2023 ARRS ANNUAL MEETING - ABSTRACTS

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2955. Moral Distress and Diagnostic Radiology
Authors * Denotes Presenting Author
  1. Priya Dave *; Beth Israel Deaconess Medical Center
  2. Bettina Siewert; Beth Israel Deaconess Medical Center
Objective:
Recent literature suggests that moral distress is a root cause of clinician burnout. This study sought to characterize the prevalence and nature of moral distress in diagnostic radiology.

Materials and Methods:
An email survey was conducted in an academic radiology department with 145 physicians. The survey consisted of 16 ethically challenging clinical scenarios (including 12 from the validated Moral Distress Scale for Healthcare Professionals, MMD-HP) to evaluate root factors of moral distress: system-level causes, clinical root causes, and poor teamwork. Participants were asked to rate the severity and frequency of each scenario on an integer scale from 0 to 4. To assess moral distress for a given factor, the frequency was multiplied by the level of distress. A composite score was derived by adding the scores together. Participants were asked to indicate useful interventions, including ethics consultation, additional curricula, and grand rounds. Results were compared to data in the literature on patient facing physicians.

Results:
50/149 completed responses were collected (response rate 34%). 46% (23/50) of radiologists reported considering leaving clinical practice due to moral distress and reported higher levels (Mean Composite Score 79.8 vs. 44.5). Moral distress was most commonly experienced due to system-level causes: being required to read a higher volume of studies than one could safely perform (Mean= 7.4), being required to perform excess cases that prevented one from teaching (Mean=6.3), lack of administrative support for problems that impacted patient care (Mean=5.6). Radiologists faced similar levels of moral distress as patient-facing clinicians for the most distressing scenarios (Mean=5.9 for both groups). The top countermeasure for mitigating moral distress, was educating leadership on its sources (50%, 25/50).

Conclusion:
Moral distress is a leading cause of burnout. The most common cause of moral distress in radiology arises due to system-level factors. Educating leadership on sources of moral distress was the most commonly suggested countermeasure. Diagnostic radiologists face similar levels of moral distress as patient-facing fields. The most common cause of moral distress in radiology arises from system-level constraints. Educating leadership on sources of moral distress was the most commonly suggested countermeasure.