{"title":"医学不应该这么难：在儿科复杂护理中，医生道德伤害和患者医疗经验的交叉点。","authors":"Erika Erlandson, Carrie Ramirez, Wendy Dean","doi":"10.3233/PRM-230027","DOIUrl":null,"url":null,"abstract":"<p><p>Dr. Jay Neufeld's story in If I Betray These Words is a detailed account of one physician's catastrophic journey through moral injury when caring for pediatric patients with complex medical conditions [1]. Many clinicians may recognize Jay's journey in their own experiences, but what deserves parallel consideration are the journeys of patients and families when they are accompanied by physicians at risk of moral injury. This case study illustrates the tight link between drivers of physician moral injury and patients' negative healthcare experiences. These include (1) decisions directed by health insurance regulations and prior authorizations; (2) the electronic medical record (EMR); and (3) healthcare systems focused on revenue generation.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"443-447"},"PeriodicalIF":0.8000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/89/prm-16-prm230027.PMC10578270.pdf","citationCount":"0","resultStr":"{\"title\":\"Medicine shouldn't be this hard: The intersection of physician moral injury and patient healthcare experience in pediatric complex care.\",\"authors\":\"Erika Erlandson, Carrie Ramirez, Wendy Dean\",\"doi\":\"10.3233/PRM-230027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Dr. Jay Neufeld's story in If I Betray These Words is a detailed account of one physician's catastrophic journey through moral injury when caring for pediatric patients with complex medical conditions [1]. Many clinicians may recognize Jay's journey in their own experiences, but what deserves parallel consideration are the journeys of patients and families when they are accompanied by physicians at risk of moral injury. This case study illustrates the tight link between drivers of physician moral injury and patients' negative healthcare experiences. These include (1) decisions directed by health insurance regulations and prior authorizations; (2) the electronic medical record (EMR); and (3) healthcare systems focused on revenue generation.</p>\",\"PeriodicalId\":16692,\"journal\":{\"name\":\"Journal of pediatric rehabilitation medicine\",\"volume\":\" \",\"pages\":\"443-447\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/89/prm-16-prm230027.PMC10578270.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of pediatric rehabilitation medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3233/PRM-230027\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pediatric rehabilitation medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3233/PRM-230027","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
Jay Neufeld博士在《如果我怀疑这些话》中的故事详细描述了一位医生在照顾患有复杂疾病的儿科患者时经历的道德伤害的灾难性旅程[1]。许多临床医生可能在自己的经历中认识到周的旅程，但值得同时考虑的是，当患者和家人在有道德伤害风险的医生陪同下的旅程。这项案例研究说明了医生道德伤害的驱动因素与患者的负面医疗体验之间的紧密联系。其中包括（1）根据健康保险条例和事先授权作出的决定；（2） 电子病历（EMR）；以及（3）注重创收的医疗保健系统。
Medicine shouldn't be this hard: The intersection of physician moral injury and patient healthcare experience in pediatric complex care.
Dr. Jay Neufeld's story in If I Betray These Words is a detailed account of one physician's catastrophic journey through moral injury when caring for pediatric patients with complex medical conditions [1]. Many clinicians may recognize Jay's journey in their own experiences, but what deserves parallel consideration are the journeys of patients and families when they are accompanied by physicians at risk of moral injury. This case study illustrates the tight link between drivers of physician moral injury and patients' negative healthcare experiences. These include (1) decisions directed by health insurance regulations and prior authorizations; (2) the electronic medical record (EMR); and (3) healthcare systems focused on revenue generation.
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