Our season wraps up with Simon and Wendy discussing the whole experience of producing the 8 seasons of Moral Matters. We highlight excerpts from just a few of the amazing conversations we've had over the last four years: Jeremy Muller, Joe Crane, Blake Alkire, Rosemary Batt, Thom Mayer, Adam Beckman, Walter O'Donnell, L. Robert Burns, Ilana Yurkiewicz, and Luke Messac. We close with a teaser from 43cc, a new podcast co-hosted by Wendy Dean and Matt Ramsey that takes an irreverent look at healthcare, with a shot to dull the pain.

Link to 43cc podcast: https://podcasts.apple.com/us/podcast/43cc/id1715895952

This will be our last episode for a little while, but we are not going anywhere. Follow 43cc for the next steps after Moral Matters, and continue to support us at the links below.

We send a big "Thank you!" to all of our faithful listeners and supporters. Good bye and stay well.

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

Link to book: https://a.co/d/imMMCLY

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Today we're looking back to one of our favorite conversations from season 1 with Dr. Don Berwick, President Emeritus and Senior Fellow of the Institute for Healthcare Improvement. Dr. Berwick is a long-time advocate for improving healthcare for both patients and providers. During this conversation, we talk about the moral imperative of change in healthcare; how we can approach the challenges more effectively; and why working together will be critical.

We want to hear from you. Send a voice memo or note to podcast@moralinjury.healthcare.

CME: https://earnc.me/0aUaBU

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Welcome to Season 8 of Moral Matters! Today, we begin the new season by celebrating the 1-year anniversary of the release of our book If I Betray These Words. And we are going to do that by looking back and revisiting both episodes in which Wendy and Simon discuss the journey and their respective experiences which led to the making of the book.

Do us a favor? Let us know the tiniest bit about you, and who you want to hear from, so we can better plan future seasons: https://www.surveymonkey.com/r/9SBSMMF

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Here’s a quick recap of Season 7, in which Wendy, Simon and Kimmy discuss the variety of guests we spoke with this season and how Season 8 will look back at the fabulous guests we've spoken with over the past three years.

Do us a favor? Let us know the tiniest bit about you, and who you want to hear from, so we can better plan future seasons: https://www.surveymonkey.com/r/9SBSMMF

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Today's episode, with Dr. Candice Chen, is about a new framework for health worker and first responder distress developed by the Workplace Change Collaborative through a federal grant. The WCC, which includes George Washington University, Moral Injury of Healthcare, the Institute for Healthcare Improvement, and the American Federation of Teachers union, thought it was critical to expand the work on distress and its solutions to include moral injury. We talk through the background of the WCC, the framework, and next steps.

 

Explore the framework: https://www.wpchange.org/explore-the-framework

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On this episode, we’re talking about debt collection in American medicine. Lightly paraphrasing today’s guest: ‘The source of much disillusion in medicine is the fundamental tension between the widely held ideals and aims of medical care and the market fundamentalism that dominates American life, which leaves those of us who work in health care with a gnawing sense that we are being drawn away from our raison d’etre.’

Luke Messac, MD, PhD, is an emergency physician and historian at Mass General Brigham in Boston and an instructor at Harvard Medical School. He is the author of Your Money or Your Life, just released by Oxford University Press, on November 1 of 2023.

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

Link to Dr. Messac’s book: https://academic.oup.com/book/49415

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We are super excited to share a brand new podcast, with our very own Wendy Dean cohosting with Matt Ramsey, MD. 43cc is an honest, fun, irreverent, <occasionally profane> and deadly serious podcast that exposes the truth about healthcare (with a shot to dull the pain). In this cross feed, we give you their very first episode. Be sure to like and follow at the links below. Cheers!

‌

More about the 43cc podcast and a link to listen here: https://www.43ccpodcast.com/

 

Or you can find it on your favorite podcast platform.

 

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This week on Moral Matters, we’re sharing another episode from Searching for Medicine’s Soul.

In this episode, Dr. Rothstein talks with Dr. Elisabeth Rosenthal, a senior contributing editor at Kaiser Health News, former New York Times reporter and New York Times best selling author of American Sickness: How Healthcare Became Big Business and How You Can Take It Back.

Drs. Rothstein and Rosenthal talk about the failures of the American healthcare system and the untenable costs and burdens it foists on both doctors and patients.

We are grateful to the Searching for Medicine’s Soul podcast for letting us share this episode with you.

