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The Moral Injury of Health Care

A recent article in Stat cited how physicians are suffering from moral injury due to the broken healthcare system.


"The moral injury of health care is not the offense of killing another human in the context of war. It is being unable to provide high-quality care and healing in the context of health care."

We spent 3 years creating Sharpen Warrior - our peer-focused toolkit featuring veterans talking to other veterans about emotional resiliency and strength. During those years, I first learned about moral injury when I interviewed >50 veterans and VA clinicians who shared their stories of ethical conflict while at war. Interviews like the one below with Gene and Jason, revealed the no-win, ethical bind that veterans felt -- needing to be okay killing another human being (or animals -- or children) as a regular course of business-of-war. Yet the ache in their souls remains for decades after - a moral injury leaving an imprint that cannot be cured or erased.



Moral injury for physicians is centered around the pressure to boost productivity and revenue while also needing to provide excellent medical care. Pediatricians have told me how overwhelmed they are, unable to provide adequate care for children in terms of treatment of mental disorders. Hospitals are reporting hundreds of children on the waiting list for mental health treatment. In their recent article, the NYTimes cites a range of factors impacting physician moral injury: from closing pediatric hospitals due to their business model not being lucrative enough, to forcing physicians to provide care to "VIP" clients over lower income families, to the over-burdening of emergency departments with patients suffering from mental illness.




These articles aptly suggest that the solution lies in shifting the entire healthcare construct in order to right the system. Colleagues of mine working in private equity-funded residential treatment centers for eating disorders have shared how they were pressured on a daily basis to "fill the beds" and "turn and burn" patients through a dystopian imperative.


Sharpen Minds is taking on one challenge connected to physician moral injury by building a digital therapeutic product to assist frontline health workers in providing excellence in mental health care. Physicians will be able to assess, refer and treat patients struggling with mental disorders -- all using evidentiary tools that work.


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