Stress, Burnout, and Moral Injury

The State of the Healthcare Workforce

The buzz in healthcare is about clinician burnout. On the one hand, administrators and policymakers are concerned that clinical staff—doctors and nurses—lack the resilience and adaptability to cope with contemporary health system environments. Moreover, many are worried that frontline caregivers operating under stress will eventually experience burnout and, in turn, may jeopardize care quality. The perceived magnitude of the issue is leading to a call to expand on the Institute for Healthcare Improvement’s Triple Aim framework of controlling costs, improving the patient experience, and improving population health by adding a fourth aim to address clinician burnout.

On the other hand, some clinicians are starting to push back on the current burnout narrative. In particular, Zubin Damania, MD (aka ZDoggMD), uses his celebrity pundit status to articulate the alternative perspective that the underlying problem is the moral injury that is being visited upon clinicians by health systems. Moral injury, ZDoggMD explains, occurs when someone must commit or witness an act that violates their moral belief system. In the healthcare context, clinicians feel that their ability to deliver care is compromised by the systems (e.g., insurance, reimbursement, electronic health record) being implemented in hospitals, clinics, and medical practices.

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APA Ford, Eric W. PhD Stress, Burnout, and Moral Injury, Journal of Healthcare Management: May-June 2019 – Volume 64 – Issue 3 – p 125-127
doi: 10.1097/JHM-D-19-00058

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