For more information about Searching for Medicine’s Soul:https://searchingformedicinessoul.podbean.com/

Dr. Rosenthal’s book: https://www.anamericansickness.com/

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Artificial intelligence is shifting how we communicate in every sector. We talk with journalist Carey Goldberg and physician informaticist Isaac Kohane about their book, The AI Revolution in Medicine: Chat GPT-4 and Beyond, and the promise and perils of the technology in healthcare.

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Leah Houston, MD practiced emergency medicine for nearly ten years - in 11 different health systems and 3 different states. But credentialing challenges and losing control of her professional identity drove her to build one potential solution. She hopes HPEC will put physicians back in control of their professional credentials.

For more information about HPEC: hpec.io

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Elena Perea, MD is a psychiatry residency director and practicing psychiatrist in Asheville, NC. We talk about mental health care in the wake of the worst of the pandemic; the specter of physician suicide; how she decided to change the focus of her work; and how she thinks about guiding the next generation of physicians, today and in the future.

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Ilana Yurkiewicz is a primary care internist and oncologist who recently published a very personal book about the perils of our unintentionally fragmented health care systems. She talks about her journey to this work, and how we all - patients and clinicians - can help reduce the gaps in our medical stories.

Link to Fragmented: https://a.co/d/0Qy6As1

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This week’s episode is a look back at a conversation from our very first season, amid the complexities of Covid19, and stands as 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

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Healthcare has become increasingly consolidated and corporatized over the past few decades and Danielle Ofri has written eloquently about its impact on the practice of medicine. In this episode, shared by Searching for Medicine’s Soul, Aaron Rothstein talks with Dr. Ofri about the challenges to the relationship between doctor and patient: administrative creep in the medical field, nonprofit hospital (mis)behavior, and the application of the adversarial patient compensation system to unintended medical errors.

Find more episodes of Searching for Medicine’s Soul here:

‎Searching for Medicine’s Soul on Apple Podcasts

 

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Alexandra Robbins is the author of the book, “The Teachers: A Year Inside America’s Most Vulnerable, Important Profession.” It’s a great look at the reality of America’s teachers: what’s working, what’s not, and how we can fix it. It might give us some ideas for healthcare, too.

We are grateful to the Reach Out and Read podcast for letting us share this episode with you

For more information about Reach Out and Read:[

Home - Reach Out and Read ]( Home - Reach Out and Read "smartCard-inline")

 

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Trauma is shockingly common. Yet trauma-engendered behaviors are often met with ‘What’s wrong with you?’, when, as Dr. Bruce Perry relates, a better framing is, ‘What happened to you?’. This conversation is especially relevant as the healthcare workforce begins processing our collective trauma from the COVID pandemic. Dr. Perry co-authored a book with Oprah Winfrey that may helps us disentangle trauma and understand the powerful, protective role of healthy relationships with family, community, and culture. Reestablishing those relationships, and repairing the rents in our work communities, too, is an essential part of moving forward out of the challenges of the last three years.

We are grateful to the Reach Out and Read podcast for letting us share this episode with you

For more information about Reach Out and Read:[

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Jason Reynolds is a much-decorated, prolific novelist, poet, and the Library of Congress’s National Ambassador for Young People’s Literature. This interview with Jason Reynolds is far-ranging and he is deeply honest about himself, and about the power of imagination, literature, and storytelling to allow America’s youth to grow, to strive, and to reverse the ills of racism and beyond. His perspective is equally relevant to adults and we are grateful to the Reach Out and Read podcast for letting us share this episode with you.

For more information about Reach Out and Read:[

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Here’s a quick recap of Season 6 and what’s been happening with Moral Injury of Healthcare’s work. We also introduce a new cohost, Kimmy Pedersen, who will be joining us on occasion beginning in Season 7.

Do us a favor? Let us know the tiniest bit about you, and who you want to hear from, so we can better plan future seasons: https://www.surveymonkey.com/r/9SBSMMF

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History can help us understand and shape the future, if we value it. Jeremy Greene, MD, PhD, shares his perspective on the hype, hope, fears, and fallacies of medical technology, from the telephone to artificial intelligence. 

The Doctor Who Wasn't There: https://press.uchicago.edu/ucp/books/book/chicago/D/bo181534150.html

More Work for Mother: https://www.amazon.com/More-Work-Mother-Household-Technology/dp/0465047327

 

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As Dan Blumberg says, moral risks in policing are not black and white. We talk with him about the grey areas and how he works with individual officers to mitigate the impacts of moral risks.

https://www.apa.org/pubs/books/the-power-manual

https://www.amazon.com/POWER-Manual-Step-Step-Resilience/dp/1433836300/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=

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The US went from small scale, local healthcare institutions to multibillion dollar megaproviders in barely a generation. Lawton R. Burns, MBA shares his perspective on how it happened, what the true costs are, and what we all can do about it.

