Beyond Burnout Docs Decry Moral Injuries From Financial Pressures Of Healthcare

 

How to Heal a Moral Injury – Healing Healthcare Workers in the Aftermath of Coronavirus

Video taken from the channel: The Doctor’s Kitchen


 

What is the Cause of Moral Distress in Healthcare Professionals? | Cynda Rushton

Video taken from the channel: Oxford Academic (Oxford University Press)


 

Moral Injury In Healthcare: Time To Fight Back

Video taken from the channel: ZDoggMD


 

Moral Injury of Healthcare—It’s NOT burnout

Video taken from the channel: Austin Dean


 

Moral Injury In Healthcare

Video taken from the channel: WBUR CitySpace


 

It’s Not Burnout, It’s Moral Injury | Dr. Zubin Damania on Physician “Burnout”

Video taken from the channel: ZDoggMD


 

Burned out doctors or broken system? | The Stream

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Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her. Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her.

Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her. ‘Moral injury’ is the root cause of physician burnout, and it occurs when clinicians are blocked from doing so by systemic barriers related to the business.

Beyond burnout: Doctors decry ‘moral injury’ from financial pressures of health care. Melissa BaileyKaiser Health News Wednesday Feb 5, 2020 at 3:27 PM Feb 5, 2020 at 3:27 PM. Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her. Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her patients in longer visits, offering both psychotherapy and medication management.

Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her patients in longer visits, offering both psychotherapy and medication management, but that became more difficult. Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. Drs. Wendy Dean and Simon Talbot, a psychiatrist and a surgeon, were the first to apply the term to health care.

Both wrestled with symptoms of burnout themselves. They concluded that “moral injury” better described the root cause of their anguish: They knew how best to care for their patients but were blocked from doing so by systemic barriers related to the business side of health care.

List of related literature:

According to Maslach (2003) anyone who works with needy people, and particularly healthcare workers, is at risk of burnout.

“Psychology for Health Professionals” by Patricia Barkway
from Psychology for Health Professionals
by Patricia Barkway
Elsevier Health Sciences, 2009

Moral distress and its contribution to the development of burnout syndrome among critical care providers.

“Oxford Textbook of Palliative Nursing” by Betty Rolling Ferrell, Judith A. Paice
from Oxford Textbook of Palliative Nursing
by Betty Rolling Ferrell, Judith A. Paice
Oxford University Press, 2019

People who have worked in health or social care for some time may be vulnerable to a condition called ‘burnout’ (Maslach et al. 2001).

“Psychology for Nurses and the Caring Professions” by Jan Walker
from Psychology for Nurses and the Caring Professions
by Jan Walker
McGraw-Hill/Open University Press, 2012

In a leading ethics journal, Eric Meslin characterized the strike as a double failure for the profession: it lost its case; and having reneged on a moral duty to provide health care, it lost sympathy and credibility.

“History of Medicine: A Scandalously Short Introduction” by Jacalyn Duffin
from History of Medicine: A Scandalously Short Introduction
by Jacalyn Duffin
University of Toronto Press, 1999

Sadly, health care professionals have reported substantially higher degrees of burnout than managers not employed in the health care industry (Golembiewski & Boudreau, 1991).

“Organizational Behavior in Health Care” by Nancy Borkowski
from Organizational Behavior in Health Care
by Nancy Borkowski
Jones & Bartlett Learning, 2016

As discussed above, burnout is associated with patient dissatisfaction, medical errors, and lower quality of care, all of which in turn are associated with malpractice claims.

“Physician Mental Health and Well-Being: Research and Practice” by Kirk J. Brower, Michelle B. Riba
from Physician Mental Health and Well-Being: Research and Practice
by Kirk J. Brower, Michelle B. Riba
Springer International Publishing, 2017

Relieve public and private charities of financial drains resulting from uncompensated work-related injuries and illnesses.

“Fordney’s Medical Insurance E-Book” by Linda Smith
from Fordney’s Medical Insurance E-Book
by Linda Smith
Elsevier Health Sciences, 2019

Professional burnout is a significant problem with staff who provide medical care to terminally ill children.

“Encyclopedia of Special Education: A Reference for the Education of Children, Adolescents, and Adults with Disabilities and Other Exceptional Individuals” by Cecil R. Reynolds, Elaine Fletcher-Janzen
from Encyclopedia of Special Education: A Reference for the Education of Children, Adolescents, and Adults with Disabilities and Other Exceptional Individuals
by Cecil R. Reynolds, Elaine Fletcher-Janzen
Wiley, 2007

Burnout syndrome among critical care healthcare workers.

“Essentials of Hospital Infection Control” by S Apruba Sastry, R Deepashree
from Essentials of Hospital Infection Control
by S Apruba Sastry, R Deepashree
Jaypee Brothers Medical Publishers Pvt. Limited, 2019

Today nobody has ajob for life; and nobodycan rely on a secure pension, anymore than theycanbe confidentabout getting a decenteducation for theirchildrenin state schools orprompt and efficient medical treatment through the NHS (Toynbee, Walker 2001).

“MMR and Autism: What Parents Need to Know” by Michael Fitzpatrick
from MMR and Autism: What Parents Need to Know
by Michael Fitzpatrick
Taylor & Francis, 2004

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Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

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  • also these kinds of profesions atract psychopaths who like to think of themselves as better then everyone else just like polotics!

  • The chronic pain community are rejecting surgeries because of bad treatment and lack of compassion when dealing with the post op pain that has become prevalent in our society. Hit them in their pocket to wake them up. Thats the only thing they understand, MONEY

  • Very interesting. I’m a patient who.always worries about her doctors and nurses. I don’t know how any of you do what you do.

    Reading the comments below, that speaking up solo just gets you punishment, can anyone tell me, have doctors organized? Do MDs or NPs have unions?
    I would much rather be seen by someone who has a good work/life balance, not for my own sake, but because that is my provider’s right.

  • The same happens to police and we are abused not only by the system but the public.
    We care but are treated like criminals even with the highest of performance and compassion

  • I’m glad I hung with this. At first I thought, call it whatever you want, I’m exhausted, antsy, and irritated with what I have to face every day. But he spins the experience to point back to the nameless, faceless, giant monster of a system we still don’t have much hope of controlling. So, Yes let’s please let us take back our power to do what we were trained to do! But how? There’s always someone to replace us who has yet to become exhausted, cynical and morally injured. And our employers know it.

  • There are over 300 hundred million people in the US if 100 million people donate $1 each 5 days a week 52 weeks per year then it will be possible to make medicine affordable for all the less fortunate

  • @ZDoggMD my Dad passed away on Oct. 9th from a PE. At 88 years and the situation looking grave. I told the doctors he was a DNR and with that the decision was made not to vent if things got worse. With that I signed the permit for a chest tube and requested a BiPAP and Comfort Care meds if needed. When the needle was inserted in preparation for the chest tube my Dad went into full respiratory failure. He slipped away peacefully.

    When Dr. Winters a fan of yours pronounced my Dad’s time of death. I looked at the doctors and nurses at his bedside. I told them, don’t look at my Dad’s passing as a failure. By questioning their training of the what, if, would or should they had done differently. But to walk away with peace knowing they did everything right from my knowledge of the situation. My gratitude was knowing everyone in that room had done their best. Most of all they afforded my Dad the right to transition with dignity.

    ZDoggMD as a longtime caregiver to both of my parents until the bitter end. I want to thank you for helping me to understand the difference between letting go and making demands of doctors to continue to torture my love ones. In a futile effort, at the very best, may have only delayed the final outcome.

  • doctors are drug dealers and killers! also doctors who are unhealthy themselves and yet people still look to these people to fix them lol the whole western medicine system is a fraud no wonder theyre killing themselves! if you want to fix people go out to the jungles and grab some herbs

  • Solving burnout involves bringing back the third shift of a twenty four hour period. These shifts would run:
    7am-3pm, 3pm-11pm, 11pm-7a this encompasses 24hrs from 7am to 7am the next day where the same cycle begins again.

    These three shifts allow for three crews. In the hospital saves money because you’re only paying people out on straight time instead of overtime.

    This overtime happened when the third shift of 11 PM to 7 AM was eliminated to save the hospital Money.

    It does not save money and cost people resources Because there’s no money to be able to buy the appropriate supplies.

    The two standard 12 hour shifts is what’s causing your burn out or moral injury because too many healthcare workers are away from their families their love ones and never get the appropriate amount of time downtime Needed to stay 20 years in a business like this one.

    This cuts down on pension plans because no one sticking around long enough to get them.

    ZzDog I hope this information helps you sir

  • I can relate Z-Dogg! I see this daily as a therapist at the agency I work for. I think we need to get rid of bad administrators & supervisors too.

  • may be it is because the Zionist criminal Big parma pay them to finish med school and they can’t tell people the truth, they have to push bad drugs or even worse about the truth about vaccines.

