May 24, 2022

Ep 7 Doctor Burnout and Moral Injury

I learned so much talking with Dr. Leitner on the topic of burnout among physicians. I wasn’t really that familiar with terms like moral injury, learned helplessness, (other) before this.

If you simply use the term burnout, it implies that the problem is something that the doctor has done, can’t do, or has failed at. It does not take into account all of the stressors on doctors that lead to the feeling in the first place. Enter the term “moral injury”. First used in relation to Vietnam vets, it broadly means that you’re being asked to do something that does not align with your value system.

This site gives an excellent rundown of the history of both the word burnout as it applies to doctor life but also some of the big factors in US healthcare that changed and led to more stress on doctors. Though, interestingly, the article does not mention the rise of Medicare in the 60s and the administrative burden of paperwork related to Medicare patient care, which has been cited by others as an additional cause for stress. Also, the article incorrectly states that burnout is classified as a medical condition by the WHO (World Health Organization), but that’s not true – it's called an “occupational phenomenon”, specifically not a medical condition.

The WHO in 2019 formally recognized burnout as “Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and 3) a sense of ineffectiveness and lack of accomplishment. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

My interview with Dr. Leitner gets into just what the external and internal forces are at work against the physician, and we discuss what coaching is and how it can help.

I really worry about future classes of medical students. Since rates of depression and anxiety are on the rise in today’s adolescents, will those young adults be ready for the onslaught of stressors on doctors embedded into today’s healthcare system?