Big Med:

Big Med

 

Seemed Like a Good Idea:

Seemed Like a Good Idea

 

If I Betray These Words:

If I Betray These Words

 

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Get Started — Fix Moral Injury

 

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Wendy and Simon dive into what it was like to write a book - what we learned, exactly how hard it was, and what were the best parts.

If you’d like to find an author appearance near you, check here: https://www.fixmoralinjury.org/book

The book is available everywhere, but if you’d like a personalized copy, you can order here; please let them know in the comments section if you simply want a signature or how you’d like it inscribed: https://www.whistlestoppers.com/notable-new-books-more/if-i-betray-these-words-moral-injury-and-why-its-so-hard-for-clinicians-to-put-patients-first

 

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Wendy and Simon give a listeners a window into what’s in their new book, If I Betray These Words.

To see if there is an author appearance near you, check here:

https://www.fixmoralinjury.org/book Book — Fix Moral Injury

 

The book is available everywhere, but if you’d like a personalized copy, you can order here; please let them know in the comments section if you simply want a signature or how you’d like it inscribed:

If I Betray These Words: Moral Injury and Why It's So Hard for Clinicians to Put Patients First — WHISTLESTOP BOOKSHOP

 

To support the podcast:

https://www.fixmoralinjury.org/get-started Get Started — Fix Moral Injury

 

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Today we are revisiting a conversation from Season 6 Episode 2 with Adam Beckman, former Special Advisor to the US Surgeon General. He and Dr. David Chokshi, former New York City Health Commissioner, called on hospitals to end five administrative practices that harm patients in their October 2022 article in JAMA Health Forum. In our conversation, we dove deep into that article, and talked about ways individuals can get engaged.

JAMA article: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2798115

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Dr. Walter O’Donnell was - in his words - “pissed” when his patient in fragile health started smoking again. He wasn’t angry with his patient, but at his hospital. We talk with him about digging into the administrative decisions that impacted his patient’s outcome, what he did in response, and what changes he wants to see in the future.

Conference link: https://cmecatalog.hms.harvard.edu/administrative-harm-professionalism-teamwork-medicine

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Jeff Cain is a family physician who’s been a lifelong advocate for better health. We talked with him about the accident that led him to advocate for common sense insurance coverage for limb loss, and how his work has created a playbook for other initiatives.

Amputee Coalition

1-888-AMP-KNOW

https://www.amputee-coalition.org

Amputee Coalition Advocacy links for information about the annual Amputee Coalition Advocacy Forum, Lead Advocate Training and links to state initiatives and activism :

https://www.amputee-coalition.org/advocacy-awareness/

 

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Adam Beckman, former Special Advisor to the US Surgeon General, and Dr. David Chokshi, former New York City Health Commissioner, called on hospitals to end five administrative practices that harm patients, in their October 2022 article in JAMA Health Forum. We dove deep into that article, and talked about ways individuals can get engaged.

JAMA article: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2798115

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

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Dr. Richard Edley is a psychologist who has been the lead executive for Rehabilitation and Community Providers Association, a lobbying organization in Pennsylvania that supports federally qualified health centers. He shares his journey to this career, and why we should all learn more about how lobbyists - and even political action committees - might be acting on our behalf.

More information about RCPA: paproviders.org

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Wrapping up the 5th season of Moral Matters - more than 50 episodes and 28,000 downloads (thank you!) - feels like a milestone. We give you a peek behind the curtain at what's involved in producing each episode, glance back at this season, and ponder what’s next. Thank you for listening, enjoy the holidays, and we’ll be back in 2023.  

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James Hu, MD, FACP, EdD is the medical director of the Sarcoma Program of USC, and is considered one of the nation’s experts in the disease. He is also Clinical Associate Professor of Medicine at USC's Keck School of Medicine, the co-director of the Adolescent and Young Adult program of USC and Children’s Hospital Los Angeles, and a retired Army COL and former commander of a combat support hospital.   We spoke with Dr. Hu about his study of leadership characteristics  https://academic.oup.com/milmed/advance-article/doi/10.1093/milmed/usac312/6763647 and his recently launched problem -based USC leadership program.  

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Thom Mayer, MD, FACEP, FAAP, FACHE is Medical Director for the NFL Players Association, Executive Vice President for Leadership at LogixHealth, Clinical Professor of Emergency Medicine at George Washington University and a Senior Lecturing Fellow at Duke University.  

Dr. Mayer discussed his 20+ years of work with the NFL Players Association and the importance of active and adaptive leadership.

