Moral Matters: Recent Episodes
Moral Injury of Healthcare
In this new podcast, Drs. Wendy Dean and Simon Talbot examine moral injury: what it is, why it matters, and the growing need for change.
Our season wraps up with Simon and Wendy discussing the whole experience of producing the 8 seasons of Moral Matters. We highlight excerpts from just a few of the amazing conversations we've had over the last four years: Jeremy Muller, Joe Crane, Blake Alkire, Rosemary Batt, Thom Mayer, Adam Beckman, Walter O'Donnell, L. Robert Burns, Ilana Yurkiewicz, and Luke Messac. We close with a teaser from 43cc, a new podcast co-hosted by Wendy Dean and Matt Ramsey that takes an irreverent look at healthcare, with a shot to dull the pain.
Link to 43cc podcast: https://podcasts.apple.com/us/podcast/43cc/id1715895952
This will be our last episode for a little while, but we are not going anywhere. Follow 43cc for the next steps after Moral Matters, and continue to support us at the links below.
We send a big "Thank you!" to all of our faithful listeners and supporters. Good bye and stay well.
Support the podcast: https://www.fixmoralinjury.org/get-started
Link to book: https://a.co/d/imMMCLY
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Today we're looking back to one of our favorite conversations from season 1 with Dr. Don Berwick, President Emeritus and Senior Fellow of the Institute for Healthcare Improvement. Dr. Berwick is a long-time advocate for improving healthcare for both patients and providers. During this conversation, we talk about the moral imperative of change in healthcare; how we can approach the challenges more effectively; and why working together will be critical.
We want to hear from you. Send a voice memo or note to podcast@moralinjury.healthcare.
CME: https://earnc.me/0aUaBU
Support the podcast: https://www.fixmoralinjury.org/get-started
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This week’s episode is a look back at a conversation from our very first season, amid the complexities of Covid19, and stands as a stunning example of how administrators and physicians can come together to ensure the well-being of their staff, patients, and community, even during a global pandemic. Ed Tufaro, SVP of Operations at the Rothman Orthopaedic Institute, and his team prioritized placing people over profit, even before state governments took action.
CME: https://earnc.me/2RsrNY
Support the podcast: https://www.fixmoralinjury.org/get-started
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Today we are revisiting a conversation from Season 6 Episode 2 with Adam Beckman, former Special Advisor to the US Surgeon General. He and Dr. David Chokshi, former New York City Health Commissioner, called on hospitals to end five administrative practices that harm patients in their October 2022 article in JAMA Health Forum. In our conversation, we dove deep into that article, and talked about ways individuals can get engaged.
JAMA article: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2798115
To support the podcast: https://www.fixmoralinjury.org/get-started
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Is organizing a solution to moral injury? Joe Crane has been a union organizer for two decades. When we spoke with him in 2021, Joe was the national organizer for the Doctors Council. He has since moved to UPAD. Joe walks us through the basic steps of organizing, what it can achieve, and how long it might take.
CME: https://earnc.me/byuINF
More information about the Doctors Council: https://doctorscouncil.org/
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Understanding human development is an important part of leadership. In this conversation from Season 3, Dr. Will Torrey, then interim chair of psychiatry at Dartmouth Hitchcock Medical Center(he is now the chair), talks about helping people find their full selves, whether in clinical care, leadership, research or education, and how to channel your outrage toward change.
CME: https://earnc.me/7yXlMa
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What we choose to measure can distort our organizations, impact our workforce, and hijack our attention and resources. Jerry Muller, professor emeritus of history at the Catholic University of America and the author of The Tyranny of Metrics, describes how that happens then offers a way to create metrics that matter.
CME link: https://earnc.me/1s88Dd
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The US went from small scale, local healthcare institutions to multibillion dollar megaproviders in barely a generation. Lawton R. Burns, MBA shares his perspective on how it happened, what the true costs are, and what we all can do about it.
Big Med:
Big MedSeemed Like a Good Idea:
Seemed Like a Good IdeaIf I Betray These Words:
If I Betray These WordsTo support the podcast:
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Rosemary Batt is the Alice Hanson Cook Professor of Women and Work at the Industrial Labor Relations School at Cornell University and a Professor in Human Resource Studies and International and Comparative Labor. Her research focuses on comparative international studies of management and employment relations, with particular attention to the impact of financialization on management and employment and the globalization and restructuring of service industries and its impact on low wage workers.
https://cepr.net/wp-content/uploads/2021/10/AB-Financialization-In-Healthcare-Spitzer-Rept-09-09-21.pdf
To support the podcast: https://www.fixmoralinjury.org/get-started
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In this episode, we look back at a conversation from Season 1 with Richard Lacquement, Dean of the US War College, about the idea of professionalism in the military and how that relates to some of the struggles in professionalism in healthcare.
Do us a favor? Let us know the tiniest bit about you, and who you want to hear from, so we can better plan future seasons: https://www.surveymonkey.com/r/9SBSMMF
To support the podcast: https://www.fixmoralinjury.org/get-started
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Welcome to Season 8 of Moral Matters! Today, we begin the new season by celebrating the 1-year anniversary of the release of our book If I Betray These Words. And we are going to do that by looking back and revisiting both episodes in which Wendy and Simon discuss the journey and their respective experiences which led to the making of the book.