  • 0:28 Thank you!
    One problem, tho:
    Many people are talking about “Moral Injury” as if it is the same as character flaw.
    So, same problem.
    Make sure we are getting the meaning straight, not just using words who’s definitions keep getting revised according to the agenda of The System.

  • Be serious! Good doctors have to work side by side with bad doctors every day. They deal with peers who care about nothing but money, and there’s nothing they can do about it without causing problems for themselves.

    One thing has always been true: a lot of doctors just aren’t very good at what they do. A lot of plumbers aren’t very good, either, most of the time nobody dies because of it, but failures to perform well can make life unbearable for the people they serve.

    Now doctors are working for the government. Government jobs are notorious for causing burnout. That’s what happens when politicians and businessmen are making medical decisions.

  • Dr Z I resigned after 13 years in social work (healthcare) for this reason yesterday. I Never thought it would happen to me bc I was so ethical and passionate and motivated but that’s what did me in

  • We must take care of those that take care of us doctors are extremely important we need a lot of doctors and nurses because without them we will be in tremendous trouble as a former law enforcement people could even deal and survive without law enforcement but without doctor Humanity does not have a chance

  • I’m a Special Education Teacher and I can relate. I’ve realized that I’ve blamed myself for the dysfunction of the education system and my own areas of inadequacy to implement a cohesive lesson plan. I’ve slowly started to heal, but it’s only been in the past few months. I had turned in my resignation at the beginning of the year because I wasn’t getting the appropriate training from the school District. And when I did the Principal gave me the excuse that his wife has her master’s and said that my case load was typical and wasn’t over whelming. And I wanted to say, “Really?! Have you looked up the turnover rate for teachers in general?!”

  • a general physician makes 700k-1.2mil a year in Canada. it almost doubles and triples for surgeons. It’s higher in the US. who said the profession and that kind of money is going to be a walk in the park? it takes 10 years for the most mortals to earn that kind of income

  • Those doctors who suicided they would nt be monotists they would be whether ethists or non GOD believers. It could call a Modern physcalgical catastrophic alergiya? If the doctors are like these what would conditions of patients. Please return to One Natural GOD and ONE natural CREED. So, medleast like countries especially Muslims countries suicide rate very small like finger counting.?

  • It is possible to be resilient to burnout.

    # Individual resilience to burnout

    It is possible to design environments where burnout if far less likely to happen.

    Assertiveness, ensuring people around you understand you situation, having a good network of friends and family, carefully unpacking the events that happen to you can all help deal with burnout.

    # Moral injury, PTED, PTSD

    I think PTSD and moral injury should be though of as distinct. PTSD tends to be more about fear / emotional arousal

    My theoretical for moral injury / post traumatic embitterment disorder, PTSD and burnout would be a little different.

    * I think conventional burnout is more like a form of “social / group ptsd” being kept in an environment where there are unreasonable / unfair expectations of you and you lack control.
    * Moral injury (which I think is the same as post traumatic embitterment disorder though this is perhaps controversial) is more about a society a society that is immoral and you can’t trust
    * PTSD tends to be about safety.

    There is some overlap between moral injury and burnout, but burnout can be more localised.

    # How to treat moral injury

    Your proposed treatment is preventing the system from causing moral injury. This works. There are alternatives treatments for moral injury / PTED.
    Linden focuses on “wisdom therapy” which involves placing situations in context.
    Some of the treatments for soldiers focus on things like: having a community accept what they have done / gone through or strong involvement in a community.

    My suspicion (following Jordan Peterson somewhat) is that another modality would look at concepts like:

    * Assertiveness to misuse of power / realising what agency you have
    * Limits of personal responsibility for the misuse of power

  • In California, the governor just signed a Nursing Whistleblower Protection Bill. I think physicians need the same thing. Front line providers need to be able to report anonymously willful harm. My daughter was killed in a hospital and I’ve been reading the medical records. I’m so horrified. My non-terminally ill daughter enter the hospital for gastric distress and ended up being euthanized against her will not just my opinion either it is also the opinion of the depty attorney general who prosecuted the nurses who were caught red handed in the act of grinding 12 hour time release morphine into my sleeping daughter’s freshly placed feeding tube (no pain charted all day). this isn’t the only act that killed my daughter 14 hours later, to make sure she died one of the grinding nurses then just started escalating fentanyl until she stopped breathing another nurse escalated Propofol and in her blood stream at death was an overdose of another when drug as well. The reason why I mention this story here is because there was another nurse a day before who honored my daughter’s refusal to NOT take the TAB Morphine, and she also didn’t start the fentanyl when it was ordered either because blood pressure was too low. This nurse was thrown under the bus by the hospital after I filed complaints about the perps. I asked the nursing board why this other nurse was being charged with anything and they said the hospital gets first shot to review complaints and can add others to it and the hospital added the nurse that refused to harm my daughter. So I clearly see what the hospital staff is up against. If you do not participate in scheduled harm, then you will be prosecuted, and you will not even be able to actually save the patient from this fate. I see it and me this graceless traumatized, grief-stricken, horrified, mother who failed to save her daughter no matter how I tried even I see you guys as yet another level of victim not the lst victim and not the 2nd but probably the 3rd level. But only YOU GUYS CAN STOP THIS GREED FUELD DEATH SPIRAL OF PATIENTS AND MORALITY AND LIBERTY, PURUSIT OF HAPPINESS, CIVIL RIGHTES, ETC…. YOU HAVE TO GET BRAVER AND GROUP TOGETHER. FIGHT FOR WHISTLEBLOWER PROTECTION AND ALSO SINGLE PAYER HEALTHCARE that pulls all the data together under the possible real time scrutiny of a government run healthcare instead of a profit seeking entity with some government oversight made up of people who plan to cycle back into a lucrative industry job on the provider side for a big bag of money. Hopefully, government will become once again FOR THE PEOPLE and be trust worthy of this responsibility but I KNOW corporatocracy cannot be trust worthy of this kind of BLIND FAITH. I watched Dirty Dancing for the first time lately not even sure why I think I couldn’t sleep and thought a boring teen love story would knock me out but instead I found a gem of hope. In the first scene the book The Fountainhead is mentioned as a guide to learn about which people matter and which dont; but at the beginning of the 3rd Act Johnny says “baby taught him that there are some people in the world that are willing to stand up for others even if it costs them something.” We have to again learn to feel grateful about the opportunity to really stand up for something and somebody, anybody who has been stripped of their voice and life. we will all lose something standing up for the vulnerable, but maybe we will learn it’s worth it. if you want all the documents to prove the above story let me know it’s way worse than I’ve described. Alternatively, you can also google NBC investigates Kaiser death 2017 TERRY PANEPINTO this woman should NOT be dead. Like my daughter she entered same bank of east bay hospitals with gastric distress only Terry was brain dead in less that 12 hours. I was told after my daughter’s death by both a guy from the BOARD OF DIRECTORS AT THE HOSPITALS and also the Dept of Public Health that a bunch of safety measures were now in place so that no other patient would die by nurses overdosing them with sedation while IGNORING VITALS SIGNS but then Terry dies and it hits the news…so it’s clear to me this is going on A LOT and didn’t slow down one bit after those “safety measures” were put in place. Plus the hospital did NOT report these drugs “errors” to the DOPH and was NOT fined for this in either case, and the DOPH did NOT fine IMMEDIATE JEOPARDY VIOLATIONS on either death as well…it’s just ridiculous. PLEASE FIND A WAY TO STOP THIS. I watched my daughter beg for her life while being drowned by fluid overload prior to the final overdose it was so terrible she was so beautiful and sweet and kind and wise and generous and had many many friends who miss her still, like me. today is her birthday: (

  • Sir, if you want to impart change to a broken system please encourage your colleagues to name names. What hospital systems, doctors, and insurance companies are doing this. Document it, share it, and run the “bottom line” folks out of the industry. Keeping the specifics out of the public eye only perpetuates the problem.

    Great videos, by the way!!

  • I got written up for productivity. The reason I was low on productivity? I was asked by the manager to help out at another location and then was asked to switch my days off to see a certain patient. But I had scheduled a dr appointment for my son for my day off so I said ok I’ll work around it. Of course that took a hit to my productivity and I got written up. I was told I can always say no. So now when I’m asked to help I say no. Of course, now I’m not a team player. If I didn’t need the health insurance I’d quit.

  • Greed and monopoly is ruining live from patients to doctor who are box in to fit a mold that the system required to generate more profits.

  • Time to bale out, it’s about control over the medical profession it’s between the insurance & pharmaceutical companies, profit over the masses

  • THE ” VA ” I(N ARIZONA and probably the country are forced to care for way too many patients and in only 30 mint. apts, the system at THE VA is broken bad, ask the vets, not the administrators!! my primary “Nurse Practitioner has over 1000.patient assigned to her!! YES!! I SAID ( 1000) THE$ “P.A.C.T. ” system that they dreamed up for the patients makes no sense, again ask the vets, not the people that will blow smoke up your “,,,,”!! I wish I knew one of your reporters, I could show him where he can find a story that he can see for himself!

