About half of doctors surveyed say they’ve felt symptoms of physician burnout., katleho Seisa, Getty Images
Doctors Say They Face ‘Moral Injury’ Because of a Business Model that Interferes with Patient Care
Physician Keith Corl was working in a Las Vegas emergency room when a patient arrived with chest pain. The patient, wearing his street clothes, had a two-minute exam in the triage area with a doctor, who ordered an X-ray and several other tests. But later, in the treatment area, when Corl met the man and lifted his shirt, it was clear the patient had shingles. Corl didn’t need any tests to diagnose the viral infection that causes a rash and searing pain.
All those tests? They turned out to be unnecessary, but left the patient with over $1,000 in extra charges. The excessive testing, Corl said, stemmed from a model of emergency care that forces doctors to practice “fast and loose medicine.” Patients get a battery of tests before a doctor even has time to hear their story or give them a proper exam.
“We’re just shotgunning,” Corl said
The shingles case is one of hundreds of examples that have led to his burnout with emergency medicine. What’s driving that fatigue and exasperation, he argued, is something deeper — a sense of what he called “moral injury.”
Corl, 42 and now an assistant professor of medicine at Brown University, is among a growing number of physicians, nurses, social workers and other clinicians who are using the phrase “moral injury” to describe their inner struggles at work.
The term comes from war: It was first used to explain why military veterans were not responding to standard treatment for post-traumatic stress disorder. Moral injury, as defined by researchers from veterans hospitals, refers to the emotional, physical and spiritual harm people feel after “perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations” [. . .]