the link below.
When the patient is a consumer there is a shift in the implied power dynamic. Rather than presenting to the physician seeking his or her expert advice and counsel, the interaction becomes a transactional one in which the physician provides a service and the patient pays for it. In this type of dynamic, the patient-customer is “never wrong,” according to Cesar Ritz’s well-known edict, broadly adopted in the hospitality industry.
Read the rest of the piece on Medical Economics. It’s time to retire the patient consumer!
When we began exploring the concept of moral injury to explain the deep distress that U.S. health care professionals feel today, it was something of a thought experiment aimed at erasing the preconceived notions of what was driving the disillusionment of so many of our colleagues in a field they had worked so hard to join.
Could burnout and anti-burnout initiatives championed by healthcare institutions be the healthcare equivalent of gaslighting?
“Gaslighting” refers to the act of psychologically manipulating someone to question their own sanity, in order to gain some advantage. Intentional or not, it carries significant repercussions for its targets, which in this case may be clinicians in our struggling healthcare system. In this article, Drs. Dean and Talbot explain Why ‘Burnout’ Is the Wrong Term for Physician Suffering.
The concept of moral injury expresses the systemic nature of the strain on physicians and the need for a comprehensive approach to address the problem. The root of the problem is “moral injury” resulting from the multiple roles physicians are playing in contradiction to their moral imperative to take care of patients, Simon Talbot, MD, and Wendy Dean, MD, wrote this month in a blog post published by Medical Economics. Are Your Physician’s Suffering from Moral Injury or Burnout?
The term moral injury has been gaining popularity in the internet-sphere, especially after, Wendy Dean MD and Simon Talbot MD’s article was released on STAT news. Moral Injury is an important topic to discuss as this terminology offers a broader understanding than the word “burnout.”
Burnout suggests a health professional is at fault for their emotional state: they aren’t resilient enough, and that they need to learn to recover better. Yet moral injury suggests something larger is at play. The consequences of this terminology and mindset change are immense, as we learn that hospital dynamics, insurance, litigation, electronic medical records, and policy must evolve, for health professionals to thrive.
Learn from our guests Wendy Dean MD and Simon Talbot as we discuss moral injury and its implications on healthcare.