Do us a favor? Let us know the tiniest bit about you, and who you want to hear from, so we can better plan future seasons: https://www.surveymonkey.com/r/9SBSMMF
To support the podcast: https://www.fixmoralinjury.org/get-started
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Here’s a quick recap of Season 7, in which Wendy, Simon and Kimmy discuss the variety of guests we spoke with this season and how Season 8 will look back at the fabulous guests we've spoken with over the past three years.
Do us a favor? Let us know the tiniest bit about you, and who you want to hear from, so we can better plan future seasons: https://www.surveymonkey.com/r/9SBSMMF
To support the podcast: https://www.fixmoralinjury.org/get-started
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Today's episode, with Dr. Candice Chen, is about a new framework for health worker and first responder distress developed by the Workplace Change Collaborative through a federal grant. The WCC, which includes George Washington University, Moral Injury of Healthcare, the Institute for Healthcare Improvement, and the American Federation of Teachers union, thought it was critical to expand the work on distress and its solutions to include moral injury. We talk through the background of the WCC, the framework, and next steps.
Explore the framework: https://www.wpchange.org/explore-the-framework
Support the podcast: https://www.fixmoralinjury.org/get-started
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On this episode, we’re talking about debt collection in American medicine. Lightly paraphrasing today’s guest: ‘The source of much disillusion in medicine is the fundamental tension between the widely held ideals and aims of medical care and the market fundamentalism that dominates American life, which leaves those of us who work in health care with a gnawing sense that we are being drawn away from our raison d’etre.’
Luke Messac, MD, PhD, is an emergency physician and historian at Mass General Brigham in Boston and an instructor at Harvard Medical School. He is the author of Your Money or Your Life, just released by Oxford University Press, on November 1 of 2023.
Support the podcast: https://www.fixmoralinjury.org/get-started
Link to Dr. Messac’s book: https://academic.oup.com/book/49415
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We are super excited to share a brand new podcast, with our very own Wendy Dean cohosting with Matt Ramsey, MD. 43cc is an honest, fun, irreverent,
More about the 43cc podcast and a link to listen here: https://www.43ccpodcast.com/
Or you can find it on your favorite podcast platform.Support Moral Matters:
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This week on Moral Matters, we’re sharing another episode from Searching for Medicine’s Soul.
In this episode, Dr. Rothstein talks with Dr. Elisabeth Rosenthal, a senior contributing editor at Kaiser Health News, former New York Times reporter and New York Times best selling author of American Sickness: How Healthcare Became Big Business and How You Can Take It Back.
Drs. Rothstein and Rosenthal talk about the failures of the American healthcare system and the untenable costs and burdens it foists on both doctors and patients.
We are grateful to the Searching for Medicine’s Soul podcast for letting us share this episode with you.
For more information about Searching for Medicine’s Soul:https://searchingformedicinessoul.podbean.com/
Dr. Rosenthal’s book: https://www.anamericansickness.com/
Support the podcast: https://www.fixmoralinjury.org/get-started
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Artificial intelligence is shifting how we communicate in every sector. We talk with journalist Carey Goldberg and physician informaticist Isaac Kohane about their book, The AI Revolution in Medicine: Chat GPT-4 and Beyond, and the promise and perils of the technology in healthcare.
Support the podcast: https://www.fixmoralinjury.org/get-started
Link to book: https://a.co/d/imMMCLY
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Leah Houston, MD practiced emergency medicine for nearly ten years - in 11 different health systems and 3 different states. But credentialing challenges and losing control of her professional identity drove her to build one potential solution. She hopes HPEC will put physicians back in control of their professional credentials.
For more information about HPEC: hpec.io
Support the podcast: www.fixmoralinjury.org
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Elena Perea, MD is a psychiatry residency director and practicing psychiatrist in Asheville, NC. We talk about mental health care in the wake of the worst of the pandemic; the specter of physician suicide; how she decided to change the focus of her work; and how she thinks about guiding the next generation of physicians, today and in the future.
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Ilana Yurkiewicz is a primary care internist and oncologist who recently published a very personal book about the perils of our unintentionally fragmented health care systems. She talks about her journey to this work, and how we all - patients and clinicians - can help reduce the gaps in our medical stories.
Link to Fragmented: https://a.co/d/0Qy6As1
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Healthcare has become increasingly consolidated and corporatized over the past few decades and Danielle Ofri has written eloquently about its impact on the practice of medicine. In this episode, shared by Searching for Medicine’s Soul, Aaron Rothstein talks with Dr. Ofri about the challenges to the relationship between doctor and patient: administrative creep in the medical field, nonprofit hospital (mis)behavior, and the application of the adversarial patient compensation system to unintended medical errors.
