The Moral Distress Syndrome Affecting Physicians : How Current Healthcare is Putting Doctors and Patients at Risk book cover
1st Edition

The Moral Distress Syndrome Affecting Physicians
How Current Healthcare is Putting Doctors and Patients at Risk

  • Available for pre-order. Item will ship after September 17, 2020
ISBN 9780367471538
September 17, 2020 Forthcoming by Productivity Press
184 Pages

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Book Description

There is a crisis going on affecting physicians, one which we thought only affected soldiers, called moral distress syndrome. Moral distress syndrome is evidenced by the rise of suicide and burn out among physicians and other clinicians and can include the following conditions: depression, PTSD, risk of suicide, divorce, emotional detachment, and the inability to build relationships and the lack of empathy.

While military veterans can report to a Veteran’s Hospital for treatment, physicians cannot find treatment or support because they are at risk of losing their medical license, hospital privileges and their jobs. As a result, their condition mostly goes untreated and many have to deal with the issue themselves or count on their family or circle of friends for support. The Moral Distress in Physicians by Eldo Frezza, MD raises awareness of this problem and details the struggles physicians are struggling with.

The book is designed to start a dialogue by having one physician talking to other physicians about the condition and their struggles in a safe and open environment. The author brings all aspects of the moral distress syndrome together in a format familiar to the physician: Grand Rounds with a Magistral lecture. This is presented in a format where the audience can ask questions and directly participate in the discussion.

Told in a business novel format, the book is divided into three parts:

In the first part of the book, the research, the data, and the crude numbers of the condition are given. Moral Distress Syndrome, PTSD, Burnout, suicide, divorce rates, emotional detachment, legal distress syndrome, and physicians leaving medicine are all topics covered.

The second part of the book describes the pain, the emotions, and the distress by having the main character define some personal experience to get the audience and the reader feeling the depth of moral distress.

In the third part, the author focuses on society, the suffering of physicians and the introduction of the term moral distress as it relates to the medical community. Part of the narrative focuses on the main character, a physician who uses his empathy to try to point out his problems, weaknesses, and issues and to find possible solutions to the situation for him and all physicians who are also struggling. The section ends with a discussion of the societal, patients’ and physicians’ responsibilities, the birth of moral injury and the American Medical Association recommendations for physicians to find good friends and a safe space to discuss these issues.

To make it easier to follow the material, each chapter begins with an outline of points to be discussed, much like a speaker providing an outline of the material covered in a presentation. Even though the format of the book is a business novel, the reader can read each chapter separately and be able to understand the points made without having to follow the storyline. However, the storyline personalizes the topic to every physician who is experiencing this condition or struggling with the day-to-day challenges of their work.

Table of Contents


  1. The Grand Round lecture
  2. Moral Distress Syndrome
  3. Litigation syndrome
  4. Burn out
  5. Suicide from Medical Student to residents to clinicians
  6. Why Physicians suffer more suicides?
  7. Malpractice: can create everlasting injury
  8. Why is Medicine burning out physicians?
  9. Broken system and corporate culture
  10. Physician Leaving Medicine
  11. Impossible Victory: working as a chain worker
  12. Emotional trauma: brain zapping and concussion
  13. Divorce among physicians
  14. Medical Malpractice Insurance crises
  15. Opioid crisis and relief

  17. Training hurdles
  18. Double Residencies
  19. How medicine can ruin a marriage
  20. The Legal Issues and hollow victory
  21. Inability to return to work: the apex of Moral distress

  23. Society responsibilities
  24. Emotional detachment and Patients responsibilities
  25. Do patients want to participate in their care?
  26. It is challenging to be a physician
  27. The loneliness of a Physician in moral distress
  28. Divorce because of moral distress
  29. The stress of the lawsuit breaks family
  30. The birth of moral distress: the syndrome
  31. Are physicians discriminated?
  32. The American Medical Association (AMA) Directions
  33. Safe space and final Introspections


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Eldo E. Frezza is a Fellow of the American College of Surgeons (FACS), American Medical Association, American Medical Physician Leadership. He is now Chief of Surgery at Nashville General Hospital and Professor at Meharry Medical school.