by Molly McMillen
Imagine becoming a physician because you have a genuine passion for caring for others, and helping people to live healthier, happier lives, but then you are unable to provide that care because a failing health care system renders patients unable to pay for it. This situation is all too familiar to physicians in the United States like Madeleine Jacobs, MD.
Moral injury, or the psychological distress experienced by committing or failing to prevent acts which oppose one’s moral beliefs, is posing an increasing threat to physicians in the U.S. as more patients are unable to afford care due to lack of health insurance. Unprecedented numbers of physicians are experiencing exhaustion, depression, and other symptoms of burnout, as well as retiring early and even committing suicide due to moral injury. The cash-hungry corporations that profit off the U.S. health care system place a massive ethical burden upon health care providers.
Dr. Jacobs is a health care reform advocate with Medical Professions for Universal Health Care and retired family physician who had a medical practice in rural Colorado for over 30 years. She retired from her practice after becoming fed up with the failures of the health care system which prevented her from caring for patients with treatable diseases.
“Being a physician used to be fun because, you know, we were doing what we were trained to do, which is take care of patients,” she said. Now, however, the simple act of caring for patients has become increasingly difficult.
“I took care of multi-generation families and over the course of that career, it just became harder and harder to take care of patients because of the obstacles put up by profiteers. My job was to teach people how to have healthy lives, but the corporate structures didn’t allow that,” she said.
Patients die from preventable, treatable diseases because our corporate health care system is broken and dominated by greed, she said. As a result, doctors are left disillusioned and disgusted with insurance companies that prioritize profits over lives.
Dr. Jacobs recounted one of her main reasons for “finally throwing in the towel.” In her last year of practice, three patients between the ages of 50 and 65 died from colon cancer because they were unable to afford colonoscopies. While insurance companies must cover screening tests, Dr. Jacobs said, if cancer is detected insurance companies will instead classify the test as a diagnostic test, which patients are forced to pay for. The fear of being unable to cope financially with these screening tests denies patients the chance of early detection which may mean the difference between life or death.
“I had three young people die from colon cancer,” she said, because they feared the cost of colonoscopy. “I mean, it was a continuous banging my head against the wall, trying to get people basic care for treatable disease.”
In a profession where one’s passion and goal is saving lives, each failure to do so becomes a massive weight on one’s conscience. Therefore, it is not difficult to understand how moral injury is rampant amongst physicians under a health care system which blatantly stands in the way of healing those who it is supposed to protect.
Our only hope of saving and improving the lives of patients and physicians alike is to institute universal health care which actually allows doctors to provide high-quality care to their patients.
Molly McMillen is a senior undergraduate pre-medical student at Fort Lewis College in Durango, CO with an intense passion for writing, health care, and advocating for better access to quality care. She is currently a certified nursing assistant and hopes to go into anesthesiology after finishing her undergraduate and graduate degrees.