  • Wow…thank you! RIP Dr. Elizabeth Gallup…died due to moral injury…for caring too much and the system winning. You were the best doctor I ever worked with.

  • I can totally relate to this. I am a doctor too. I have worked as emergency physician for 3 years. I got so frustrated with extensive duty hours, no leaves, no holidays and assaults by patient’s relatives that i left practice and took up teaching in medical college

  • This is capitalism at its finest. Talk about a government issue but where the hell are they. This is not politics this is bull shit. If we as humans can actually sit back and take this crap. I am Canadian and free healthcare is nice. But when human life is based on money give me a break. The US and Capitalism DRUGS and Patient care what is wrong with you. Some of the best countries in the world have free healthcare. I think the US government should go out and spend another 600 Billion Dollars on Defense and to hell with people that cant afford healthcare. Doctors are the best professionals in the world and when some invest banker makes more then a Doctor does there is really really something wrong. The US citizen should get their heads out of their ass and demand change. Insurance companies the biggest crooks in the world. AIG did the US citizen bill these assholes out in 2008. What a JOKE

  • Now we are talking. Together we can change the system. Alone we will continue bear the consequences of it and so will the population. Even worse, we contribute to it and sustain its existence. Heal people, let the over concentrated business of healthcare expire.

  • This is not surprising, I as a patient am also frustrated as well with the lack of care.
    I want to leave the country to seek out care but apparently the us has pushed its fake opioid war into other countries too. I can’t move in the US to get better care of leave the country. I found one Dr that will care for me after months of suffering & searching for a doctor that will treat my pain. The exact same pain I’ve had since 1998 when I was in the accident. My doctors nurses and people I’ve met along the way have done nothing but suffered from this.
    Put it out there directly, removing pain medication from people that need it is wrong. Giving people ipads after surgery for pain relief in Colorado is not medical practice but pure ignorance. Killing patients to save addicts is wrong & has only killed thousands more people that have no drug addiction, only benefiting insurance agencies & fueling the illicit drug markets & sending good people in the alleys in search of Dr’s care. This all includes the men & women that are willing to give their lives to protect our country, our vets.
    The science & facts show our government is lying & refuses to stop its propaganda & imprisonment of Dr’s doing there jobs helping people. It is the most disgraceful thing I’ve ever seen happen in my 55 years.
    I hope media will stop ignoring this & fight for patients rights so that Dr’s will be free to do their jobs again without knowingly harming people.
    How many Dr’s & patients must die before this insanity ends.

  • I’ve just quit a 30 year nursing career due to the cruel and unreasonable treatment I was expected to give to a terminally ill MS patient. I knew what they were doing was wrong and harmful and I ended up having a mental breakdown after a year of struggling. I was a good nurse. I loved my job. Nursing is nothing more than an arse covering exercise now. I’m out for good. Care homes are glorified concentration camps.

  • There is some nebula of qualities that follows the air around Dr. Dingdong that you feel as a patient the moment they step into the room.

  • I’m not even a doctor and these words resonated with me so hard. I left another industry due to moral injury. I knew people who put everything on the line for their dreams and some were suicidal. That was a red flag before the moral injuries took their role on me. Lost all my passion and motivation for a long time period. I thought one day it was probable if things didn’t go well I’d end my life peacefully. Struggled with feeling lost and disillusioned. It’s a problem when older professionals check out. The younger ones, their heads filled with illusion, that is really their only motivation outside of social likability… I’ve seen so many people go into spirituality for pure escapism from the real world and feeling powerless. I’m very spiritual but I like that you called me out! Burn out is bullshit. We don’t need to be meditative vegetables and hide from the world! We need to refocuses our passion into it’s new inspirationcorrecting the problem. Thank you.

  • This is why a public health system is better for everyone, If they don’t like the system,moved to another country with a public system. Health is better than Wealth any day.

  • I just spoke to a nurse coworker who used the term “burnout” about how she was dodging bullets and fights in the ER and made her think about being a nurse any more or in health care for that matter. She came to my hospital and thinks that it isnt happening here but the truth is it’s on it’s way to being that. Less staff and more patients, demanding we stay late to finish cases that the administration knew would be longer than our set day. I told her that it’s not called burn out but rather what was said here “moral injury.” There is true brainwashing going on in health care to gotchya new younger nurses and staff in to believing that this system of caring is ok.

  • The whole “go fuck yourself” ‘movement’ or whatever you call it appears to be working. Every time they say the word burnout I remember to tell them that, it’s what I learned on here.

    A few execs have cried here and there but overall it’s been a pleasant experience.. well for me at least.

  • I live in Canada ����, so I don’t think Doctor’s here suffer the same because we have universal health care. So Doctor’s can prescribe medicine and patients are cared for. Prescriptions are not covered by the universal health care, but if someone in Canada can not afford their medication the government steps in to ensure medical needs are always met. I can’t imagine living in a society where my life depends on co-pays and what a insurance brokers says what treatments I’m allowed. My friend had Cancer and she was admitted to the hospital for all her needs, no payments after, or the stress of being denied for anything. Sure we pay higher taxes here, but my belief is, all humans deserve health care, without the burden of bills, or lack of treatment. Tell your Doctors to move here so they can feel good about themselves again!!

  • Here’s one of these dudes thats suppose to be a doctor… https://www.youtube.com/watch?v=3NzgMqIbZc8 I don’t see how this guy is thiinkiing about patients healthcare, but his own student debt of 1m+

  • TOXIC GEOENGINEEEING IS SENDING MANY PATIENTS TO ER OVERWHELMING THE SYSTEM, SHAME OM OUR EVIL GOVERNMENT FOR SPRAYING TOXIC CHEMTRAIL.SMOG MAKING US ALL VERY VERY SICK

  • I’m so sad.. I’m a neuro-telemetry monitor watched a chest tube removed, no report of extra sedation, ICP went over 35, EEG went flat.. herniation.. I was 1500 mi away too far

  • The job is no longer rewarding when you see a decline in health of your patients. Due to the control of insurance and dx protocol.

  • well…we already got bounces of people who don’t “give a shit” and they are our politicians.
    and have you noted that they never suffer from burnout!

  • I suffer from moral distress when I’m forced to hand out opioids (aka legalized heroin) like candy to patients who don’t need it because it’s been pushed by the pharmaceutical agenda.

  • Insightful to learn the American medical system does not treat its medical professionals well. It certainly does not treat patients well. Then who does it serve??
    Medical care lost its heart and sole when it allied itself with Insurance. Now it is squarely under the thumb of Insurance governance. Your medical managers are only implementing orders from the top. Patients are victims too!

  • Dearest brothers and sisters. I stand beside you. While we witness the death of a beautiful callingthe desire to care for our fellow man. We do this at a time in their lives when they are at their most vulnerable. When they need us the most. And YET;
    Daily and sometimes hourly we are separated from the ill, our charges, the very ones we swore to advocate for.
    Over the last 10 years of my nursing experiences, I have been berated for not pushing through admissions (in a For Profit hospice) even though the family didn’t even realize their loved one was being referred for hospice! These lashings occurred every day at 5p during a meeting in which the CEO of the company came in for our ‘pep talk’.
    I’ve come in to receive report to learn that there was no report on 4-5 poor souls because the nurse had not even SEEN them during her 12 hour shift! Because the acuity of her 26 patient load was too high to manage. Some who admitted this did so with tears in their eyes and hearts breaking. Others who had the same case load were cavalier, stone faced and blamed others. Accepting no moral obligation.
    I’ve watched the nurses that care move from position to position praying they can break a whole through the ever tightening fabric of apathy. The others stay and become interlacing fibers strengthening the moral decay. Before nursing some 30 years ago I was in the military X7 yrs. This was good preparation for the war at hand. This is going to be a difficult road. But I believe one thing. They’ve underestimated their opponents. You and I. Fight well.
    My apologies for the wordiness of this rant. I blame it on the Good Doctor.

  • The US is a warmongering lawless rogue state. It is founded on genocide, slavery and wars. By the time the Indian wars ended in the late 19th century, the original 500 Indian tribes and two million natives have been reduced to a few tribes with the few thousand survivors incarcerated in reservations or concentration camps. 14 million African slaves were kidnapped to the Americas. Wars with Mexico and Spain expanded the American empire.

    Trump is a low life pathological liar and a little Adolf Hitler while Pence from the fascist Christian Right is  a little Joseph Goebbels.

    Check out Chris Hedges, Joseph Stiglitz, Kishore Mahbubani and Jeffrey Sachs videos on YouTube.

