Why ‘GP burnout’ is as relevant as ‘moral injury’
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Why ‘GP burnout’ is as relevant as ‘moral injury’

In a recent video, healthcare commentator Dr Z claimed we need to stop talking about ‘GP burnout’ and focus more on the concept of ‘Moral Injury.’

MedicalDirector’s Chief Clinical Advisor and GP, Dr Charlotte Middleton, argues that GP burnout is still very much relevant, and that we shouldn’t discount it as a pressing issue for the health industry.

What is moral injury?  

According to Dr Z, moral injury arises when healthcare professionals have certain values when they enter the profession, and then face a range of onsite pressures and traumatic experiences that knocks or ‘injures’ their morals and values. For instance, how a patient’s insurance or socio-economic status, can affect the level of care a health professional can provide a patient. As a result, he argues healthcare professionals realise they can’t deliver what they thought they would in terms of ideal patient-centric health care, which leaves them feeling disillusioned and ‘morally injured’.

It is this phenomenon, he says, that’s often misconstrued as ‘burnout’, which is why he argues we need to focus more on addressing moral injury within the industry, and stop confusing it with the concept burnout.

Why GP burnout is still relevant

Moral injury is just one of many of the things healthcare professionals experience and it forms part of a wider ambit of personal, emotional and psychological challenges that we can go through if we don’t feel supported. Yes, we can feel moral injury, but we can also experience fatigue, depression, stress, anxiety – and burnout.

Expectations as a health professional in what we hope to achieve, how we envision what ‘ideal’ healthcare looks like from those early years as a student, and the reality of the day-to-day challenges of patient care, can leave us feeling disillusioned. Unsupported, it can wear us down mentally and physically, and more often than not, it’s a daily struggle.

The issue is compounded by the fact that most doctors are high achievers or type A personalities, so when we’re not achieving a certain standard or meeting our own expectations of success, we can quickly feel like failures. Every day, we go home feeling we haven’t reached our potential in achieving our ‘ideal’ standard of health care, if we’re working in a system doesn’t support that. From the very early years, we’re expected to work at a very high level – and put in extremely long hours. If this is against a backdrop of administrative inefficiencies and lack of peer support, it’s no wonder that over time, this ends up eroding away at us, impacting our mental and physical health.

Having the right support structure

It’s important we start giving health professionals the right support structures to pave the way in achieving their vision for ‘ideal’ healthcare now, and for the future. Already, we’re seeing the appointments of ‘Wellness Officers’, such as Australia’s first Chief Medical Wellness Officer, Dr Bethan Richards from Sydney Local Health District, whose role is to offer a cultural and systematic change in the hospital system, with the aim of  reducing stress and burnout among junior and senior doctors. It’s the nation’s first wellness program for doctors, based on the world-leading Stanford University model.

While this a fantastic move, it’s still very much an industry exception and not yet the ‘norm’, which demonstrates we still have a long way to go in order to reach the appropriate level of support the wider health community needs.  

Moving away from ‘mandatory reporting’

Compounding the issue further is the concept of mandatory reporting. One of the dangers of mandatory reporting of doctors seeking help for mental health is that it will deter doctors to get the help they really need. Doctors who would otherwise seek help, will fear their treating doctor could report them as a risk to patients.

On top of this, the RACGP’s concern with this legislation is that it puts too much pressure on treating clinicians to decide what issues are significant. If this law passes, treating clinicians may be forced to report things that perhaps do not even need to be reported.

Any situation that discourages medical practitioners from seeking vital help is a bad outcome – not only for the doctor, but also for their patients. Doctors are human beings and have the right and expectation to receive treatment like any other professional, without fear of prejudice. No other profession is subject to these laws – not even those who have public safety in their hands.

How technology can help

The role of technology in all of this is to make life easier for doctors, not harder, so doctors can focus on their patients, and not their paperwork.  With the right systems and process in place, we can efficiently manage our electronic medical records and clinical notes, streamline our workflow and ease the administrative burden on ourselves and our team.

We can re-ignite closer teamwork and real-time collaboration, by leveraging the power of interoperability and the cloud.  Most importantly, we can and offer more flexible and personalised patient care and help achieve what our vision for ‘ideal’ healthcare looks like now, and for the future.