A young physician at the Anthony Jordan Health Center's Brown Square Clinic in Rochester says he rarely sees a patient he is able to help in the way he was trained, or how he expected to when he decided to become a doctor.
"Almost every single patient that I see every day suffers in some way at the hand of the systemic inequities that we've propagated in this country," said family physician Dr. Christian Archer.
Archer wrote about his disillusionment with the U.S. health care system in his essay "Expanding Moral Injury: Why Resilience Training Won't Fix It,” published in the Sept. 2022 issue of the Journal of the American Medical Association.
The Miami, Florida native, who graduated from the University of Florida College of Medicine in 2020, said he was well aware of the health inequities in the U.S. "I just anticipated that the medical system I was entering would be doing more to work to correct them as opposed to trying to put Band-Aids on issues as they arose," he said.
In his essay, Archer described his growing sense of dread about his work during the COVID-19 pandemic, which included treating patients with chronic obstructive pulmonary disease who needed but could not afford inhalers and other medications.
"The challenges that they face," Archer said, "I'm almost loathe to call them health challenges because they're really life challenges."
He mentioned patients who had difficulty reading medication instructions and understanding nutrition labels as well as individuals who live in food swamps where it is easier to purchase alcohol, cigarettes, and potato chips than fresh produce.
"Many of the people I care for have been systematically preyed on by hundreds of years of exploitation due to the color of their skin, perpetuating states that foster sickness," he wrote.
Archer chose the term 'moral injury' to describe his response to the inadequacies of the U.S. medical system, he said, after learning that it was a military reference to the feelings of soldiers forced to perform objectionable actions on behalf of their governments.
"The language of burnout for me, feels like it kind of puts the blame on the individuals that are experiencing the feelings, that they are not resilient enough," he explained, "but moral injury puts the blame on the system we're forced to operate in."
Archer, who admits he has questioned his decision to become a physician, said he is tired and does not have a plan to solve the problems he outlined in his essay.
He said he is somewhat comforted by the fact that other colleagues have shared his experiences and told him he adequately expressed what they were feeling and could not put into words.