    Read the following books:
    America the farewell tour, by Chris Hedges.
    ‘How Fascism Works’ by Jason Stanley.
    ‘Giants The Global Power Elite’ by Peter Phillips.
    ‘Moving beyond fear: Upending the security tales in Capitalism, Fascism and Democracy’ by Charles Derber, Yale R Magrass.
    ‘The Management of Savagery’ by Max Blumenthal.
    The Great Reversal: How America Gave Up on Free Markets by Thomas Phillipon.
    A People’s History of the United States by Howard Zinn.
    A New Foreign Policy: Beyond American Exceptionalism by Jeffrey Sachs.
    War with Russia? By Stephen F Cohen.
    Has the West lost it? by Kishore Mahbubani.
    The Age of Illusions, by Andrew Bagevich

  • Try being a nurse�� you get bullets shot at you from every direction, and on top of that no respect or appreciation. The list goes on…….

  • I finally walked out in Nov. 2012. It took me years to be able to talk again. I was a recluse for four years. It has become a horrible profession. I feel so sorry for the doctors on the frontline of Covid19. The for-profit medical-industrial complex is killing millions.

  • Doctors are usually calm and have less stress compared to nurses who are more stressed due to high nurse patients ratio and also because of stress in advocating for the patient. I hope they can truly see this.

  • This massage sums up EVERYTHING I’m feeling. And as a nurse I know the system must be changed. Do you have any suggestions on how exactly I can help this change happen?!

  • Another IT guy here with moral injury who is in the process of bailing into another career. I’ve walked away from something that used to not be this way. Being the on call specialist 24/7/365 for a bunch of ingrates will take its toll on all of us. We all are embedded in a dysfunctional rentier run system that expects us to help people yet impedes our ability to accomplish the mission by micromanaging and expecting perfection without wanting the spend the monies require to achieve it. The system is at fault and never again will I used the term burnout. Every healthcare worker I personally know is in the same place with all of you.

    Thanks for helping me Dr. Z!!!!

  • Not bad. Nice and wordy. Lots of semantic juggling. I’d stray away from millenial words like “resonate” though. They are pretty obvious.

  • I’m from Italy, we have OSS, a figure that helps us with the patients’basic needs like bath and cleaning feces and urine. Guess what, we nurses often do that too, so they don’t really do the “bad” part for us, they just help a little..some of them even can’t think of take temperature again of a patient had high fever, and we nurses have all the responsabilities. The OSS are paid 100 euro less than us nurses, don’t have to register anything, don’t have responsabilities and can really stay near the patient.

  • doing one task for long time can cause you to burn out, ruins your health and Become completely exhausted through overwork, here is my poor advice to authorities, doctors should be given more off day then other normal people, and this enables them to spend much time to their friends, not for being (bookworm)

  • We need the right tools to fight back. I don’t want an MBA, but increasingly I’m feeling that it might be what I need to successfully and meaningfully advocate for my patients.

  • I’m currently assigned to a “Family Practice’ by my health care corporation. However, very predictably, every two years, my current doctor will quit or ‘leave’ the practice with little notice. A few years ago I had a wonderful doctor, a doctor who saved my life. Due to lousy record keeping practices I was given the wrong test results by office staff. This doctor asked me on our first visit, why I hadn’t followed up on the scary test results & was horrified to learn I never received the correct results. They orchestrated a plan that had me in an extremely capable surgeon’s hands that day for a consult, which is the only reason I’m alive today. They were fired a year later because they spent TOO much on their patients. They were the kind of doctor that bothered to remembered things about me & my family that didn’t necessarily pertain to physical issues but definitely affected our overall health. They’d often have printed materials ready that pertained to us & were extremely helpful. We are a complicated family & for them to remember the salient details that were casually mentioned in previous visits meant we were being listened to & treated holistically, in terms of treating us as a whole person, not in terms of naturopathic medicine, although they were open to that, as well. That is the golden ticket health care pIan! I was so sad when they told me it was our last visit that I actually hugged my physician & wished them luck. I’m not a higher. When’s the last time you felt comfortable enough with your doctor to spontaneously hug them?!? I tried to follow them to their next practice but insurance prevented that. It was heartbreaking. The practice I had to go to due to insurance cared more about moving us, the sheep, thru quickly than being thorough about our health. I should have died in my situation. I have young children. I would’ve became a statistic due to chronic lazy & incompetent record keeping if my doctor hadn’t bothered to study my chart before our 1st visit (BTWthe person at fault retired a few years later, reputation intact). A doctor who cared about their patients was fired for giving excellent health care.. I owe this doctor my life & I’m sure I’m not the only one. Factory Family Medicine is hard on doctors, nurses & the people who keep them employed, the patients. Insurance companies are just practicing legalized gambling so I want to know how & why they get to decide what a patient needs or should be allowed to seek help for. Obviously, their lobbyists are strong but when are physicians, en masse, going to stand up, lift their weary heads & remind their managers that they took an oath to do no harm but the insurance companies didn’t & exploit that makes their job harder & results in shoddy medical care. What can be done with this dicotomy of health practitioners & profit based health management companies? Take the profit outlet’s see what happens then.

  • Our healthcare model is centered around a for profit health insurance and prescription drug industry. Until we have a universal healthcare system, all these issues you’re talking about are just going to get worse.

  • Been a nurse for 10 years. I don’t know how doctors experience their work but for a nurse it’s a low self esteem job. Would love to try a different type of industry but it’s not easy. I’m 46 years old. The older you get the harder it gets to switch to a different industry. And then when you do you are starting at the bottom of the career ladder and there are not that many productive years left. I think low self esteem has been the biggest problem in this industry. “Too stupid to hack medical school”.

  • Zdogg…please do an educator version of this video. Talk to educators. Talk to me or contact NAfME or the NEA or MSTA and work with them to do a education version of this. It is in line with what they deal with also…..almost 100%

  • I think it’s an excuse for laziness, who gives a shit if feel bad from work, get over it, and keep going, you’re not special. Give up being a sissy snowflake and grow up. Oh yeh and quit going to the doctor and taking medicine. By the way if you are really physically sick go to the doc, but I wouldn’t advise telling a doc to go f**ck themselves. This guy is a snowflake sissy boy.

  • I am a therapist in rehab and you didn’t mention us but this video hit me really hard. Thank you is all I can say. I have 25 years of experience. I am fit l, healthy but haven’t been feeling well for a year or so. Ended up in ER, passed out a couple of times, etc. Tests and tests later I have been told that I have developed illness from everything you said. Had to stop working. I kept saying I was burned out. Thank you. It is moral injury and that’s why I couldn’t keep up because I was not changing how I treated my patients. I am sad not to be working right now. So many young therapists I have encountered have said they made the biggest mistake by becoming a therapist and looking for another field. I tell them to run now and to go into sort else. Hopefully in the future things change in time at least for the next generation.

  • but can moral injury be either the result or a cause of burnout?
    Why completely separate the two concepts? After all, you are fed up and unhappy with the arrangements of the healthcare system of your job. How is this completely different from burnout?

  • Why Are NOT the Doctors.. all over the Country.. Standing UP.. to the DEA.. CDC.. Ect.. Unbelievable.. We have what we Tolerate “!!! Pain Patients all over the Country as you know are suffering bad.. But.. Doctors.. Need’s to file Suit against the System.. They are the only one’s that can reverse what’s happening!!

  • What really hurts is when one is able to make a comparison between what was the ‘ caring profession ‘, do no harm, honesty, respect, and be accountable for mistakes made…..That was 1969, where we nurses worked for pennies, but our patient’s welfare came first…..I noticed a change in the early ’80’s and today I barely recognize the profession….

  • I get it, I have experienced it, but I refuse to see us doctors (psy.d. here) as victims. Without us the health care system cannot run. We seem to have forgotten this and the fact that, once upon a time, the practitioner-expert was the one who made the clinical and treatment decisions. How did we become largely irrelevant and externally determined? How did this happen to us? It is hard to be brave when student loan debt is enormous, when aspirations for career advancement get in the way of taking a stand against detrimental organizational practices, and when doctors’ own expectations for a comfortable lifestyle make them complicit in a system of health care management that focuses on numbers and profit rather human lives. Seeing 4 medical patients per hour or seeing 2 psychotherapy patients per hour is an injustice primarily to the patient. Patients have not chosen to be ill, but we have chosen to enter the field of health care provision, which endows us with the unique and utmost responsibility of ensuring best outcomes for our patients and optimal conditions for treatment provision. If this is a responsibility we are not willing to undertake, then we are not worthy of being clinicians. Again, it is hard to do so, when the current focus is more on matters such as how to avoid liability and deliver “cost effective” “empirically validated” services, rather than on aspirational and humanitarian ethical principles that may actually prove more economical in the long run. As a side note, the whole principle of “efficacy” is a potential fallacy in health care, as in our day-to-day practice, we neither see clear text book cases nor do we operate in controlled experimental conditions, making “efficacy” inappropriate and misguided an exclusive standard to use. Real life “effectiveness” should be our primary guiding paradigm. Unless we get in touch with our ontological foundations, treatment outcomes, morbidity, and mortality in the US will continue to be rather poorer compared to other western countries. In those casualties, there will be doctors and other health care professionals too. We are not victims or pawns. We are highly specialized experts, investigators, educators, advocates and, most of all, aspiring heelers. We are leaders and as such we must act.