 

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Marvin S. Swartz, M.D., is a Professor of Psychiatry and Behavioral Sciences at Duke University. He has also served as a member of the MacArthur Foundation Research Network on Mandated Community Treatment and a Co-PI on multiple NIMH studies of intervention effectiveness.

Dr. Swartz shared insights from his decades of work in mental healthcare in North Carolina, how policy has driven care and staffing trends, and how a shortage of mental health workers and inadequate support for mental health services effects patient outcomes and contributes to moral injury.

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J. Stephen Bohan, MD, MS, FACP, FACEP, is Executive Vice Chair of the Department of Emergency Medicine at Brigham and Women's Hospital. He is also Assistant Professor at the Harvard Medical School.

Dr. Bohan's research focus is the established and growing problem of overcrowding and hallway boarding in Emergency Departments, including impacts on ED workers and patients, and possible solutions.

Dr. Bohan on Emergency Department Hallway Boarding for Stat News

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Dr. Caitlin Delaney, MD, is a practicing Emergency Physician at MedStar Washington Hospital Center, Director of Business Development and Medical Advisor at flipMD, and on the faculty at Georgetown University School of Medicine. Dr. Delaney is also a US Navy combat veteran. She is passionate about bringing the voice of the practicing physician to industry, and is working to create sustainable careers for physicians.

https://ymyhealth.com/2022/06/22/the-war-in-healthcare-is-still-raging-millennial-combat-veteran-and-emergency-medicine-doctor-shares-how-healthcare-workers-are-suffering-moral-injury-not-just-burnout/

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Is organizing a solution to moral injury? Joe Crane has been a union organizer for two decades. When we spoke with him in 2021, Joe was the national organizer for the Doctors Council. He has since moved to UPAD.  Joe walks us through the basic steps of organizing, what it can achieve, and how long it might take.

CME: https://earnc.me/byuINF

More information about the Doctors Council: https://doctorscouncil.org/

Donate: https://www.fixmoralinjury.org/get-started

Find us:

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Rosemary Batt is the Alice Hanson Cook Professor of Women and Work at the Industrial Labor Relations School at Cornell University and a Professor in Human Resource Studies and International and Comparative Labor. Her research focuses on comparative international studies of management and employment relations, with particular attention to the impact of financialization on management and employment and the globalization and restructuring of service industries and its impact on low wage workers.

https://cepr.net/wp-content/uploads/2021/10/AB-Financialization-In-Healthcare-Spitzer-Rept-09-09-21.pdf

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Jay Baruch, a practicing emergency room physician, is Professor of Emergency Medicine at Alpert Medical School of Brown University and the author of two award-winning short fiction collections, What's Left Out and Fourteen Stories: Doctors, Patients, and Other Strangers. His book, Tornado of Life: A Doctor's Journey Through Constraints and Creativity in the ER, was released on August 30, 2022 . To support the podcast: https://www.fixmoralinjury.org/get-started

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Reverend Brian Hughes has been providing support to UnitedHealthcare and Optum Providers since 2018. Wendy was traveling, but Simon spoke with him about his role providing spiritual care and support for a large insurance workforce.

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As we conclude four seasons of Moral Matters, we reflect on what it means to "return to normal". Thank you for getting us to 21,000 downloads. We'll return at the end of the summer.

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Resources and Articles Mentioned:         https://hiddenbrain.org/podcast/do-less/         Subtract: The Untapped Science of Less: https://www.leidyklotz.com/         The Good Jobs Strategy https://www.zeynepton.com/book/         Blanchard & Burke Article: https://thehill.com/opinion/healthcare/599669-two-years-into-the-pandemic-and-our-health-care-workforce-is-still/         April 30, 2020 article: https://www.statnews.com/2020/04/30/suicides-two-health-care-workers-hint-at-covid-19-mental-health-crisis-to-come/         April 1, 2020 article: https://www.medscape.com/viewarticle/927859

Dr. Blake Alkire MD MPH has studied the economics of global surgery for more than a decade. He never imagined when he started out that the same principles would be so critical for mitigating the risk of financial toxicity for his patients in Boston. He shares what he's learned, and how it's changed his practice.

