'Moral injury' common among interventional radiologists

Moral injury is common among interventional radiologists, according to a study published November 3 in Academic Radiology.

The term "moral injury" describes the impact of psychological, social, and spiritual events that involve the betrayal of a person's deeply held moral beliefs and values. A team led by Andrew Woerner, MD, of the University of Washington in Seattle assessed the incidence of this condition among interventional radiologists via a 29-question survey that incorported a global quality of life (QoL) scale and the MI Symptom Scale‑Healthcare Professional (both of these tools use a scoring system of 1 to 100), and two open-ended questions. An MI Symptom Scale‑Healthcare Professional (MISS-HP) score of 36 or greater indicated moral injury.

The survey was distributed on March 30 to interventional radiologists via the Society of Interventional Radiology (SIR) Connect Open Forum website, Facebook, LinkedIn, Twitter, and email; 365 individuals responded. Respondents included both practicing and in-training interventional radiologists and a mix of practice settings (academic, community, and hybrid).

The researchers found that the mean QoL score in the total respondent cohort was 71, "suggestive of 'good' QoL," they noted. In a subgroup of respondents who reported experiencing moral injury, mean QoL was 68.

Of the 365 survey participants, 223 (61%) scored more than 36 on the MISS-HP (with a mean MISS-HP of 40), indicating professional-related moral injury, the group wrote. Mean MISS-HP in the moral injury subgroup was significantly higher compared with the rest of the group, at 47 versus 28 (p < 0.05).

The most common reasons participants cited for moral injury in the professional sphere were "ineffective leadership, barriers to patient care, corporatization of medicine, non-physician administration, performing futile procedures, turf battles, and reduced resources," the group reported. The most common ways to mitigate moral injury according to survey respondents included the following:

  • More autonomy and less bureaucracy
  • More administrative support
  • Physician-directed leadership
  • Adequate staffing
  • Changes to the medical system
  • Physician unionization
  • Transparency with insurance companies
  • More time off
  • Leaving medicine/retirement

"Moral injury is prevalent among interventional radiologists, and it negatively correlates with quality of life," the group concluded. "Future work should investigate causative factors and mitigating solutions."

The complete study can be found here.


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