  • Absolutely right on! Twenty years in automotive industry as machinist, engineering and was always putting accuracy and precision first. Thought nursing would be a good fit. Ten years in as an RN and all I can say is: this occupation is about as accurate and precise as Taco Bell! It’s all about the money period! Staffing and nurse mental health is non existent! I have known three nurses that have committed suicide because of this system. It’s a shame, I once was a happy carefree person who looked forward to the future, now I dread every single second of existence as a nurse. Once you get in its impossible to escape this hell on earth! God help anyone who enters this field.

  • Insurance company should not be able to dictate what Drs. Should do. Congress should put laws in place to protect Health Care Professions.

  • Rules: 1. I’m Intv Cardio. Being told what tools, stents, pacemakers I “have” to use. These are complex procedures. I’m facile with and comfortable with certain “tools.” But I’m told what I have to use…..and I’m the one who gets sued if something goes foul. One tool may be $100 less then the one I like…but trust me. Doesn’t get rebated to the patient. 2. Nurse told me she can’t measure a CVP off a dual lumen Shirley dialysis catheter (that I put in). Patient done with dialysis. Catheter out soon. A CVP would truly help me….Cardiomyopathy and renal insufficiency…Since when can a young nurse with community college degree tell me “no,” I won’t measure a CVP off the Dialysis Catheter because it is a rule. I’m left frustrated I can’t do what is best for patient

  • Really sad, our doctor completed neglected my husband’s kidney issue until it go so bad that they had to do an invasive painful surgery which was completely avoidable. He was just “too busy” with patients to help my husband. Then the urologist who did the procedure left a stent in my husband 10 days past what it should have been. Patient care has declined immensely for those of us on HMO’s. Not because Dr.’s are “bad” it’s the way HMO’s are operating.

  • The whole paradigm is off! Most of allopathic medicine does heal, cure or prevent illness or pain. Drugs, surgery, radiationjust looks at Cocchran Most of our stuff is proven not to help. But I didn’t figure this out until I was thousands of dollars in debt. Maybe we wouldn’t burn out if we were actually helping people.

  • If you do the opposite of what your morals tell you(in any case in this world)…then you will always end up in a bad place….why not speak up?
    I used to work in a car delaership…very very very good at it…but i recognized i wasn’t treating everyone as i would want myself treated, so i quit…
    I will be no sinners martyr.
    If something is wrong, and i dont speak up thru action, i am the sole one to blame.

  • Teachers are leaving or not taking job offered due to the new “Israeli Loyalty Oath” that’s sweeping across America, could this new Oath be actually contributing to the factor?

  • I’m sorry to hear that a lot of doctors are depressed.
    They certainly do long hours.
    It must be a difficult job. This has given me a bit of an insight in to what it must be like on the other side of the desk.

  • It was a good discussion that gave me an insight into the issues. But why leave it high and dry when talking about the systemic solutions to it, than just hit-and-miss meditation!

  • It breaks my heart as a nursing student..I grew up believing I wanted to go in to law..then I changed course and went in to healthcare..i cry so much every time I see a patient die who SHOULDN’T HAVE

  • Always appreciate when your conscience speaks out loud. As a patient, I have been subjected to expensive, ineffective treatments by actually good decent doctors who are in fact good people working in a lousy system. For example a great dermatologist once referred me to a laser treatment for a surgical scar. After she was liberated from her practice, she confessed that that laser treatment wasn’t effective and prescribed silicon wraps for my scars which worked beautifully. She was previously under pressure to mutually refer patients with this laser surgeon.

    Each institution seems to have a different protocol for treatments. For example, UCSF pulmonology has different drugs that they prescribe versus say the Palo Alto Medical Foundation or Stanford. I’m not sure if these differing protocols are due to economics, physician preference or experience in certain protocols. I suspect that optimizing patient benefits isn’t necessarily at the top of this list.

  • Not much sure about moral injury in indian scenario but, burnout surely is big issue here and more more young doctors and residents have some kind of experience related to it…

  • I couldn’t agree more. I’ve worked in both the USA and Canada, now back in Canada. And it is the same here, although it it the Government holding the funds for ransom. It’s done on the sly, very quietly and most of the public don’t realize that there are specialists who can’t find a job, surgeons who can’t get enough OR time, nurses are not being replace, beds are shut down. It’s terrible. And unsafe. And then when something happens, it is on us. Why didn’t we do this, why did this happen. It’s awful.

  • every hospital should work in sync and give people a break and time off, theres more deaths due to misdiagnosing and wrong meds given due to exhaustion ur mind is not focused or able to properly think so there not doing no one a favour by making them work 12-14 hr shifts thats rediculous

  • Please speak to Andrew Yang, if he heard these stories I’m absolutely positive he would be receptive to including solutions for these problems into his platform

  • In the US, we no longer have a healthcare system, we have a wealthcare system. It’s political, bureaucratic and driven by profit, not patient. Vultures feeding off of the sick and dying…

  • I’ve lost jobs because I stood up for my patients’ safety. I’ve been a nurse for almost 30 years and healthcare is no longer about doing the right thing for the patients. It’s about making the hospital money and avoiding litigation.

  • Yes yes yes!!!! I was a nurse for over 20 years. I am no longer a nurse. I quit renewing my license. There’s no need. I don’t want to be a part of this kind of “healthcare” anymore.

  • It’s same in Pakistan. the situation in Pakistan is worse.in Pakistan there is a system which force you to work in stress situation with very less pay.

  • There is no speed on check ups. If doctors would from other continents they would finish more than 50 patience in an hour. In USA they check up one person for an hour or 4 hours and still blaming the systems? ������

  • Hospitals constantly asking us to be “medical directors.” Don’t pay us for countless meetings, My gosh, that would be illegal. Please insure we hit our “metrics.” But God forbid if they give the physician medical director any authority. Good luck directing some change in care. We have no authority. Sort of like being a “military advisor” in some war. Stand behind the shooter. Tell him where to shoot. But don’t you dare touch the rifle, aim, and shoot the gun appropriately

  • It’s the management style of “do more with less” less time, less staffing, less authority, less resources, so the quarterly report looks good. Cuts across all employment sectors not just medical. I have a good job, but everyone is tired and counting time till retirement.

  • I’m going to make this simple.
    I can’t change the system.
    You can’t change the system.
    And the system is never going to change.
    It’s run by GREED!
    So we nurses either soldier up… Or leave and go into another profession.

  • Idk what medical school teaches its students but if it’s to treat each patient like they are already dead then they’re doing a bang on job. Most people are sheep… we need more people to break the system of follow the leader. Fuck the system

  • Electronic ‘health’ system started in 2012 with Obama who started this whole thing! Mandates and the “glorified large cash register” computer? 1000% Obamacare mandate. Glad I didn’t vote for him, but sadly, many did and that’s the reason it’s like this.

  • Google project Nightingale. You want proof of the commoditization of human beings relating to healthcare. Its right there. We have to stop this.

  • I just retired from almost 30 years working as a counselor in several different hospital systems and this is SPOT ON. The system is causing the morally injury and harming patients and medical staff.

  • I bet moral injury is, to a degree, also to blame for all the police officer suicides that are happening. That, bad PR and a bunch of rotten apples that do the wrong thing in a society where everyone is being watched and scrutinized at every moment. No room for mistakes or errors anymore especially in the climate of critical professions like doctors and law enforcement.

    I have a hunch that we would have seen more suicides in the past if the social pressures and shame from accidents were as compounded with guilt as they are now. It does seem to only be getting worse with no signs of the pressure letting up. As technology and business become more powerful and integrated so too does depersonalization. Adapting to this may take a VERY long time. I don’t think society will be the same. Perhaps this is the natural course of our evolution. For better and for worse.

  • I agree with everything you said. It’s so courageous of you to say these things which are dangerous to our careers to say. The only thing I would add is that we feel used by patients who seek free medical care with reckless abandon making no contribution to their own health whether that be by not making payment or by not exercising to lower the cholesterol or not quitting smoking to avoid cancer COPD and aneurysms. after many years in the ER I feel so used and abused by everybody The patient the system the hospital the insurance company

  • usually i love your videos. i personally don’t care for “moral injury” though, but that’s just me i guess. it just seems very extreme to me

  • Hi doctor, it isn’t just in the healthcare industry, it’s a broad social phenomenon. I’m not exactly sure but I think I’ve been hurt badly, morally injured by the corporate culture during the past few years I’ve worked as a structural engineer. Thanks for this video.

