Dr. Zubin Damania, more commonly known as ZDoggMD, is an internal medicine physician who speaks out against the brokenness of the medical system. Occasionally interjecting comedy and music, his videos and monologues dive deep into the truth behind the shiny glass windows of clinics and hospitals.
In one of his most recent videos, he talked about the term "burnout," specifically addressing how this term results in victim shaming by suggesting physicians aren't resourceful or strong enough to make it through the rigors of medicine. Those of us, like myself, who have either supported someone through medical school, or lived through it themselves, know beyond a shadow of a doubt burnout is not the accurate term for what is taking place. Medical school in and of itself is created in a way that organically weeds out the people who are prone to true burnout. It is close to impossible for a medical student to successfully complete the courses, exams, and clinicals required to graduate while simultaneously lacking resourcefulness and strength.
So, why then are physicians suddenly "burning out" despite the resilience they have demonstrated throughout their lives that has allowed them to become practicing physicians? As ZDoggMD argues, they aren't. He states, "We're not suffering from burnout, we're suffering from moral injury." He further states that "humans are moral, idealistic creatures that resonate love for other humans." One doesn't simply "go into medicine." The rigors and difficulty of the field almost require an authentic passion to help others. So, he asks, what happens when these idealistic morals of caring for others in the most genuine way meet the real world of insurance company bottom lines and administrative staff's lack of understanding of the front line? What happens when the hospital's revenue is seen as more important than the care provided within the hospital or when the IT staff who develop complicated electronic medical record systems receive more support than the clinical staff on the front line?
Moral injury.
So, he asks, "What's going to happen to a good person in a bad system when they feel they can't change the system, but they have to adapt?" They're going to attempt to adapt until they break and others are going to label it as burnout. He further argues that we can't fix something we can't accurately acknowledge or label.
The answer isn't more sleep, although arguably physicians rarely sleep long enough. The answer isn't better food options in the physician's lounge. It's fixing the system that is resulting in moral injury. It's helping the front line do what they so desperately want to do-help their patients.
My friends, this perspective is so necessary in our society because we can't change what we don't acknowledge. It is the brokenness of the system that has caused me to do the work I do in helping others find the clarity they need. And while I love what I do and the people I help, I would love it even more if the system was fixed such that my services were no longer needed.
Until that day comes, know that I am here doing my part, both in my advocacy work and in spreading awareness of the moral injury occurring in our medical system.