Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Organizational approaches to address burnout and moral distress 

Aldebra Schroll, MD
Physician
March 13, 2022
77 Shares
Share
Tweet
Share

My interest in the topic of physician wellness dates to my residency. We were required to do a project, and I opted to survey my colleagues about their health habits and concerns. I was not surprised to find that residents were unable to commit to the health recommendations we give our patients. For example, only 25 percent of respondents met the American Heart Association recommendations for physical activity. Access to healthy meals was another concern. The response at the time was to point out that vending machines were available during overnight calls, not a good source for nutritious food. Thirty percent of my colleagues had been treated for depression in the preceding year. Others described feeling anxious, depressed even suicidal but did not have the time to seek care or did not feel comfortable asking for help. Fortunately, the conversation is evolving, and we are beginning to recognize the need to address physician wellness and the conditions that place us at risk for burnout. The pandemic has emphasized the urgent need to address these issues.

Historically, much of the discussion around burnout and physician wellness placed the onus on individual providers, advising resiliency training and mindfulness, among other approaches. However, the issue of burnout is not solely an individual problem but rather a systemic issue. There is a growing body of research and recognized institutional policies to support caregivers.

In their recent Lancet commentary, Drs. Linzer and Poplau discuss the challenges of burnout and moral injury (MI) among health care workers. Moral injury occurs when an individual feels constrained in pursuit of ethical care. It is the result of contradictions to our deeply held moral beliefs. As an example, understaffing limits the ability to offer high-quality care. Moral injury and burnout are highly correlated; both contribute to a provider’s intent to leave practice.

In their podcast Moral Matters, Dr. Wendy Dean and Dr. Simon Talbot explore moral injury through a variety of guest interviews covering topics from how metrics influence institutional priorities to a discussion on what leads people to speak up when faced with a moral challenge and personal stories from those on the frontlines of the pandemic. They offer a great avenue to further explore the issues leading to moral distress among health care providers.

Studies on stress and burnout find that chaotic work cultures, misalignment of personal values with organizational leadership, time pressures, and lack of control elevate the risk of burnout. Since the arrival of COVID-19, concerns around exposure to infection and the risk of spreading it to loved ones are added sources of stress. The pandemic has also emphasized the underlying disparities in health care access, a source of moral distress for many providers. The polarization and political divisiveness have further aggravated health care workers’ stress levels.

Research has uncovered important mitigating factors, including feeling valued by the organization and sharing a mission. However, it is not simply a matter of verbalizing appreciation; the staff must feel heard. If they are left without the needed support to do the work, then people do not feel valued. Organizations must respond in concrete ways to demonstrate their appreciation for their workers, asking, “How can we help? What do you need?” Then, there must be follow-through to mitigate stressors. Maintaining the staff’s trust should be an essential priority; once lost, it is very hard to regain.

Organizations have struggled to respond to these challenges, often resulting in high turnover and the associated expenses of replacing staff. Moving forward will require a partnership between providers and executive leadership. Recommendations include making burnout and moral injury organizational priorities with regular assessments to identify the levels of burnout/MI among medical staff. Mental health support and suicide prevention should be offered, assuring staff that help is available and removing the stigma of asking for help. Other suggestions emphasize providing time for meaningful clinician-patient engagement, workload assessment, enhanced efficiency, flexible scheduling to improve work-life balance, and a supportive, compassionate organizational culture. These approaches offer a wise investment in sustaining our health care workforce for the future.

Aldebra Schroll is a family physician.

Image credit: Shutterstock.com

Prev

Requesting disability accommodations in medical school [PODCAST]

March 12, 2022 Kevin 0
…
Next

To treat future COVID variants, we need more than vaccines

March 13, 2022 Kevin 0
…

Tagged as: Psychiatry

Post navigation

< Previous Post
Requesting disability accommodations in medical school [PODCAST]
Next Post >
To treat future COVID variants, we need more than vaccines

More by Aldebra Schroll, MD

  • We need to talk about the bullying in health care 

    Aldebra Schroll, MD
  • Tired of the dying: Finding parallels in COVID-19 and HIV

    Aldebra Schroll, MD
  • Should professional athletes get priority in COVID testing?

    Aldebra Schroll, MD

Related Posts

  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • Moral injury in medical school

    Anonymous
  • A medical student’s reflection on burnout

    Sarah B. El Iskandarani
  • Burnout doesn’t start in medical school

    Anna Goshua
  • Why are we failing to solve burnout?

    Baird Brightman, PhD
  • The medical profession must address the injustices Black patients suffer

    Angi Kang, MD, MPH

More in Physician

  • Heartwarming stories of cancer patients teaching us about life and the human spirit

    Johnathan Yao, MD, MPH
  • We need a new Hippocratic Oath that puts patient autonomy first

    Jeffrey A. Singer, MD
  • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

    Ton La, Jr., MD, JD
  • How can there be joy in medicine if there is no joy in Mudville?

    Arthur Lazarus, MD, MBA
  • Physician entrepreneurs offer hope for burned out doctors

    Cindy Rubin, MD
  • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

    Elizabeth Cerceo, MD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Catching the Optimal Amount of Z's May Be Protective Against Long COVID
  • Treating Early Hospitalization Blood Pressure Deemed a No-No for Patient Safety
  • Addressing Burnout in an Invisible Part of the Health Workforce
  • Family-Oriented Sedation Protocol Helps Kids With ASD Manage Routine Healthcare
  • Bariatric Surgery in Kids With Obesity Becoming More Common

Meeting Coverage

  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • The Role of Amyloid PET in the Management of Alzheimer's Disease
  • New Inflammation Inhibitor Proves Effective and Safe for Dry Eye Disease
  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Organizational approaches to address burnout and moral distress 
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...