From the May/June Issue...
The buzz in healthcare is about clinician burnout. On the one hand, administrators and policymakers are concerned that clinical staff—doctors and nurses—lack the resilience and adaptability to cope with contemporary health system environments. Moreover, many are worried that frontline caregivers operating under stress will eventually experience burnout and, in turn, may jeopardize care quality. The perceived magnitude of the issue is leading to a call to expand on the Institute for Healthcare Improvement’s Triple Aim framework of controlling costs, improving the patient experience, and improving population health by adding a fourth aim to address clinician burnout.
On the other hand, some clinicians are starting to push back on the current burnout narrative. In particular, Zubin Damania, MD (aka ZDoggMD), uses his celebrity pundit status to articulate the alternative perspective that the underlying problem is the moral injury that is being visited upon clinicians by health systems. Moral injury, ZDoggMD explains, occurs when someone must commit or witness an act that violates their moral belief system. In the healthcare context, clinicians feel that their ability to deliver care is compromised by the systems (e.g., insurance, reimbursement, electronic health record) being implemented in hospitals, clinics, and medical practices.
One particularly troubling aspect of the burnout dilemma is the common description of clinicians as “frontline” care providers. The term frontline evokes images of soldiers at war and the concomitant mental health issues they often suffer from, such as post-traumatic stress disorder. There is no escaping the fact that many healthcare encounters are fraught with human suffering. However, the mission of health professionals should not be equated with the experience of going to war. The need to redesign our health systems based on both human factors and the spiritual needs of clinical staff and patients is a pressing one.
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