In this thought-provoking episode of Endocrine Matters, we are joined by the insightful and compassionate Dr. Wendy Dean to explore the concept of moral injury in healthcare. Dr. Dean is a physician, leader, author, and podcaster whose work has illuminated the emotional and ethical challenges physicians face in today’s healthcare systems. Together, we discuss her groundbreaking book If I Betray These Words, the complexities of moral injury, and actionable ways to reclaim humanity in medicine.

 • 03:12 Defining moral injury and how it differs from burnout.

 • 09:46 The systemic factors that perpetuate moral injury in healthcare.

 • 18:15 Dr. Dean’s personal journey from psychiatry to moral injury advocacy.

 • 29:03 The impact of hospital consolidation and vertical integration.

 • 41:27 Patients’ misconceptions about billing and the challenges of transparency.

 • 54:12 Why direct primary care is a win-win for physicians and patients.

 • 01:10:45 How physicians can address moral injury and advocate for change.

 • 01:22:18 The power of collective action and building coalitions in healthcare.

 • Moral Injury vs. Burnout: Burnout suggests exhaustion from the work itself, but moral injury stems from systemic pressures forcing physicians to compromise their ethical commitment to patient care.

 • The Cost of Healthcare Systems: Hospital consolidation, vertical integration, and profit-driven motives have created barriers to ethical care, leaving physicians struggling to fulfill their oaths.

 • Direct Care as a Solution: Dr. Dean advocates for direct patient care models, which offer transparency, stronger relationships, and better outcomes for both physicians and patients.

 • Building Trust in Healthcare: The importance of restoring the physician-patient relationship and challenging the systemic issues that harm both.

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