I was invited on to this TV show to share why burnout and moral injury fail to address the underlying cause of physician distress—human rights violations in medicine. View full TV show here.
Doctors have the highest suicide rate of any profession. I run a doctor suicide hotline and I’ve investigated more than 1,300 doctor suicides. Root cause analysis reveals human rights violations as the culprit. Doctors who don’t succumb to suicide are victims too. Coping with abuse is not a solution. Ending abuse is. Injured morals offers no solution. Burnout is a smokescreen that distracts from human rights violations that are killing doctors—and patients. Let’s focus on facts and real solutions through institutional triage, definitive diagnoses, and targeted treatment.
1) Institutional Triage
As physicians, we address life-threatening emergencies first to save our patients’ lives. Stop the arterial bleed, the treat the acne. Institutional triage means prioritizing doctor suicide prevention by eradicating human rights violations in medicine that lead to suicides. When doctors are groomed to accept a culture of abuse, we perpetuate it on ourselves, our peers, and our patients. Eliminating hazardous working conditions will create a culture of wellness for us all.
2) Definitive Diagnoses
Students enter the medicine with their mental health on par with or better than their peers. We are then wounded by hazardous working conditions Illegal in all other industries that value safety. As a result, doctors may develop lifelong health sequelae such as new onset constipation, insomnia, anxiety, depression, PTSD, and suicidal ideation. Precise language is paramount. Burnout and moral injury distract and confuse victims while deflecting attention from abuse perpetrated by the medical system that labels victims as defective. By holding the system accountable for violating the specific rights of doctors (and patients), we can proceed with a targeted treatment plan.
3) Targeted Treatment
Unlike moral injury and burnout, human rights violations have proven medicolegal solutions that protect victims. Sleep deprivation is a known torture technique, yet new doctors are forced to work 28-hour shifts. The solution—a bed and a pillow. Food and water deprivation are common among sleep-deprived doctors who have no set breaks on marathon shifts. The solution—regular meals. Hazing and harassment is rampant in our hospitals. The solution—legal prosecution as is standard at other institutions that value human life. Doctors are collapsing from overwork, found dead in hospitals. The solution—comply with the same labor laws that protect pilots who fly 8-hour shifts (not 28-hours). All human rights violations in medicine are categorized here with simple, effective treatments.