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If I Betray These Words

Moral Injury in Medicine and Why It's So Hard for Clinicians to Put Patients First

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If I Betray These Words

De: Wendy Dean, Simon Talbot
Narrado por: Wendy Dean
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Through stories and solutions, leading physicians tackle the conundrum of how best to care for patients while being thwarted by the business side of healthcare

Moves "away from calling doctors’ difficulties 'burnout'—thus blaming doctors—to 'moral injury'—like soldiers floundering under unjust orders. A brilliant expansive book.”—Samuel Shem, Professor in Medicine at NYU Medical School, author of The House of God and Man's 4th Best Hospital

“Wendy Dean diagnoses the dangerous state of our healthcare system, illustrating the thumbscrews applied to medical professionals by their corporate overlords… Required reading for all stakeholders in healthcare.”—Danielle Ofri, MD, PhD, author of When We Do Harm; A Doctor Confronts Medical Error

Offering examples of how to make medicine better for the healers and those they serve, If I Betray These Words profiles clinicians across the country who are tough, resourceful, and resilient, but feel trapped between the patient-first values of their Hippocratic oath and the business imperatives of a broken healthcare system.

Doctors face real risks when they stand up for their patients and their oath; they may lose their license, their livelihood, and for some, even their lives.

There’s a growing sense, referred to as moral injury, that doctors have their hands tied—they know what patients need but can’t get it for them because of constraints imposed by healthcare systems run like big businesses.

Workforce distress in healthcare—moral injury—was a crisis long before the COVID-19 pandemic, but COVID highlighted the vulnerabilities in our healthcare systems and made it impossible to ignore the distress, with 1 in 5 American healthcare workers leaving the profession since 2020, and up to 47% of U.S. healthcare workers now planning to leave their positions by 2025.

If I Betray These Words confronts the threat and broken promises of moral injury—what it is; where it comes from; how it manifests; and who’s fighting back against it. We need better healthcare—for patients and for the workforce. It’s time to act.

©2023 Wendy Dean and Simon Talbot (P)2023 Steerforth Press LLC Administración y Políticas Industria de la Medicina y Salud Médico Profesionales e Investigadores Cuidado de la salud Medicina Negocio Educación médica Lesiones

Reseñas de la Crítica

"A fierce denunciation of American medicine in which physicians are the heroes—mostly… An expert bottoms-up examination of our diseased health care system."—Kirkus Reviews (starred review)

“This is a great story of an adventurous and wide-ranging doctor dedicated to bringing the human into medicine. Having felt the whip of money and ‘administrators,’ in both large institutions and small hospitals, she and Simon Talbot moved away from calling doctors’ difficulties 'burnout'—thus blaming doctors—to 'moral injury'—like soldiers floundering under unjust orders. A brilliant, expansive book.”—Samuel Shem, MD, DPhil, Professor in Medicine at NYU Medical School, author of The House of God and Man's 4th Best Hospital

"A manifesto for our times! Wendy Dean diagnoses the dangerous state of our healthcare system, illustrating the thumbscrews applied to medical professionals by their corporate overlords. By making it impossible to do the right thing for patients, the profit-hungry system casually gouges the moral fiber of healthcare workers, threatening patient safety. Luckily, Dean lays out a path forward. Required reading for all stakeholders in healthcare."—Danielle Ofri, MD, PhD, author of When We Do Harm: A Doctor Confronts Medical Error
Well-researched Insights • Incredibly Written Stories • Powerful Voice • Concise Explanations • Accessible Information
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What a journey. Thank you for giving us a voice and putting into words what so many of us feel but cannot articulate.

Life changing

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
Very insightful and intelligent journey that should be taken by all in healthcare and legislation. We need to do better in order to serve our patients.

A must read!

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
I really didn’t expect this to be so gripping and hold my interest. But it did. Wendy Dean does an amazing job at illustrating the system failures of medicine. It is well researched, well written and enjoyable to listen to. Really superb.

Great!

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
As a neurology resident, I recommend to anyone wanting to understand modern healthcare challenges

Richly insightful and thought provoking

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
A vitally important look into what ails our healthcare system and why it’s gotten harder to get quality physician care, why physician’s die by suicide more than any other profession, and why legislative changes to date have failed to restore quality, reduce costs, or relieve strain on physicians. Wendy Dean’s book is concise, poignant and rooted in the desire to bring CARING for patients back to the center of healthcare.

Important for Health in America

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
I’m so thankful to the authors for standing in the gap for patients and health care workers who have so often been abandoned by the government and health systems they work for in the name of profit. This should be required reading in every boardroom, C suite, MBA and MHA program in the country. Unfortunately, that would require for those who inhabit those spaces to recognize that patient care is the priority. Hopefully we can all work together to bring that truth back to the light it deserves. This book is an inspiration and a blueprint for those of us who care.

Required Reading - necessary transformation

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
Appreciated the author’s giving words to use to better understand the struggles we health care workers face on a daily basis.

Relatable

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
This is a must ready for physicians, aspiring doctors, brave healthcare administrators and ideally, by anyone who has been baffled by the inequities and illogical mess modern healthcare has become. As a physician I could relate to most of the vignettes, and at least one (“Broken”—featuring a colleague) made me horrified about what could have happened to me. The term Moral Injury resonates well and expresses what many of us have felt, more accurately than “burnout” or “compassion fatigue.” Having an accurate term helps promote self-forgiveness, and a pathway beyond the harm.

Why “dust bowl”? Well, I just kept thinking that the current trend of corporate medicine is essentially burning all the good from the practice of medicine, just as aggressive and foolish farming practices destroyed the farmland of the US in the 20’s, resulting in decades of loss and painful recovery. Is it too late for medicine to recover? I don’t know. I did retire early, though not a day goes by without me replaying concerns and frustrations that lead to my decision.

The insights in this book give me hope, and validation that I wasn’t just imagining a trend where my team—and our dear patients—were merely Revenue Generating Units.

Kudos to the authors and the brave souls who shared their stories.

Dust bowl

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
This is a must read for anyone in healthcare. Incredibly written true stories of people working in an environment of competing interests yet all unwavering in their commitment to the Hippocratic oath.

Important book

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
As a physician, this book put into words how I feel on a daily basis. I hear story after story of how physicians endure daily moral injury. The book very well articulates the sentiments of so many of my colleagues.

Simply amazing

Se ha producido un error. Vuelve a intentarlo dentro de unos minutos.
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