Find more episodes of Searching for Medicine’s Soul here:
Searching for Medicine’s Soul on Apple Podcasts
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Alexandra Robbins is the author of the book, “The Teachers: A Year Inside America’s Most Vulnerable, Important Profession.” It’s a great look at the reality of America’s teachers: what’s working, what’s not, and how we can fix it. It might give us some ideas for healthcare, too.
We are grateful to the Reach Out and Read podcast for letting us share this episode with you
For more information about Reach Out and Read:[
Home - Reach Out and Read](Home - Reach Out and Read"smartCard-inline")
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Trauma is shockingly common. Yet trauma-engendered behaviors are often met with ‘What’s wrong with you?’, when, as Dr. Bruce Perry relates, a better framing is, ‘What happened to you?’. This conversation is especially relevant as the healthcare workforce begins processing our collective trauma from the COVID pandemic. Dr. Perry co-authored a book with Oprah Winfrey that may helps us disentangle trauma and understand the powerful, protective role of healthy relationships with family, community, and culture. Reestablishing those relationships, and repairing the rents in our work communities, too, is an essential part of moving forward out of the challenges of the last three years.
We are grateful to the Reach Out and Read podcast for letting us share this episode with you
For more information about Reach Out and Read:[
Home - Reach Out and Read ]( Home - Reach Out and Read "smartCard-inline")
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Jason Reynolds is a much-decorated, prolific novelist, poet, and the Library of Congress’s National Ambassador for Young People’s Literature. This interview with Jason Reynolds is far-ranging and he is deeply honest about himself, and about the power of imagination, literature, and storytelling to allow America’s youth to grow, to strive, and to reverse the ills of racism and beyond. His perspective is equally relevant to adults and we are grateful to the Reach Out and Read podcast for letting us share this episode with you.
For more information about Reach Out and Read:[
Home - Reach Out and Read ]( Home - Reach Out and Read "smartCard-inline")
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Here’s a quick recap of Season 6 and what’s been happening with Moral Injury of Healthcare’s work. We also introduce a new cohost, Kimmy Pedersen, who will be joining us on occasion beginning in Season 7.
Do us a favor? Let us know the tiniest bit about you, and who you want to hear from, so we can better plan future seasons: https://www.surveymonkey.com/r/9SBSMMF
To support the podcast: https://www.fixmoralinjury.org/get-started
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History can help us understand and shape the future, if we value it. Jeremy Greene, MD, PhD, shares his perspective on the hype, hope, fears, and fallacies of medical technology, from the telephone to artificial intelligence.
The Doctor Who Wasn't There: https://press.uchicago.edu/ucp/books/book/chicago/D/bo181534150.html
More Work for Mother: https://www.amazon.com/More-Work-Mother-Household-Technology/dp/0465047327
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As Dan Blumberg says, moral risks in policing are not black and white. We talk with him about the grey areas and how he works with individual officers to mitigate the impacts of moral risks.
https://www.apa.org/pubs/books/the-power-manual
https://www.amazon.com/POWER-Manual-Step-Step-Resilience/dp/1433836300/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=
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The US went from small scale, local healthcare institutions to multibillion dollar megaproviders in barely a generation. Lawton R. Burns, MBA shares his perspective on how it happened, what the true costs are, and what we all can do about it.
Big Med:
Big Med
Seemed Like a Good Idea:
Seemed Like a Good Idea
If I Betray These Words:
If I Betray These Words
To support the podcast:
Get Started — Fix Moral Injury
Twitter - @fixmoralinjury
Instagram - @moralinjury
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LinkedIn - @moral Injury of Healthcare
Wendy and Simon dive into what it was like to write a book - what we learned, exactly how hard it was, and what were the best parts.
If you’d like to find an author appearance near you, check here: https://www.fixmoralinjury.org/book
The book is available everywhere, but if you’d like a personalized copy, you can order here; please let them know in the comments section if you simply want a signature or how you’d like it inscribed: https://www.whistlestoppers.com/notable-new-books-more/if-i-betray-these-words-moral-injury-and-why-its-so-hard-for-clinicians-to-put-patients-first
To support the podcast: https://www.fixmoralinjury.org/get-started
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Wendy and Simon give a listeners a window into what’s in their new book, If I Betray These Words.
To see if there is an author appearance near you, check here:
Book — Fix Moral Injury
The book is available everywhere, but if you’d like a personalized copy, you can order here; please let them know in the comments section if you simply want a signature or how you’d like it inscribed:
If I Betray These Words: Moral Injury and Why It's So Hard for Clinicians to Put Patients First — WHISTLESTOP BOOKSHOP
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Dr. Walter O’Donnell was - in his words - “pissed” when his patient in fragile health started smoking again. He wasn’t angry with his patient, but at his hospital. We talk with him about digging into the administrative decisions that impacted his patient’s outcome, what he did in response, and what changes he wants to see in the future.
Conference link: https://cmecatalog.hms.harvard.edu/administrative-harm-professionalism-teamwork-medicine
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Jeff Cain is a family physician who’s been a lifelong advocate for better health. We talked with him about the accident that led him to advocate for common sense insurance coverage for limb loss, and how his work has created a playbook for other initiatives.
