In this episode, Chris McDonald from Nothing Left to Giveinterviews Moral Injury of Healthcare Associate Elizabeth Holman, PsyD who is the palliative care psychologist at a Hospital in Colorado where she also serves on the ethics consult service. She is the handler of facility dog Tootsie and her research has focused on human-animal interactions.
Elizabeth shares her journey through burnout and how she overcame it. She describes what moral injury is, when it occurs and how it impacts healthcare providers. She describes the differences between burnout and moral injury. She also discusses ways providers can move through it.
In a recent article by Pratihba Gopalakrishna, a new study is discussed that focuses on burnout and how commonplace it may be. However, Drs. Wendy Dean and Simon Talbot believe the definition of burnout needs to be reexamined.
“If we’re going to talk about the condition of burnout, then we need to be much more rigorous about applying a strict definition and measure so that everybody’s talking about the same thing using the same scale,” said Wendy Dean, a psychiatrist and the co-founder of the nonprofit organization Moral Injury of Healthcare. Dean was not involved in the new research.
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.