  • It is not just MD’s and nurses but therapists as well! It becomes all about the money vs patient care! Like you, I became cynical/ was not treated like a human but a money making machine. Pt’s were treated the same way80-90 year old grandmothers expected to attend therapy 75 min 2xdayyou and I don’t exercise that muchit comes down to greed7 deadly sins! But it is no longer about the patient nor is it about us as humans! There should be no financial gain to patient caresick people deserve love and understandingthe last thing they need is to be used so the rich can become richer!
    And you are rightthey push and push and make you feel like it is your problemI thought this was all my fault “I am not good enough”I ended up going to the doctor myself saying “something is wrong, I am not keeping upI must have ADHD” so I went on Adderall so I can meet the crazy demands and you can imagine what happen. I “burned out” even faster!!!! Now my own life was jeopardized you can only run on artificial energy for so longcrash!!!!
    It was not me! Our world has gone crazy! Not fast enough, not pretty enough, not rich enough, not skinny enoughwhen are we ever going to meet the “standards of the world”?
    “In the buttocks”:-) Would not be my choice of words but I can relate! I developed such a “flowerful vocabulary” at one point I did not know if I was God’s child or a heathen:-)
    The bad thing isthose who are gaining financially one of these days you will be 80-90 years old and someone is going to come along and make you work 75 min 2x day! No one will care if your legs hurt, no one will care if you have the flu and you need a day of restno! You have to get your butt out the bed and do this exercise “we need our units” what you don’t feel good? You want rest? You need time to recover? Some robot is going to come along and say “not my problem”! How do you think you will feel thenwhen it is your turn to be treated like this?
    The golden rule “treat others like you want to be treated”!
    We need God! We need to go back to His standards!

  • I’m 57. When I was a kid the family doctor knew me and my parents. My dad had his own doctor, who knew him well and saw him every six months and every year he had a physical. So far as I know, Blue Cross payed for most of it and my dad paid for the deductible. This was the 1960’s. Doctors had nice offices and a few nurses and receptionists, and everyone knew the patients by name. No one would have imagined my dad’s doctor would refer him to any specialist who my dad’s doctor didn’t trust, because my dad’s doctor of course would not want to lose him as a patient. By the 1980’s the system was a sea of paperwork and clerks who simply sign papers and distribute them to other people who are paid to sign them and pass them off to others. The entire system has been broken half a Century now and appears to only be getting worse. Now it appears to consider people nothing more than a single data point in a sea of fiduciary statistical reports to stock holders.

    This is why we need single payer. Let the bean counters find useful and productive jobs, or let them live off welfare.

  • Man this is so true…No longer a Nurse. It nearly killed me. I suffered for so long I had to quit. My wife told me to stop because she felt it was breaking me. 

    When my co-worker died in her office due to an overdose from shooting up with Fentanyl because the was so stressed she didn’t know any other way out. Knowing she was dead but also feeling she needed every ounce of my help in spite of the fact I knew she was dead. With each cracked rib a part of me died too. With every chest compression I lost more of myself. No amount of CPR would bring her back. On that day 2 nurses died. She died and the nurse in me died. I miss that person who had almost all to give. I still want to help but I am beyond wounded. I spent 15 years in service to my community as a nurse and 20 total in health care. I will never come back. I just don’t have the fight in me. I have only enough left to give to my friends and family. I no longer have nightmares thankfully. Stupid nightmares of missing an insulin shot or a CBG or a med pass, or terrifying ones like doing CPR on a dead friend. Never again.

  • All medical professions. Nurses are abused by peers. Poor leadership abilities in management. Proprietary business for profits. To many patients for nurses, with scapegoating them…long term care… Wendy, I concur. Thanks

  • Nearly all doctors are just criminals now. I have an honest doctor now and I am in much better health, spend much less for health care, and feel much more confident. My old doctors constantly tried to sell me expensive drugs that were not approved for my condition and/or were contraindicated with my comorbidities. The last thing my old doctor did was insist I could have a CT scan with contrast. I had three episodes of renal failure, one following a cardiac cath. The doctor doing the cardiac cath said he would use very little contrast, only use hand injection. He simply lied. Another doctor wanted to give me a drug I’m allergic to. He said I was merely sensitive to the drug and he would give steroids and antihistamines intravenously so I would be fine. I wanted him charged with attempted murder, but he’s a doctor, and they can do no wrong.

  • A lot of people have invisible injuries that are not “moral” injuries in the way he described it. That doesn’t invalidate their illness or injury, it just means not everybody fits into the same check box. If we misdiagnose their legitimate injury by calling it moral, when it’s something else, they will never receive the appropriate care for that injury. How many different types of heart attacks are there? How many different types of fractures are there? Legitimate medicine gets as specific as possible when dealing with the illness, and mental health/psychological/invisible injuries are as legitimate as cardiac.

    We need to stop trying to rename illnesses. In the past century we’ve seen what we now call PTSD re-named a half dozen times. As a result there is confusion which results in delayed treatment and stigma. I appreciate that the intent is to try and reduce stigma and shame, but it seems to be more harm than good in the long run. Why “disorder” is a good term is because it gets people’s attention to something that needs care. What gets your attention faster “heart attack” or “myocardial infarction”? One results in you getting to a doctor ASAP, and the other finishes washing the dishes and folding the laundry before you give it a second thought. “Disorder” may not be stigma reducing or a nice sounding word, but it is a pretty good call to action which is often the biggest issue with treating these illnesses. Invisible injuries need to be addressed immediately the same way a stroke or heart attack does. They do not heal on their own (despite notions like “time heals all”). We just develop bad new habits to cope and compensate which make the problem worse.

    I appreciate what he is doing in trying to bring understanding to these injuries, why they happen and the stigma associated. The spirit of this is something we should absolutely take and run with.

  • Thank you for this video! I also believe the notion of burnout is a form of epistemic injustice specifically Hermeneutical Injustice. Burnouts, the rise of mental health issues and sick days among health care workers (but not exclusively) show us that is something wrong with the world and how it works. Fast paced mindsets and unrealistic expectations. We have a say, we have to take care of ourselves, respect our minds and bodies and not let anyone in this society to make us feel “we are the ones that can’t make it”. No. The system needs changing. We are Humans. Not machines not robots. I know how difficult is to stand up to the system. That’s why we need to empower each other and when we have some power and the chance to reinforce change to take the opportunity and do it, even in the most simple ways which is to respect your colleagues, don’t neglect your breaks _ it’s your right _, listen to your colleagues, don’t shame anyone, unite with them. We fight for the same purpose. Productivity doesn’t mean work harder but work smarter.

  • Do I suffer burnout or moral injury? I thought for a long time. I decided the best course of action is to drink vodka in the basement alone while staring at a brick wall. So far, seems to work. Impaired physician here and damned proud!

  • After reading a lot of the comments I see the Good Doctor is being urged into the presidential campaign. While I know we deserve someone like him in office….Let’s preserve his brains, heart and integrity for the right war. That will keep him more than busy and he will be able to focus on a cause that presidents do not have the time or ability to address. Instead we may ask him to act as the conservationist of human rights. God knows humanity needs him!

  • ✴️1 million a year…!?��
    DEAD ����bang
    [“Pa-lleeasse”]��
    You don’t start off a program by insulting your audience…

    There’s only 70,000 opioid deaths a year.

    Gee…”��”…
    You think we would have heard of ->
    a “million” Doctors.?

    Oh✴️…!
    that’s right ; this is
    Al Jazeera.

  • And we wonder why Cuba a communist country has better patient outcomes than the US and the EU it’s because they are NOT profit driven in fact they run their system at a loss!

  • Thank you Z. As a child psychiatrist in an overburdened, over-bureaucratic and under-resourced mental health care system, this spoke volumes to me. Our agency just bought a crappy computer record system (so poor I won’t even call it an EMR), and is talking about “peer-review” and trotting out a bunch of micromanaging moves to address “burnout” while not-so-subtly blaming us and offering “more training” to get “comfortable” with our new system, instead of actually working on program and service development.

  • This applies to the tech industry too. “Burnout” is a very popular term here, with hospitalisations due to stress being easy to come across. I’ve been there myself. We are worked like dogs and propagandised with fanciful notions of ‘changing the world’ and ‘passion’ it’s all about money. And we’re the lucky ones. Amazon’s warehouse workers are barely a step up from slaves.

  • Indian Government is one of the most Corrupt in terms of. Health care.Quality health care is accessible to only wealthy people. Poor people have to fend for themselves without any support from Government. Insurance sector is most corrupt one here. You have to fend for yourself only. India is worst and Doctors are businessman who want to extract money from patients.

  • Thank you. You put this into words better than I could imagine. I’ve been working 70 hours a week as a CNA for several months, understaffed, and I’ve been saying I’m “burnt out”, but I keep coming in to make sure my residents are taken care of. I start nursing school next year and will only work part time to ensure I can push through and get my RN. I’m hoping my career in healthcare improves, and I really think that it will. Your videos are informative and inspirational, thank you.