Amputee Coalition
1-888-AMP-KNOW
https://www.amputee-coalition.org
Amputee Coalition Advocacy links for information about the annual Amputee Coalition Advocacy Forum, Lead Advocate Training and links to state initiatives and activism :
https://www.amputee-coalition.org/advocacy-awareness/
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Adam Beckman, former Special Advisor to the US Surgeon General, and Dr. David Chokshi, former New York City Health Commissioner, called on hospitals to end five administrative practices that harm patients, in their October 2022 article in JAMA Health Forum. We dove deep into that article, and talked about ways individuals can get engaged.
JAMA article: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2798115
To support the podcast: https://www.fixmoralinjury.org/get-started
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Dr. Richard Edley is a psychologist who has been the lead executive for Rehabilitation and Community Providers Association, a lobbying organization in Pennsylvania that supports federally qualified health centers. He shares his journey to this career, and why we should all learn more about how lobbyists - and even political action committees - might be acting on our behalf.
More information about RCPA: paproviders.org
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Wrapping up the 5th season of Moral Matters - more than 50 episodes and 28,000 downloads (thank you!) - feels like a milestone. We give you a peek behind the curtain at what's involved in producing each episode, glance back at this season, and ponder what’s next. Thank you for listening, enjoy the holidays, and we’ll be back in 2023. To support the podcast: https://www.fixmoralinjury.org/get-started
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James Hu, MD, FACP, EdD is the medical director of the Sarcoma Program of USC, and is considered one of the nation’s experts in the disease. He is also Clinical Associate Professor of Medicine at USC's Keck School of Medicine, the co-director of the Adolescent and Young Adult program of USC and Children’s Hospital Los Angeles, and a retired Army COL and former commander of a combat support hospital. We spoke with Dr. Hu about his study of leadership characteristics https://academic.oup.com/milmed/advance-article/doi/10.1093/milmed/usac312/6763647 and his recently launched problem -based USC leadership program. To support the podcast: https://www.fixmoralinjury.org/get-started
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Thom Mayer, MD, FACEP, FAAP, FACHE is Medical Director for the NFL Players Association, Executive Vice President for Leadership at LogixHealth, Clinical Professor of Emergency Medicine at George Washington University and a Senior Lecturing Fellow at Duke University. Dr. Mayer discussed his 20+ years of work with the NFL Players Association and the importance of active and adaptive leadership.
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Marvin S. Swartz, M.D., is a Professor of Psychiatry and Behavioral Sciences at Duke University. He has also served as a member of the MacArthur Foundation Research Network on Mandated Community Treatment and a Co-PI on multiple NIMH studies of intervention effectiveness.
Dr. Swartz shared insights from his decades of work in mental healthcare in North Carolina, how policy has driven care and staffing trends, and how a shortage of mental health workers and inadequate support for mental health services effects patient outcomes and contributes to moral injury.
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J. Stephen Bohan, MD, MS, FACP, FACEP, is Executive Vice Chair of the Department of Emergency Medicine at Brigham and Women's Hospital. He is also Assistant Professor at the Harvard Medical School.
Dr. Bohan's research focus is the established and growing problem of overcrowding and hallway boarding in Emergency Departments, including impacts on ED workers and patients, and possible solutions.
Dr. Bohan on Emergency Department Hallway Boarding for Stat News
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Dr. Caitlin Delaney, MD, is a practicing Emergency Physician at MedStar Washington Hospital Center, Director of Business Development and Medical Advisor at flipMD, and on the faculty at Georgetown University School of Medicine. Dr. Delaney is also a US Navy combat veteran. She is passionate about bringing the voice of the practicing physician to industry, and is working to create sustainable careers for physicians.
https://ymyhealth.com/2022/06/22/the-war-in-healthcare-is-still-raging-millennial-combat-veteran-and-emergency-medicine-doctor-shares-how-healthcare-workers-are-suffering-moral-injury-not-just-burnout/
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Rosemary Batt is the Alice Hanson Cook Professor of Women and Work at the Industrial Labor Relations School at Cornell University and a Professor in Human Resource Studies and International and Comparative Labor. Her research focuses on comparative international studies of management and employment relations, with particular attention to the impact of financialization on management and employment and the globalization and restructuring of service industries and its impact on low wage workers.
https://cepr.net/wp-content/uploads/2021/10/AB-Financialization-In-Healthcare-Spitzer-Rept-09-09-21.pdf
To support the podcast: https://www.fixmoralinjury.org/get-started
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Jay Baruch, a practicing emergency room physician, is Professor of Emergency Medicine at Alpert Medical School of Brown University and the author of two award-winning short fiction collections, What's Left Out and Fourteen Stories: Doctors, Patients, and Other Strangers. His book, Tornado of Life: A Doctor's Journey Through Constraints and Creativity in the ER, was released on August 30, 2022 . To support the podcast: https://www.fixmoralinjury.org/get-started
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Reverend Brian Hughes has been providing support to UnitedHealthcare and Optum Providers since 2018. Wendy was traveling, but Simon spoke with him about his role providing spiritual care and support for a large insurance workforce.
