When Doctors Can't Help Patients: The Moral Injury Crisis

And she says the problem can become especially painful when a physician feels powerless to protect patients.

Dr. Singh recalled a physician she'd interviewed who had returned to rural Kansas, where he'd grown up, to provide medical care.

He described a case involving a patient with a serious neurological problem that another doctor had failed to recognize.

When he raised concerns about the quality of care, the hospital administrator defended the other physician.

Well, you know, maybe

he wasn't perfect, but he's a really good team player.

Maybe you should learn

to be a good team player.

The Kansas physician was torn.

He didn't want to work under such conditions, but couldn't bear to abandon his community either.

This is how he explained it to Dr. Singh.

We tried to do that direct primary care, but I was working, you know, 12 hour days and trying to like spend the weekends organizing labs and papers and That didn't work.

And I just, I don't know what to do.

And it would break my heart to leave Kansas where I grew up and came back because clearly these people need good medical care and clearly they're not getting it.

and clearly their hospital doesn't care about giving that to them.

That's moral distress.

That's moral injury.

Knowing the right thing, knowing that the system is not incentivized to actually provide that care.

In the

PNHP survey, 43% of respondents said they often or always felt pressured to prioritize productivity over patient care.