  • I’m a mental health professional. I worked for a homeless shelter for teens and I had moral injury. I saw the opioid crisis happen among its youngest victims. I stayed awake wondering how it could happen why it happened. I got sick. I couldn’t do my job anymore. I dreaded going into work because how the hell am I gonna deal with another overdose. I started anticipating it. Eventually my work life and my home life became taking care of people in need and I simply couldn’t do it anymore. I needed a rest. The government does not understand what is happening with these individuals.

  • It’s getting very hard to care about patients genuinely. I’m a nurse and an empath and I couldn’t do what I wanted to do. It’s never about care, it’s just about checklists and protocols. Only people that don’t give a damn about patients and care only about money thrive in environment like this. I couldn’t do it just for money…

  • let’s get to the root of the problem: money driving health care; money driving politics; money driving science and the cdc, fda. vote Bernie and he will change this.

  • Front line feels it more than anyone, for sure. But this problem runs through every inch of the industry. Try being a reg doc negotiator for clin trials, then talk to me about bottom line pressure

  • Wow!!  Your video of Moral Distress in Healthcare was powerful and hit home where I live and and used to work!! I am a Hospice Lifer believing whole heartedly in the hospice holistic philosophy of comprehensive pain and symptom management as well as a unified interdisciplinary team dedicated to practicing consistent communication for a peaceful pt death and successful positive family/caregiver experience.  Sadly, I left hospice a month ago because of this very experience; however, my heart and soul will always remain a hospice nursing team member.  I am now bringing my extensive knowledge, experience and high moral values directly to families of hospice patients who wants to fill the hospice gap during the last hours of life.  Thanks again, I needed to view your video and you are my new hero!!

  • STRONGLY APPLAUD THIS VIDEO! As a frontline MD, I couldn’t agree more. Who are the kind of people who would give this a thumbs down!? Clueless and ignorant I guess. Thanks for doing this, and making me LOL with your other videos!

  • Moral injury is equipment fatigue: when language is needed to treat, is too much equipment incongruence a part of pain as tenacious stress?

    Maybe AI is incongruent, or favoring profit-not function.

  • Amazing video. We appreciate your informative video. Such impactful infomation,Doctors your all doing a good job don’t let anyone say otherwise

  • from a UK doctor, this is all very recognisable. Our system may be different, but the abuse of healthcare professionals is instantly recognisable. Brilliantly put

  • I’m an RN in NY.I’ve worked in the Medical field for 21 years including my not an RN experience. It’s a lot to work in the Hospitals and Homecare. Outside of patient care. It’s a system of money first. Not patient first( from the State and Federal perspectives)! As well as Liabilities. I’m glad MDs have alternatives.

  • Watch my video titled freedomcare, noble careers part 3

    Additionally…Drop the rent rates drastically NOW….if you legislate caps instead of dropping the rates drastically back to the 375/month range..you lose far more than any gains that could have come from the vast willfull wage growth in our time….do not legislate tobacco or
    college…or healthcare farther…i have far better solutions.. Watch my videos for a start…empower me to do my job.

    Also…stop with the toleration of fake impeachment and outlandish representation from the “left”..you are being trapped by the mechanical liability of vanity…you judge stuff great relative to horrible examples fed to you by media and willfull mischief….

    You need to drop rent rates huge in every nation very carefully and very swiftly…it is being used to destroy currencies and industries to irresponsibly consolidate….much much more to this topic…drop the rent rates now. Watch my videos..will produce more.

  • Or even worse is, if that patient you reluctantly “inter-system” referred them to, has a surgical complication… When your gut feeling told you they would have been better off going somewhere else…

  • Welcome to the club, Doc. This is something 1st responders have been dealing with forever. Cops, Medics, Firemen, Soldiers, Corrections officers. Thank you Doc, you “get it.” Finally. Someone who “gets it.”

  • Direct Primary Care appears to be the best option for both patients and physicians, but it’s being swept under the rug as it sticks a huge middle finger to big pharma and the big provider/payer networks.
    In short Direct Primary Care reduces costs, cuts wait times, increases healthcare access, extends the duration of time you have with your doctor and diminshes your physician’s workload/burnout. There’s still more I personally need to learn about it, but by all accounts thus far it seems like the clearly best option.

  • the PTSD of not being able to live up to our ideals…note the high % age of those in the U.S. congress are immune. must be some primitive resistance.

  • I thought things would be better when I returned to Canada I was WRONG, Canada spends nearly 12% of its gross domestic product on health care so about 254 Billion or $6840 per Canadian. Entire provinces are amalgamating in order to save money the province I returned to Saskatchewan, only has 1.1 million people and it use to have the most hospital beds per capita in the free world that changed! Now they are bringing in business consultants to LEAN out the process of health care. Turning our hospitals in to factories how do you compare the population that uses the ER to a Honda factory in Japan crazy thinking.

  • Worked in NHS, was myself suffering from nervous breakdown underwent retraining under supervision discovered undiagnosed unknown condition impacting patient when i was not supported or supervised. Underwent lots of coaching therapy mentoring meditation became better doctor by stopping being doctor. Chose and elected to request voluntary erasure from licensing… Dr should first heal themselves. Without support for health care workers they will burnout from stress. There is a saying physician heal thyself!

  • Self infliction. If you can’t fallow the Hippocratic oath, then you’re not a doctor. And the rest is self-infliction. Let’s look at it on a karma level. If you’re told not to do something for patient that helps them, then you’re not a doctor. If you falsify the medical record, that’s known as obstruction of justice. Because medical records are legal documents and often end up in court. The abuse and neglect is towards the patient. If they feel like killing themselves it comes from a guilty conscience, and I’d have to bring up the word karma when their pocket books are filled with money and their patients are in pain and suffering. Nobody wants to support that system, or the weak-minded people that cave into the dollar for it.

  • I am from Sudan and here burn out hits us since our internship year since the system here rely on junior doctors heavily and we are terribly underpaid without laws or regulations for our rights let alone wellbeing.

  • HOWWWWWW??? I was just talking about this with some colleagues at work! Question is how…what are the action steps to making this happen? How do we make this change happen? I only dream of the day when healthcare might actually be about the people and not the paper

  • Govt intervention help create the current mess. Hmm doctors 1950s did charity cases in office, charge the rich a bit more to cover the poor. Then came medicare they paid very well in the beginning all doctors jump on board…got rich. Then the rules and regulations came. Under Medicare, Medicaid you can’t charge rich folks more, you can’t waive copays for the poor. Everyone must be equal. Then crony capitalism set in with big insurance and big hospital systems. They make direct deals to Medicare that they can take care of patients at lower cost…hand over the patients to them. By creating a network of denial or delay of service they have shown costs savings. Medicare brought it hook line and sinker. If you are honest about healthcare cost, you must promote cost transparency and cash paid system not thru insurance or middle man. Health insurance should be like car insurance only for catastrophic reasons.
    Medicare for all isn’t perfect, it will provide universality but not quality. Universality is forcing healthcare providers to keep saving the drunk, irresponsible people that cost tax payers the majority of cost. Only in America can a homeless drunk whom refuse to stop drinking will wind up in nursing home collected to tubes to keep him alive and watching tv for life on tax payer dime. If you have quality and affordability in healthcare; it is not universal because it doesn’t cover for stupid. People whom fall through the cracks should be picked up by charity from churches, doctors, hospital or community….not govt mandate.

  • How do justify yourself when you post videos bashing alternative, healing and effective modes of treatment because you are personalty bound by the b.s. of your profession. Feel sorry for you.

  • Thank you Aljazeera for talking about this topic touching what we go through as doctors. While the welfair of a doctor in Europe or the U.S is better, we in Africa have the worst welfair. Call it burnout or moral injury in most of Africa, we go through a lot of it and don’t talk about it, yet deep within ourselves we are burning!

  • Thank you so much for this! Just shared with FB and new counselor for my own “Moral injury”! Feels so good to be heard! I will be FIGHTING THE FIGHT!

  • One of the major problems we refuse to talk about are all the slimy Indian doctors in our profession, who have slowly made themselves a majority demographic. They primarily come from a bartering culture which is no surprise when you see how they practice a business model. It’s also a social stigma growing up in an Indian family that unless you become a doctor, you’re considered a disgrace to the family. I had many Indian classmates who explained the social pressures they had and that their hearts are not in it.

  • Agree 100%. Those physicians that keep their mouth shut are being selected via a Darwinian process. Seen it many many times, when a physician raises his/her hand, he/she is crushed.

  • We need to start changing the system. I worked at a hospital for more than 18 years and the issue is insurance companies. Why don’t people speak up. When I graduated from nursing school in 2006 was so excited. I would see first hand how insurance and money dictates care. In the end found myself working sub acute with up to fifteen patients. Most seriously critical such as one patient on heparin drip, another on oxygen with trache filled out mucus plugs and gun shot victims. I refused to work under those conditions. If you don’t speak up, then you say to the system that. How you and your patients are fine with it.