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As we conclude four seasons of Moral Matters, we reflect on what it means to "return to normal". Thank you for getting us to 21,000 downloads. We'll return at the end of the summer.
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Resources and Articles Mentioned: https://hiddenbrain.org/podcast/do-less/ Subtract: The Untapped Science of Less: https://www.leidyklotz.com/ The Good Jobs Strategy https://www.zeynepton.com/book/ Blanchard & Burke Article: https://thehill.com/opinion/healthcare/599669-two-years-into-the-pandemic-and-our-health-care-workforce-is-still/ April 30, 2020 article: https://www.statnews.com/2020/04/30/suicides-two-health-care-workers-hint-at-covid-19-mental-health-crisis-to-come/ April 1, 2020 article: https://www.medscape.com/viewarticle/927859
Dr. Blake Alkire MD MPH has studied the economics of global surgery for more than a decade. He never imagined when he started out that the same principles would be so critical for mitigating the risk of financial toxicity for his patients in Boston. He shares what he's learned, and how it's changed his practice.
To support the podcast: https://www.fixmoralinjury.org/get-started
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CME: click here to reflect on this episode and earn one hour of Category 1 credit: https://earnc.me/kMgDsz
Drs. Cadey Harrel and Brad Dreifuss are physicians, educators, and advocates. In the second part of our conversation with Dr. Harrel and Dr. Dreifuss, we delve into specific details of their advocacy work, and discuss actionable steps for others looking to advocate. To support the podcast: https://www.fixmoralinjury.org/get-started Twitter - @fixmoralinjury Instagram - @moralinjury Facebook - @MoralInjuryofHC LinkedIn - Moral Injury of Healthcare
Drs. Cadey Harrel and Brad Dreifuss are physicians, educators, and advocates. In Part 1 of our conversation, they share what drew them to advocacy work and where they’re making change.
To support the podcast: https://www.fixmoralinjury.org/get-started Twitter - @fixmoralinjury Instagram - @moralinjury Facebook - @MoralInjuryofHC LinkedIn - Moral Injury of Healthcare Click the link to reflect and unlock credits & more: https://earnc.me/0CtQi8
Leslie Flores, MHA, SFHM brings a healthcare administrator’s perspective to a conversation about how to move forward in uncertain times. She shares ideas for both clinicians and administrators about how to break down barriers, so they can start coproducing solutions.
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Click the link to reflect and unlock credits & more: https://earnc.me/EO1YS4
Priya Mammen, MD, MPH practices emergency medicine and advocates for legislative changes based on the patterns she sees in her practice. She shares the power that story-telling, curiosity, humility, courage, and collaboration have in her efforts.
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This Podcast is not approved for credit by CMEfy, however, you may reflect on how this Podcast applies to your day-to-day and engage to earn AMA PRA Category 1 Credit(s)™ via point-of-care learning activities here: https://earnc.me/VqLtxC
In late February, 2020, MIHC testified before the New York City Council about the safety of NYC emergency rooms, days before the first case of COVID-19 was diagnosed in the city.
In this episode we're reflecting on what was true then, where we are now, and what's next.
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This Podcast is not approved for credit by CMEfy, however, you may reflect on how this Podcast applies to your day-to-day and engage to earn AMA PRA Category 1 Credit(s)™ via point-of-care learning activities here: https://earnc.me/nJUBWY
Claire Unis MD, got her MFA while in medical school to keep her accountable for writing about that experience. Now, she is a practicing pediatrician, and shares with us how she also uses her love of writing to help colleagues process and reflect on the work they do.
PREORDER Balance Pedal Breathe: A Journey Through Medical School by Claire Unis (Hard Cover)
Reflect on this content to earn CME here: https://earnc.me/fxDlu1 Support the podcast: https://www.fixmoralinjury.org/get-started
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Professor Rudolph Leuschner talks with us about the unique aspects of the healthcare supply chain in the US, why it was - and still is - vulnerable to pandemic disruptions, and what changes might make the system more resilient in a crisis. Professor Leuschner is an Associate Professor in the department of Supply Chain Management and the Program Director for the online Master of Science in Supply Chain Management program at Rutgers Business School.
Reflect on this content to earn CME here: https://earnc.me/Yqvnzd Support the podcast: https://www.fixmoralinjury.org/get-started
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What if you could get CME for a conversation with a colleague, or for listening to a podcast? In this episode, Niraj Swami and Brian Cohen discuss how physicians can take back CME, earning credit for the everyday learning they do already, for a nominal cost.
CME: https://earnc.me/ZMe9rG
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Understanding human development is an important part of leadership. Dr. Will Torrey, interim chair of psychiatry at Dartmouth Hitchcock Medical Center, talks about helping people find their full selves, whether in clinical care, leadership, research or education, and how to channel your outrage toward change.
CME: https://earnc.me/7yXlMa
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We're three seasons into Moral Matters and approaching 15,000 downloads. In case you jumped in part of the way through, or want a quick recap of the ground we've covered, we took a few minutes to recount the concepts of each season, and the memorable conversations we've had.
