Locke Amy, Rodgers Tanya L, Dobson Margaret L
University of Utah Health, Salt Lake City, UT, USA.
Osher Center for Integrative Health, Salt Lake City, UT, USA.
Glob Adv Integr Med Health. 2025 Mar 17;14:27536130251325462. doi: 10.1177/27536130251325462. eCollection 2025 Jan-Dec.
There are many known drivers of burnout and distress among physicians and other healthcare providers. Current conversations have not fully characterized the significant impact of workload increases alongside staffing shortages as drivers of moral distress and subsequent burnout. Together these factors pose a significant systemic threat to the workforce, and a personal threat to the individuals within it. Physicians are at high risk for moral distress because of work ethic and culture. The drive to do the right thing for the patient limits an ability to set boundaries around work. Moral distress is experienced when the needs of patients can't be met; this drives us to work even harder. Culturally, there has been limited opportunity to acknowledge this distress, so we haven't been able to deal with it outright. Financial pressures continue pressure health systems to drive productivity. Additional patient encounters drive more after visit work that requires time and attention. Simultaneously, the remaining physicians are further stretched as people burnout and leave. There are few groups of workers more mission-driven than primary care physicians. We are committed to doing the right thing for patients and our teams. If we can acknowledge and talk about moral distress as an indicator that we need to change the way we do things, we can use it as a tool to optimize patient care. The physician voice may help us move beyond the learned helplessness and shift to engagement in solutions. We propose three solutions: 1) acknowledge the presence of routinized stress injury that occurs in healthcare 2) leverage data on physician wellbeing to understand how to optimize care, and 3) foster connection and community. Fundamentally, when our healthcare workers feel seen, heard, and valued, they are healthier themselves, and better able to support the missions of the medical system.
在医生和其他医疗服务提供者中，有许多已知的职业倦怠和心理困扰的驱动因素。目前的讨论尚未充分描述工作量增加与人员短缺同时出现作为道德困扰及随后职业倦怠驱动因素的重大影响。这些因素共同对医疗 workforce 构成了重大的系统性威胁，也对其中的个人构成了个人威胁。由于职业道德和文化，医生面临道德困扰的风险很高。为患者做正确之事的动力限制了设定工作边界的能力。当患者的需求无法得到满足时，就会产生道德困扰；这驱使我们更加努力地工作。在文化上，承认这种困扰的机会有限，所以我们一直无法直接应对它。财务压力持续迫使医疗系统提高生产力。更多的患者诊疗会带来更多需要时间和精力的随访工作。与此同时，随着人员倦怠和离职，剩下的医生负担更重。很少有比初级保健医生更有使命感的工人群体。我们致力于为患者和团队做正确的事。如果我们能承认并谈论道德困扰，将其作为我们需要改变做事方式的一个指标，我们就可以将其用作优化患者护理的工具。医生的声音可能会帮助我们摆脱习得性无助，转向积极寻求解决方案。我们提出三个解决方案：1）承认医疗保健中存在常规性压力损伤；2）利用医生健康状况的数据来了解如何优化护理；3）促进联系和社区建设。从根本上说，当我们的医护人员感到被关注、被倾听和被重视时，他们自己会更健康，也更有能力支持医疗系统的使命。
