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Burn Out? No, It's Moral Injury.

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It’s hard to talk among any health care providers today without hearing all kinds of angst.

   I can’t get my charting done and have to take it home.

   My EHR is impossible.

   I spent more time on my computer than actually interacting with my patients.

   Is it normal to see ____ (fill in the blank) patients in a day?

   I hate that my prescribing practices are based on formularies and prior authorizations and not on what’s best for my patients.

   Why do Epi Pens and insulin cost so much?

   I know I am ordering tests the patient probably doesn’t need and maybe can’t afford, but I am afraid of being sued if I don’t.

   This billing and coding stuff is not what I went to school for….

Providers are talking about finding an exit plan, retiring early, or starting alternative type practices, including direct pay practices. Many are depressed and miserable and while not talked about much, the suicide rate among health professionals is rising.

Many articles have been written about the health care crisis and burn out. It’s as if we are to blame. Why can’t you see 85 patients in urgent care in 12 hours and feel good about the care you give? You want more pay? You want more time off? That will take money away from patient services. You need to learn how to manage your time better.

I bought into all this until just recently when I watched video by Zubin Damania, MD (ZDogg MD) called “It’s Not Burn Out, It’s Moral Injury”. And , it was one of those light bulb moments. In a few minutes, he articulated what so many of us are feeling. He nailed it.

Burnout implies something is wrong with us. We’re the problem. We’re not strong enough, committed enough, resilient enough. Moral injury happens when we are forced to be a part of or bear witness to events that go against our moral values to provide the best possible health care to all.

It’s not our fault. Calling it by its rightful name, moral injury, stops placing the blame on us and will help us to refocus our energies on identifying the problem so that change can actually start to occur. Now.

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