reminding us that we document for billing and not necessarily for patient care . We may feel betrayed and devalued by the epidemic of midlevel encroachment . Our politicians favor corporate lobbyists rather than the earnest opinions of professionals . Opportunities for us to own our practices are declining , and we find ourselves working for someone else ’ s bottom line rather than for our patients .
I do not think most of us experiencing “ burnout ” are actually burned out . I have spoken with physicians who present themselves as jaded and cynical , but any conversation peels away the acidulous shell and reveals a professional who is still enamored by medicine and relentlessly advocates for patients . We become physicians for our patients , but the values of our health care system have shifted to become values of the health industry , and we no longer have a say in the navigation of our profession .
We want to , and are asked always to put patients first , but are not provided with the resources to do so . We are motivated to give high-quality care , but most of the other parts of this system have different values and incentives ( usually financial ). With these areas of disconnection , it is no wonder that we may appear to be suffering from burnout . But , again , I do not think that the symptoms we experience are a result of burnout . I believe that many of us feel
MENTAL HEALTH betrayed by the current environment of our health system and these ever-widening schisms have caused us moral injury .
Why is the differentiation important ? In my opinion , prevention of burnout requires a change in the culture of the practice of medicine , which is certainly necessary in some areas . But treating and healing moral injury requires an alignment of the values of the health industrial complex with those of us physicians , a conversation which has been curiously overlooked in many sectors . These two problems are related , but discrete . It is far more beneficial to treat the disease rather than continue with symptomatic management that does not address the underlying problem . We may not actually be burned out . Our health system may just prefer the warmth of a different fire leaving us morally injured .
Dr . Farooqui is a resident at the University of Louisville Department of Psychiatry .
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MARCH 2021 19