Wendy Dean MD and Simon Talbot MD; Moral Injury, Episode 2

Rotations

In this episode we continue with the discussion of moral injury. I can boil it down to a single concept: If you are thinking that you are unsure of whether or not you can continue to remain moral and ethical in your current practice, you have moral injury. The ideas in this episode are tough. How do we educate medical students to be aware of this concept? How do we empower physicians to deal with it? How do we work around administrations that are indifferent and only serve a spreadsheet? How do we work with sympathetic administrators who actually do want a healthy physician and clinician group but are constrained by insurance companies and regulations in their options to work toward that? The cynic will shout “Nationalize all Health Care”. But here is a news flash, The VA is federalized medicine and moral injury is not a stranger in the VA. Large bureaucracies don’t work well toward the goal of building familiarity and common understanding of local group needs. This is a very tough topic. We end with a discussion on physician unions. The dialogue doesn’t make that a panacea either. Private practice folks cannot unionize for some reason but employed physicians can unionize. But keep in mind, what does a strike look like? The reality is that like air traffic controllers, you can have a union but do you strike when it means you are not caring for patients? I ran this long because we had enough content for 2 episodes but not quite enough for 3, so forgive me. Wendy Dean MD Twitter @WDeanMD Simon Talbot MD https://physiciandirectory.brighamandwomens.org/details/1847/simon-talbot-plastic_surgery-boston Moral Injury https://fixmoralinjury.org/ Burnout https://www.aafp.org/fpm/2015/0900/p42.html https://www.npr.org/2016/12/08/504864961/when-a-psychologist-succumbed-to-stress-he-coined-the-term-burnout The Mini Z https://www.vumc.org/health-wellness/sites/vumc.org.health-wellness/files/public_files/PDFs/wlc/wlcMiniZ.pdf Malach Burnout Scale https://en.wikipedia.org/wiki/Maslach_Burnout_Inventory Fiduciary Responsibility http://www.businessdictionary.com/definition/fiduciary-duty.html Press-Ganey Scores https://www.pressganey.com/About/News/Patient-Satisfaction-Scores-Optimizing-The-Patient-And-Clinician-Experience Pay Parity https://www.nursepractitionersoforegon.org/page/news20160225/Legislature-Votes-to-Make-NP-Payment-Parity-Law-Permanent.htm#:~:text=Oregon's%20nurse%20practitioner%20payment%20parity%20law%20is%20the%20first%20law,they%20perform%20the%20same%20services. [e-mail] But honestly, we seldom check it. Use the Social Media links… Catch us on twitter at @RotationsPcast Todd @MedicalCinema. Brian @Profplow and Nisarg @NisargBakshi You can also send comments to Todd at TR Fredricks on Facebook. Look for more Rotations Content at mediainmedicine.com/Rotations and on Soundcloud and iTunes at Rotations Podcast. Intro and Outro Music: Corals Under the Sun by Sivan Talmor Courtesy of Artlist.io Produced by: Todd Fredricks DO and Brian Plow MFA Edited by: Todd Fredricks DO Cohost: None, I did this after hours and you know work rules for students Disclaimers: Todd Fredricks, DO Cut Clip: None… we are getting there with production Rotations is produced using (and we always accept donations from any gear folks): Rode Podcaster Pro Rode NT1-A mics Zoom H4N Rode Lavalier Go Polsen Studio Headphones Kopul XLR cables SanDisk media Final Cut Pro X MacBook Pro Tama mic stands Rotations is part of the Media in Medicine family of medical storytelling and is copyrighted. Rotations is made possible by the generous understanding and accommodation of our beloved institution, Ohio University and by the Ohio University Heritage College of Osteopathic Medicine and Scripps College of Communications. The comments and ideas expressed on Rotations are that of the content creators alone and may not reflect official policy or the opinion of any agency of the Ohio University.