CME link: https://earnc.me/55rZ0P
Twitter: @WDeanMD, @simontalbotmd, @fixmoralinjury
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What we choose to measure can distort our organizations, impact our workforce, and hijack our attention and resources. Jerry Muller, professor emeritus of history at the Catholic University of America and the author of The Tyranny of Metrics, describes how that happens then offers a way to create metrics that matter.
CME link: https://earnc.me/1s88Dd
Twitter: @WDeanMD, @simontalbotmd, @fixmoralinjury
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"Despite all that we know about burnout and [moral injury], the trauma, regrettably, continues."
We talk with Dr. Mark Linzer and Dr. Michelle LeClair, from Hennepin Healthcare in Minnesota, about their work to clarify the causes and potential mitigation strategies for clinician distress.
CME: https://earnc.me/Ps3gdY
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00370-9/fulltext
Twitter: @WDeanMD, @simontalbotmd, @fixmoralinjury
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Is organizing a solution to moral injury? Joe Crane has been a union organizer for two decades. Currently the national organizer for the Doctors Council, Joe walks us through the basic steps of organizing, what it can achieve, and how long it might take.
CME: https://earnc.me/byuINF
More information about the Doctors Council: https://doctorscouncil.org/
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A tragedy in her son's freshman college dorm set Catherine Sanderson on a mission to understand what gets in the way of doing what we know is right. She shares what she learned about the psychology of inaction, and how we can use those insights to shape better communities and better organizations, in healthcare and elsewhere.
Why We Act: Turning Bystanders Into Moral Rebels
CME: https://earnc.me/nGi2NO
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Corey Feist’s worlds converged with the tragic death of his sister-in-law, Dr. Lorna Breen in March of 2020. As the CEO of the UVA Physicians Group and President of the Dr. Lorna Breen Heroes Foundation, he talks with us about adding value rather than burden, decreasing administrative barriers, and bringing clinicians to the tables where decisions are made, as ways to mitigate clinician distress.
CME: https://earnc.me/HiM1Tk
Information about the legislative action referenced: https://drlornabreen.org/about-the-legislation/
How to find your Congressperson: https://www.govtrack.us/congress/members
http://npsaday.org/
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David Vozza is an attorney in Manhattan who specializes in defending physicians in all types of legal actions, except malpractice. He’s a staunch physician advocate, dating back to his premed days in college. We talk to him about identifying legal emergencies, choosing the right lawyer, and how to protect yourself in a corporate healthcare environment.
https://norrismclaughlin.com/attorney_profiles/david-n-vozza/ CME: https://earnc.me/7eRNEE Donate: https://www.fixmoralinjury.org/get-started
Ron Purser is a professor of management at San Francisco State University, a practicing Buddhist, and author of the book "McMindfulness”. We spoke with him about the commodification of wellness and mindfulness into multi-billion dollar industries; how mindfulness changed in the process; and how to take back self-care to use it as a form of resistance.
McMindfulness
CME: https://earnc.me/ZTkQHq
Support the podcast: https://www.fixmoralinjury.org/get-started
Moral injury isn’t specific to the United States healthcare system. In this episode, Deborah Morris, an academic and consultant clinical psychologist based in the United Kingdom, lends her perspective. Morris splits her work between an in-patient setting and conducting trauma research with a focus on the experiences of marginalized people. We discuss the intersections of trauma and moral injury, the difference between personal and professional moral injury, and how the experience manifests in healthcare systems outside of the United States.
CME: https://earnc.me/w6hWaY Support the podcast: https://www.fixmoralinjury.org/get-started
In this bonus episode, Dr. Mona Masood, DO describes how she made her vision a reality - without having any clue what she was doing. Dr. Masood is an outpatient psychiatrist who saw a need, had an idea, and mobilized her community to create the Physician Support Line, a group of 700+ psychiatrists volunteering to support their colleagues. To hear more about the support line and Masood’s work, listen to episode 18.
CME: https://earnc.me/vIpNLv
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Moral injury is not a one-size-fits-all issue. In this mini-episode, Drs. Dean and Talbot discuss the mechanisms of moral injury, the various levels at which it occurs, and how understanding those nuances can help frame solutions.
CME: https://earnc.me/LOhAJx
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Ask a question, shut up, and listen - that’s how our guest this week prioritizes the physician perspective. Jim Beckner is the executive director at the Richmond Academy of Medicine, a society of more than 2,000 physicians using the Moral Injury framework to value physicians, value the physician-patient relationship, and recreate a strong medical community. Jim provides an excellent example of how medical societies can be powerful partners in helping their physician members bring needed change to their workplaces.
CME: https://earnc.me/BROT7b
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We know that we’re working in systems that don’t do what they’re designed to do - now what? In this episode, we speak with our guest about moral injury in the behavioral healthcare system and how to resist the urge to burn the system down by advocating to make it better. Hannah Karpman, M.S.W., Ph.D. is an assistant professor at the Smith School for Social Work. Her career began with an interest in mental healthcare policy which has led to her current research on the interactions of marginalized and LGBTQ+ families with the behavioral healthcare system and a passion for advocacy.
