Physician Burnout or "Moral Injury" what difference does it make?

Posted by Dike Drummond MD

moral-injury-human-rights-abuses-stop-physician-burnout-physician-coaching-dike-drummond-Opt-150WIt's not Physician Burnout dammit - it's Moral Injury, Victim Shaming, Human Rights Abuses, Right?

There is a wave of righteous indignation sweeping the online discussion of physician burnout recently. It is spawning a series of increasingly outraged new terms to define burnout as a symptom of systematic, deliberate abuse perpetrated by "the system".

Some even go so far as to accuse physician burnout coaches of "cannibalizing the corpses of their colleagues" - one of the more inappropriate and creepy examples of alliteration I have heard in a while. But hey, jump on the bandwagon.

Even the Z Dogg is in on the trend and his video is worth watching for sure.



This is Blog Post #291
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Here's my question

Will using terms like these change anything or make anything easier, better, less stressful for doctors 

My answers are YES and NO and MAYBE


1) YES the term "Moral Injury" can help - as a wake up call

The highest and best use of these terms is to get your attention, wake you up, grab you by the lapels and slap you around a little. The point is that the working conditions of many physicians are: 

victim-mode-moral-abuse-physician-burnout-dike-drummond-thehappymd-opt-300WIf you look at these new catch phrases and it wakes up a stainless steel katana blade of outrage in your soul ...  YAY. Perhaps you are ready for what is wanting to happen next. 

Whenever you are asked to do mindless work that does not contribute to quality patient care or the highest function of your organization ... it is time to jump into action to make a change in 
- what you are doing
- the system in which your practice is embedded
with a steel spine of resolve.

Outrage can be channeled to a productive end AND that doesn't happen most of the time. 

The Disruptive Physician Toolkit is HERE

2) NO - the term "Moral Injury" makes things worse - as a victim stance

One of the most common examples of Head Trash inside an overwhelmed/burned out physician is Victim Mode.

Let me be clear on that term.

If someone is deliberately tormenting and abusing you - consciously and on purpose - you are a victim and they are your perpetrator.

If you feel tormented and abused and blame others when they are not deliberately tormenting you ... you are playing the role of the victim. You are in Victim Mode.


Three signs you are playing the victim

Any time you find yourself doing any of these and not changing your actions to address your situation - you are in Victim Mode.

  • Blame 
  • Justify 
  • Complain

The truth is this: 

The C-suite and/or faculty is not sitting in some leadership bunker yukking it up while they hatch diabolical plans to torture the doctors and break their spirits. (except for the occasional true psychopath sprinkled into everyone's Org Chart)

Victim Mode is the Lock on Einstein's Insanity Trap

If you accuse, blame and complain - WITHOUT CHANGING YOUR ACTIONS - you are using Victim Mode as the lock on the door to your own little private hell inside Einstein's Insanity Trap. 

Anytime you are complaining it is a sign that SOMETHING NEEDS TO CHANGE.  If you simply vent that steam of outrage, and keep doing the same old same old you are missing a big opportunity and on the road to burnout.

Victim mode and self righteous indignation and finger pointing and blame let you off the hook for creating your own reality. You found a perpetrator; someone you can blame for your situation. 

The Manage Your Boss Worksheet is HERE

3) MAYBE - the term "Moral Injury" can help - if your outrage can be used to drive positive change

physician-burnout-moral-abuse-human-rights-abuses-on-doctors-victim-mode_opt300WOutrage is fuel for change when used properly. Here is a potential chain of thought/questions  you might use to figure out what to do.

Notice you are outraged!

  • Ask yourself - what is it I am outraged about?
  • Define the issue as specifically as possible - BTW it is never, ever useful to blame the generic system if you actually want things to improve
  • Ask yourself - can I change this on my own? - write down how
  • Ask yourself - who else needs to help to get this change done? - write down who
  • What is my first new action step? - smaller is better
  • When will I get started? - put the date, time and action step in your calendar/planner

If you find these questions daunting or confusing
Get a Free Discovery Session with one of our Coaches
Walk away with a step-by-step action plan 

What if ...

What if you could enroll the leadership of your organization in this sense of outrage?  Wake them up and get them moving to address your biggest concerns?

What if you used your personal outrage to work with your personal care team - your personal receptionist, MA, Nurses, etc. - to do everything you can to lower your collective stress levels, find a different way to complete repetitive tasks that don't do anything to help provide quality patient care?

And if none of your best efforts are effective - none of them make the change you want to see, no matter how you try - What if you turn around, quit, walk away and set up a different practice?

If you feel like you are being injured or abused and cannot change - GET OUT .


Here is my fear about these new turns of phrase

These are perfect phrases to throw in the face of your least favorite manager when you are having another busy whirlwind of a day. 

My Fear:
They will be used in a Victim Mode accusation as above and automatically increase conflict and disconnect between front line caregivers and their leaders/administrators. 

  • Both sides will go to DEFCON Level 5 
  • You will get labeled Disruptive
  • Your legitimate concern will be ignored to the detriment of all



What do you think of these new terms?
Do you think they will help or harm physicians in general?
What is the first change you will be making in your practice?
How and when will you get started?


Tags: stop physician burnout