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CME: click here to reflect on this episode and earn one hour of Category 1 credit:  https://earnc.me/kMgDsz

Drs. Cadey Harrel and Brad Dreifuss are physicians, educators, and advocates. In the second part of our conversation with Dr. Harrel and Dr. Dreifuss, we delve into specific details of their advocacy work, and discuss actionable steps for others looking to advocate.   To support the podcast: https://www.fixmoralinjury.org/get-started Twitter - @fixmoralinjury Instagram - @moralinjury Facebook - @MoralInjuryofHC LinkedIn - Moral Injury of Healthcare  

Drs. Cadey Harrel and Brad Dreifuss are physicians, educators, and advocates. In Part 1 of our conversation, they share what drew them to advocacy work and where they’re making change. To support the podcast: https://www.fixmoralinjury.org/get-started Twitter - @fixmoralinjury Instagram - @moralinjury Facebook - @MoralInjuryofHC LinkedIn - Moral Injury of Healthcare Click the link to reflect and unlock credits & more: https://earnc.me/0CtQi8

Leslie Flores, MHA, SFHM brings a healthcare administrator’s perspective to a conversation about how to move forward in uncertain times. She shares ideas for both clinicians and administrators about how to break down barriers, so they can start coproducing solutions.

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Click the link to reflect and unlock credits & more: https://earnc.me/EO1YS4

Priya Mammen, MD, MPH practices emergency medicine and advocates for legislative changes based on the patterns she sees in her practice. She shares the power that story-telling, curiosity, humility, courage, and collaboration have in her efforts.

 

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This Podcast is not approved for credit by CMEfy, however, you may reflect on how this Podcast applies to your day-to-day and engage to earn AMA PRA Category 1 Credit(s)™ via point-of-care learning activities here: https://earnc.me/VqLtxC

 

 

In late February, 2020, MIHC testified before the New York City Council about the safety of NYC emergency rooms, days before the first case of COVID-19 was diagnosed in the city. 

In this episode we're reflecting on what was true then, where we are now, and what's next.

 

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Facebook - @MoralInjuryofHC

LinkedIn - Moral Injury of Healthcare

This Podcast is not approved for credit by CMEfy, however, you may reflect on how this Podcast applies to your day-to-day and engage to earn AMA PRA Category 1 Credit(s)™ via point-of-care learning activities here: https://earnc.me/nJUBWY

 

Understanding human development is an important part of leadership. In this conversation from Season 3, Dr. Will Torrey, then interim chair of psychiatry at Dartmouth Hitchcock Medical Center(he is now the chair), talks about helping people find their full selves, whether in clinical care, leadership, research or education, and how to channel your outrage toward change.

CME: https://earnc.me/7yXlMa

Donate: https://www.fixmoralinjury.org/get-started

Find us:

Twitter - @fixmoralinjury

Instagram - @moralinjury

Facebook - @MoralInjuryofHC

LinkedIn - Moral Injury of Healthcare

Claire Unis MD, got her MFA while in medical school to keep her accountable for writing about that experience. Now, she is a practicing pediatrician, and shares with us how she also uses her love of writing to help colleagues process and reflect on the work they do.

 

PREORDER Balance Pedal Breathe: A Journey Through Medical School by Claire Unis (Hard Cover)

 

Reflect on this content to earn CME here: https://earnc.me/fxDlu1  

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

Twitter - @fixmoralinjury

Instagram - @moralinjury

Facebook - @MoralInjuryofHC

LinkedIn - Moral Injury of Healthcare

Professor Rudolph Leuschner talks with us about the unique aspects of the healthcare supply chain in the US, why it was - and still is - vulnerable to pandemic disruptions, and what changes might make the system more resilient in a crisis. Professor Leuschner is an Associate Professor in the department of Supply Chain Management and the Program Director for the online Master of Science in Supply Chain Management program at Rutgers Business School.

  Reflect on this content to earn CME here: https://earnc.me/Yqvnzd  

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

Twitter - @fixmoralinjury

Instagram - @moralinjury

Facebook - @MoralInjuryofHC

LinkedIn - Moral Injury of Healthcare

What if you could get CME for a conversation with a colleague, or for listening to a podcast? In this episode, Niraj Swami and Brian Cohen discuss how physicians can take back CME, earning credit for the everyday learning they do already, for a nominal cost.

CME: https://earnc.me/ZMe9rG

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

Twitter - @fixmoralinjury

Instagram - @moralinjury

Facebook - @MoralInjuryofHC

LinkedIn - Moral Injury of Healthcare

Understanding human development is an important part of leadership. Dr. Will Torrey, interim chair of psychiatry at Dartmouth Hitchcock Medical Center, talks about helping people find their full selves, whether in clinical care, leadership, research or education, and how to channel your outrage toward change.

CME: https://earnc.me/7yXlMa

Donate: https://www.fixmoralinjury.org/get-started

Find us:

Twitter - @fixmoralinjury

Instagram - @moralinjury

Facebook - @MoralInjuryofHC

LinkedIn - Moral Injury of Healthcare