CME: https://earnc.me/5PMhPK
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In this episode, we look at moral injury in the context of the BIG issues that define all of our lives- politics, economics, social justice, ethics, and morality. For our guest, preventing moral injury it isn't about making "right or wrong " decisions, it's about developing a framework that facilitates people's ability to act on and speak to their personal and professional goals. Ira Bedzow, Ph.D., is an associate professor of medicine and the UNESCO Chair of Bioethics at New York Medical College. He is a Senior Scholar of the Aspen Center for Social Values, and a contributor to the MirYam Institute and the Forbes' Diversity, Equity and Inclusion section.
CME:https://earnc.me/LonQrN
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Dr. Mona Masood, DO is an outpatient psychiatrist in Philadelphia, who realized, early in the pandemic, that physicians needed support from their peers. Without any expertise, she stood up the Physician Support Line nearly overnight. For the past year, 800 volunteer psychiatrists have fielded calls from thousands of physicians, entirely free of charge. It is an inspiring story of how a strong community comes together in a crisis.
https://www.physiciansupportline.com/
CME: https://earnc.me/kUsosq
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Dr. Michael Myers is a specialist in physician health, and a professor of Clinical Psychiatry at SUNY Downstate Health Sciences University in Brooklyn, NY. Early in medical school, a fellow medical student and friend died by suicide.* That event shaped the rest of Dr. Myers' career, which he devoted to caring exclusively for physicians, medical students, and their families. In this episode, we talk about how we can care for physicians today, and how we can advocate for a better tomorrow.
*This conversation includes conversations about suicide and loss, so please consider whether and where you listen.
CME: https://earnc.me/YWiHCl
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In recognition of Mental Health Awareness Month, we are dropping a bonus episode featuring Dr. Lara Briseno-Kenney.* The career in medicine that Lara expected changed in a matter of hours, when planes hit the twin towers and the Pentagon on 9/11. Serving as an Army doctor in Iraq and Afghanistan during the Global War on Terrorism forged Lara into the doctor she is today. Yet, when she returned to civilian medicine, she found the skills she thought would advance her mission to provide exemplary care were treated as a hindrance to profit. Her attempt to serve “two masters”, the patient and her employer, left her morally distressed and deeply unhappy. Then she found hope, and a new vision– opening her own clinic.
*This was an intense conversation that ranged across 9/11, war, thoughts of suicide, and the hope that comes with new opportunities. It can be difficult in places, though, so it might be worth thinking about how and where you listen.
CME: https://earnc.me/xXkJKv
Support the podcast: https://www.fixmoralinjury.org/get-started
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Physicians are at risk of losing their profession, but what does that really mean? In this episode, we get at the heart of professionalism, how it relates to moral injury, and what constraints on physician autonomy could mean for the profession of medicine. Professor Richard Lacquement, a leading voice on military education and professionalism, joins us for this episode.* He served as Dean of the School of Strategic Landpower at the US Army War College for 8 years, after retiring from a 29-year Army career. His career included senior-level assignments in Iraq, Afghanistan, Korea, and the Pentagon, and teaching at West Point, the Naval War College, and the Army War College. He has devoted his life to understanding how professions, and the military in particular, serve the needs of US society.
*The opinions expressed here do not represent those of the Army War College, the Department of Defense, or any part of the U.S. government.
My Lai and Military Professionalism:
https://warroom.armywarcollege.edu/podcasts/how-memories-of-my-lai-influenced-military-professionalism/
Professionalism: https://www.amazon.com/System-Professions-Division-Expert-Institutions/dp/0226000699/ref=sr_1_4?dchild=1&keywords=andrew+abbott&qid=1617905980&s=books&sr=1-4
CME: https://earnc.me/rVzOjv
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What if we could create built environments that empower people and improve their level of engagement? Clairanne Pesce, a Senior Interior Designer of Healthcare environments at Array Architects in Washington, D.C., does just that. Despite a well-established correlation between the built environment and well-being, no one had ever asked Clairanne to develop a design to reduce workforce distress. In response, she and her colleagues at Array have established a revolutionary new approach to Clinician-Centered Design: a design method to positively impact clinician performance and well-being. Yet, instituting these changes is a challenge in itself...
CME: https://earnc.me/mpdXpX
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In this episode, Jenny Andrews, a public defender in Santa Barbara, CA, and Jeff Sherr, the Training Director for the National Association for Public Defense talk about why the language of moral injury matters for public defenders. Systemic obstacles preventing "gold standard" representation is a familiar frustration. Burdened by excessive caseloads, endless hours of work, and with their client's freedom on the line, many public defenders are struggling to stay in the profession. Why? Just like healthcare workers, public defenders are experiencing moral injury.
CME: https://earnc.me/nESe88
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This week, radiologists Dr. Mark Labuski and Dr. Joe Bellissimo join us to talk about a practice that is taking exceptional care of both their patients and their employees. Their commitment to a strong culture of care and service, and to making sure clinicians are doing what they trained for, are the key elements in their success. This is a story of leadership excellence.
