Moral Matters

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

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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:

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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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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CME: https://earnc.me/DYxr9J

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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

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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

Support the podcast: https://www.fixmoralinjury.org/get-started

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