Modern healthcare systems ask much of primary care doctors. They are expected to diagnose, reassure, coordinate care, manage chronic illness and increasingly fill the gaps when other parts of the system come under strain.<\/p>\n
In New Zealand, general practitioners (GPs) deal with around 90% of all medical problems<\/a>. Research consistently shows<\/a> that strong relationships with a GP improve patient health outcomes while saving money, with every $1 invested in primary care returning up to $13 elsewhere in the health system.<\/p>\n Yet primary care is facing a mounting workforce crisis. New Zealand is already short by almost 500 full-time GPs<\/a>, with that deficit expected to grow<\/a> in the coming years.<\/p>\n Our newly published research<\/a> sheds new light on a psychological factor adding to this pressure \u2013 and one that tells us much about the taxing environment doctors work in today.<\/p>\n The everyday burden of moral distress<\/p>\n As part of our study, we interviewed 26 GPs in New Zealand and 24 family physicians in the United States about the joys and challenges of their work.<\/p>\n Beneath many of the structural pressures doctors face each day \u2013 from heavy caseloads to underpaid administrative work<\/a> \u2013 we found widespread instances of what is known as \u201cmoral distress<\/a>\u201d.<\/p>\n This arises when people know the right thing to do but are unable to do it because of circumstances beyond their control. As one doctor told us: \u201cA lot of my work felt harmful and in conflict with what I knew to be best for my patients.\u201d<\/p>\n It typically leads to feelings of guilt, inadequacy and a deep emotional fatigue that can be confused with burnout<\/a>]. The most common source was cost barriers preventing patients from receiving the care they needed.<\/p>\n