  • ZDoggMD, I commented on your video “Are You Happy?”. Private practice is getting me kicked in the ass. I try to hang on, but I’m not sure how much longer. As a pediatrician, all I have to rely on is my reputation. My practice survives month to month. I want to sign up for your paid service (which clearly indicates that subscribers get more).In private practice, I have no negotiating power with insurance companies.I feel trapped. Not looking for answers, just venting!!! God Bless!!!

  • Support a national healthcare plan and help remove the private for profit insurance model, check out:

    Physicians for a National Health Plan: https://pnhp.org/what-is-single-payer/

    Many physicians know this is the way forward and you can meet them at a local chapter:
    https://pnhp.org/take-action/chapters/

  • I am a PA, and suffer from burnout… I have been dealing with this for approx 5 years or so with total length of time since being a PA is approx 7yrs. I have been in counseling over this… I did get the loan repayment program… So next Nov… I am going to decided if I want to cont this job… which was once a calling or say enough is enough… I did two tours in IRAQ as a Navy Corpsman and it was easier, than my daily job

  • When did doctors stop controlling health care? When did politicians and non-medical professionals start making the decisions? Thats when it became a business.
    And it might sound evil, but lets be 100% honest, those politicians and CEOs pay these doctors too much for them to ever unite against the for-profit form of health care. Doctors, nurses or whatever will not be the ones fixing this. They will sit in front of you and tell you everything thats wrong with healthcare, but everything thats wrong with health care is what lines their pockets, pays for their expensive vehicles and allows them to live in their fancy gated communities. How many of them are willing to give up that money and step down from their pedestal and stand next to their patients? Second you threaten their income, they will bond with those politicians and CEOs to ensure their comfy lifestyles. The massive student loans hovering over them won’t allow them to be so willing to disregard the value of money. And by the time those loans are paid off, the doctor has most likely already become a part of the problem.

  • The National Health Insurance Fund in Kenya (NHIF) also manipulates doctors decisions,particularly in imaging ( CT-scan,MRIs,ultrasound) frustrating both the patients and the care givers,just so as to avoid paying.
    I’m a doctor, I know this first hand.

  • 9 years going on 10 years as a nurse, was a nursing assistant for 4 years before becoming a nurse. Worked at a nursing home for almost 8 years (specialized in Alzheimer’s, Dementia and behavioral health) and ultimately left because we didn’t have enough staff to feed our patients who were dependent on us to feed them. When I asked for more help, the ADON, came in to “assess the need” (while I was off) and said there was no need for assistance.

    Went to a small hospital for 5years going on 6, from the CDU to PCU to CVICU, thinking it would give me more opportunity to care and get to know my patients and help them through their illness. Ratio was too high and barley had time to get the bare necessities done let alone address the patient’s and family’s emotional needs.

    Now I’m at a big university hospital, moved my entire family, hoping to be able to just take care of patients holistically and not just get bare minimum tasks and care done. I’ve been here 3 months and am now realizing it’s the system and doesn’t matter what facility I work for.

    I’m discouraged and disheartened because I never feel like I do enough for my patients. I miss my lunches to care for them (and I don’t mind) but get talked to about missing lunches (which sometimes cannot be avoided) and they offer no solutions for me. I’ve been telling my husband I’m burnt out in a field I truly do love, but you’re right. It’s moral injury.

    I just want to take care of my patients.

  • Doctors did this shit to themselves. And they still are.
    I’m in private practice and have already realized I am more needed than I need any corporation.
    I get to take care of who I want, when I want, and I save patients money. I provide great care and have to turn patients away.

    You only have your time and your expertise to sell. Do not give them away to anyone for free.

  • Amen. This brought me to tears. You put into words what I’ve been feeling. Frontline working RN. More than 40 years. It is so much moral injury. I was taught you look and listen to your patient he/she will tell you everything you need to know and technology was a nice little addition. Now I see everything is technology driven. It’s the computer first, then monitor then oh there’s a patient attached to the monitor. Often feel the actual patient is an afterthought

  • I was in the middle of my clinical rotation in nursing school and said no thanks. I realized if it was a disaster as a nursing student, it would be no different as a professional.

  • Dude. Take this down, cut that bs at the end and take yourself seriously for 5 whole minutes. We really need you to succeed. Stop sabotaging yourself with that immature dumbassery.

  • As a patient I feel this! I went to the ER for severe pain, localized to my left arm, about three years ago. They referred me to a orthopedic specialist and said they could do nothing for me (literally nothing, except more muscle relaxers that were only making it worse). The specialist they referred me to, who was part of their network, had me wait almost an hour extra past my appointment time, they took x-rays, and he only saw me for about 10min and decided it was a hematoma and left the room without explaining what that was or why he thought that. He never even touched my arm or answered any questions. He just heard I had been roller skating that past weekend, and despite not falling or anything, I clearly must have just injured myself. Told me to wear a sling and he was gone. They handed me the sling, in a box, and sent me on my way to figure it out. Luckily I’m massively skeptical about this stuff and I’d already heard terrible rumors about this doctor, so I had another appointment set up with my Dad’s orthopedic guy but it was about 4 days out (soonest they could see me). The sling seemed to be working, but I was still concerned because I also felt like I was losing my arm functions. Low and behold, go to get that second opinion and during an actual physical exam (where he almost sent me through the roof) he’s like “you have severe, and I mean severe, tendinitis in your left elbow”. Huh, imagine that. Ended up being a worker’s comp case (which was a nightmare), but I had already started losing range of motion in that elbow from the sling. Had to work through that and the tendinitis itself via physical therapy to get stuff under control. Also explained why the muscle relaxers were only putting me in more pain. So yup, the in-network guy almost cost me usable function of a joint and probably my job, where as the guy who was highly recommended made sure to do the right thing. I was FURIOUS. And of course when I tried to complain to the hospital you could tell they were just ignoring everything.

  • Holy shit your example story was my life until recently when our institution separated with this person. I asked multiple people, how can it be ok to do X, Y, Z to pts with NO accountability?!?! There was NO WHERE to turn with my concerns.

  • Maybe they need Caribbean vacations “!° To rejuvenate themselves and unwhine”° because normally ° Phycians on the hold are°⚖ Workerholics°!” ⚖°.

  • From what they are committing suicide? Patients are waiting for them and waiting and no one takes care of them. All they are doing is looking into computer, who cares of you? Healthcare is in shambles in US, that’s for sure.

  • My health system outsources their hospitalists and I seem to be the only one bothered by it. I think it diminishes continuity of care and lacks skin in the game for these hospitalists.

  • I am among those doctors who are burned out. I feel like I can’t continue as doctor. I feel like I am caged in a room with no door or no window. I am trying hard to keep my sanity and my focus in work. Depression has burdened my head. When I feel extremely distressed, I wish for end of life.

  • this is broken to put doctors in a position where they are run down and burnt out from overworking and the system being broken.. it’s wrong..we need them rested and able to perform at their best!! to give the best care to their patients.. y’all need to reach out to the top levels even the Trump administration and get this fixed! The system needs to be corrected for everyone..

  • Doctors collude everyday w everything that was described in this Zubin video every mental patient in a psyche inpatient likes to call his situation as a result of moral injury will psychiatrists trash their DSM livelihood or refuse to continue billing for services that are really in the pale Doctors want their bite of cheese though corporations walk away w the loot that was made possible only by the Doctor’s work no nuring home or Hospital can bill for anything unless a Doctor documents it as necessary for patient’s cure everything in life is moral but everyone writes their own moralsask the politiciam or the priest or even the school teacher? AMA has 500 million$ budget? Holy Doctors?

  • I have many friends who are doctors and I have notice their stress level and moods according to their work schedules. Overwork and understaffed medical workers is among the key issues. Moral injury and burnt out is used differently but nonetheless they can be both the causes and its consequences

  • One old medschool friend he had burnout in his third year,and later on he self medicated himself anti-depressants and gone off them,he went crazy and even was not thinking rationally that he even tried to hit on his cousin.I told him don’t do it man,she has a boyfriend and you are her cousin…

  • More physicians should go toward political realm to stop BS at the highest levels. All these accreditations from groups that should have no business in patient care, should go away because they waste tax dollars (medicare requires a clinic to be accredited to get reimbursement) and waste time for patients and physicians alike. Don’t run away to better paying jobs. We need to continue marching up the steps of congress whether it’s a letter to your rep or senator to create awareness. If we’re not at the dinner table then we’re on the menu!

  • Quit my job as a DON a few months back, completely burnt out from 9+ years of crisis after crisis, staffing shortages and then the final straw is being told I needed to do more and create a better “team” so staff are as willing to work themselves to death. My problem now is now though every hospital and SNF are using the same clinical model so I don’t really have an option other then going back to the floor somewhere quiet where I can help my patients as best I can…doesn’t really feel like a good option. Definitely looking outside of healthcare for opportunities