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Moral Injury not Burnout

  • 1.  Moral Injury not Burnout

    Posted 14 days ago
    New language is being applied to the poorly fitting shoe of why physicians and associate providers are feeling not well in their practices. Rather than the dichotomous opposite of being Well, being Burnt out where the initiatives to correct these less than resilient doctors capacities, Moral injury taken from the military model and battered employee taken from the domestic violence model is catching fire.

    When a doctor is asked to more with less and work faster and simply suck it up and not complain the relationship in the medical culture is the problem, not the capacity to adapt to a withering standard....

    Does this resonate?

    Adam Schwarz
    Sent from my iPhone


  • 2.  RE: Moral Injury not Burnout

    Posted 12 days ago
    Exactly
     Bring up issues and you are "complaining"
    EVEN when suggesting the  solution

     I am head of the primary care service at my local hospital  Every month I send them an article - IMP stuff,various
     thought provoking stuff

     A few months ago I sent-so see if you can find it- one from JAMA about grieving doctors So thoughtfully done- you must know the author Adam by  how you write. We are grieving over loss of autonomy and inability to do our jobs and constantly  having to find work arounds to a  horribly broken system."medicare will not pay  for you to put the oxygen on her prn  even though her sats drop to77 and she has sever AS and is waiting waiting waiting to see cards) etc
    Other than the one on the use of the  word Provider by Alan Goroll  about 2 yrs ago  it  has been the article that resonated the most.
     thank you
     It is very  very hard out here now
    I take care of endless poor  disenfranchised  depressed  obese ignorant abused and abusing people
    Jean

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    Jean Antonucci
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  • 3.  RE: Moral Injury not Burnout

    Posted 12 days ago
    Moral Injury is appropriate term and I'm glad it's being used.   Not having that vocabulary when I wrote - but fought to keep the term "disenfranchised" in the title to at least broach the harm/injury that ignoring (and inciting) grief in a knowledge-based and ethically driven workplace causes, dare I refer folks to the article I authored (I'm not one to do so but feel it's pertinent) in 2016 (pub '17) see link below.

    The article does refute the notion that "lack of resilience" is part of burnout, though only briefly, and since detailed review of the literature does not support this - and I have spoken on this at CME conferences.

    Annals of Family Medicine 2017  Disenfranchised Grief and Physician Burnout .

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    D Lathrop
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  • 4.  RE: Moral Injury not Burnout

    Posted 11 days ago
    Yes that was the article I met
    Ok JAMA schmama
    It  was Annals  Great piece

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    Jean Antonucci
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  • 5.  RE: Moral Injury not Burnout

    Posted 12 days ago
    I think this is exactly right. I have long she can my head in disbelief and frustration at “wellness programs” that essentially perpetuate the status quo. Well yogurt during lunchtime is a nice idea, a nicer idea might be to allow positions to simply practice medicine.

    I see very little burn out among physicians who have reasonable patient loads and who feel they are able to do right by the person in front of them. I see lots of burn out among physicians who do not enjoy that type of practice environment but where there are multiple “wellness programs.”

    The part of this that is the most amazing to me though is how everyone knows what the problems are, but no one addresses them head on. Seeing 20 to 25 patients a day, endless hours in front of the computer, ever increasing amounts of busywork etc. will not be effectively countered by programs to prevent burnout. Moral injury does a better job of capturing this dynamic and burn out doe.