Abstract
[This is an excerpt.] Physicians make a promise, when joining this profession, to care for ill and injured patients, to the best of their ability, absent self-interest. Throughout training that obligation is ingrained in our every decision. Mentors and colleagues demand that we live up to the same exceptionally high standards they have maintained, or risk rebuke, shunning, and serious sanctions. Our patients believe our oath—that we will put their best interests ahead of personal or professional gain—and, as one author said, they “offer their trust as a gift.”2 In accepting the honor of such freely given vulnerability, most physicians strive, in every encounter, to be worthy of it. However, over the last three decades reimbursement and regulatory pressures have corporatized medicine. Physicians, small business/private practice owners in decades past, are now mostly employed and increasingly torn between their covenant with patients and the allegiance they owe to employers. When that rift is irreconcilable, the result can be moral injury. [To read more, click View Resource.]
