The Sunday Read: ‘The Moral Crisis of America’s Doctors’

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Jul 16, 2023

Eyal Press, a contributor to the New York Times Magazine and author of 'Dirty Work,' discusses the alarming moral crisis faced by American doctors. He highlights the distress experienced by physicians due to a profit-driven healthcare system that prioritizes efficiency over patient care. The conversation uncovers the emotional toll of ethical dilemmas, rising unionization among medical residents, and innovative models of direct patient care that aim to restore the doctor-patient relationship. Press also sheds light on the growing phenomenon of 'moral injury' in the medical field.

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ANECDOTE

Physician Suicide Rates

Psychiatrist Wendy Dean was startled by the high suicide rate among doctors, even higher than that of active military members.
She discovered this after reading an article about a physician's suicide and began researching the issue.

INSIGHT

Moral Injury in Healthcare

Doctors and nurses resonated with Dean and Talbot's essay on moral injury, finding it described their struggles.
The essay compared the moral distress of healthcare workers to that of soldiers.

ANECDOTE

Doctors' Reluctance to Speak Out

Eyal Press, the author, initially found it hard to believe doctors faced moral crises similar to low-wage workers.
However, many doctors, despite their high salaries, were afraid to openly discuss their struggles.

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Some years ago, a psychiatrist named Wendy Dean read an article about a physician who died by suicide. Such deaths were distressingly common, she discovered. The suicide rate among doctors appeared to be even higher than the rate among active military members, a notion that startled Dean, who was then working as an administrator at a U.S. Army medical research center in Maryland. Dean started asking the physicians she knew how they felt about their jobs, and many of them confided that they were struggling. Some complained that they didn’t have enough time to talk to their patients because they were too busy filling out electronic medical records. Others bemoaned having to fight with insurers about whether a person with a serious illness would be preapproved for medication.

The doctors Dean surveyed were deeply committed to the medical profession. But many of them were frustrated and unhappy, she sensed, not because they were burned out from working too hard but because the health care system made it so difficult to care for their patients.

By the time the journalist Eyal Press met Dean, the distress among medical professionals had reached alarming levels. Professional organizations like National Nurses United, the largest group of registered nurses in the country, had begun referring to “moral injury” and “moral distress” in pamphlets and news releases. Mona Masood, a psychiatrist who established a support line for doctors shortly after the coronavirus pandemic began, recalls being struck by how clinicians reacted when she mentioned the term. “I remember all these physicians were like, Wow, that is what I was looking for,” she says. “This is it.”

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