CME: https://earnc.me/bF1l4t
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As the first wave of COVID-19 cases hit the US, severe respiratory distress dominated conversations about treating the disease. Dr. Andrea Levine, a Pulmonary Critical Care physician at the University of Maryland and program director of their Critical Care Medicine Fellowship shares her experience as a respiratory expert on the front line of the pandemic. While alarmingly ill patients flooded the ICU, Dr. Levine was reminded to lean on her knowledge of evidence-based medicine over the “social media-based medicine” prevalent during the first few weeks of the crisis. This episode discusses the limitations of care when resources are scarce, the importance of patient-centered care, and how the healthcare system can rebuild trust with patients and physicians.
CME: https://earnc.me/hPUkgo
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You asked, we answered! Join us for our 10th episode of Moral Matters, where Drs. Dean and Talbot field listener questions about what Moral Injury is, who it affects, and what you can do about it.
CME: https://earnc.me/DYxr9J
Support the podcast: https://www.fixmoralinjury.org/get-started
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The system is broken, and we aren’t just talking about healthcare here. Dr. Hallie Brooks joins us to describe her experience as an ER physician during the COVID-19 pandemic. This episode is raw and from the heart.
CME: https://earnc.me/xp2GOr
Support the podcast: https://www.fixmoralinjury.org/get-started
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This week’s episode is a stunning example of how administrators and physicians can come together to ensure the well-being of their staff, patients, and community, even during a global pandemic. Ed Tufaro, SVP of Operations at the Rothman Orthopaedic Institute, and his team prioritized placing people over profit, even before state governments took action.
CME: https://earnc.me/2RsrNY
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Carlina Rivera never expected to find herself in politics, and she certainly never expected to be the chair of the New York City Council's Committee on Hospitals during a global pandemic. This week, CM Rivera provides us with an invaluable behind-the-scenes look into the bureaucratic challenges of managing the COVID-19 pandemic in NYC, from canceling the St. Patrick's Day Parade to advocating for healthcare workers' mental health and safety, and more.
Contact CM Rivera to share data and stories at district2@council.nyc.gov
CME: https://earnc.me/Lo2k5h
Support the podcast: https://www.fixmoralinjury.org/get-started
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In this episode, Michael Fedor shares a harrowing account of advocating for his wife, Serena, and their infant son, Luke, through a perilous childbirth and for weeks afterward. Michael shares how he leveraged his experience in public service and teaching to fight for their lives. This conversation is about the critical illnesses of Serena and Luke. It gets pretty intense at times, so you might want to consider when and where you listen. We ran out of time to include our conversation about his own healing, but for Michael, making his Chicken Noodle Soup offers comfort on many levels.
CME: https://earnc.me/7HzYw1
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In this episode of Moral Matters, Dr. Wendy Dean interviews Dr. Elena Perea. Dr. Perea works as a hospital psychiatrist at the crossroads of medicine and mental health. Dr. Perea's account of moral injury is powerful and stems from the gap between what she knows is the best care for patients and what, too often, is the reality of limited care available for mental health conditions in the US. This conversation includes a bit of strong language and brief mentions of child abuse, so please consider whether and where you listen.
CME: https://earnc.me/fNtcXt
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In this episode of Moral Matters, Dr. Jane Kim, an Emergency Medicine Physician on the front lines of COVID-19 in New York City, shares her experience of COVID, and how moral injury pervaded her experience both professionally and personally. We want to hear from you. Send a voice memo or note to podcast@moralinjury.healthcare.
CME: https://earnc.me/MLbI3g
Support the podcast: https://www.fixmoralinjury.org/get-started
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In this episode of Moral Matters, Dr. Wendy Dean interviews Dr. Don Berwick, President Emeritus and Senior Fellow of the Institute for Healthcare Improvement. Dr. Berwick is a long-time advocate for improving healthcare for both patients and providers. During this conversation, we talk about the moral imperative of change in healthcare; how we can approach the challenges more effectively; and why working together will be critical.
We want to hear from you. Send a voice memo or note to podcast@moralinjury.healthcare.
CME: https://earnc.me/0aUaBU
Support the podcast: https://www.fixmoralinjury.org/get-started
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In this episode of Moral Matters, Drs. Simon Talbot and Wendy Dean discuss their own experiences with personal challenges that led them to develop the framework of moral injury.
Do you have an experience that sounds similar? We want to hear from you.
Send a voice memo or note to podcast@moralinjury.healthcare.
CME: https://earnc.me/c7F3pQ
Support the podcast: https://www.fixmoralinjury.org/get-started
Twitter - @fixmoralinjury
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Join Wendy Dean, MD and Simon G. Talbot, MD., the authors of the STATNews article that started the conversation about moral injury in healthcare and elsewhere. In this first episode, they explore how this idea started, how it affects us all, and the growing need for change.
CME: https://earnc.me/9nqVN2
Support the podcast: https://www.fixmoralinjury.org/get-started
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In this brief introduction, hear from Dr. Wendy Dean and Dr. Simon G. Talbot on how the conversation started to turn from burnout to moral injury across industries. And, more importantly, they'll be discussing how to change the drivers of distress.