Background: Moral distress, the inability to act in accordance with one’s ethical beliefs due to hierarchical or institutional constraints, has been associated with burnout and poorer well-being.  Significant moral distress amongst American physician trainees might occur when they feel obligated to provide treatments at the end of life that they believe to be futile or [...]

Case Presentation: Mr. A is a 48-year-old male with a past medical history of end-stage heart failure. He was transported from prison due to worsening dyspnea and was admitted to the hospital with acute kidney injury. He rapidly deteriorated, requiring transfer to the Intensive Care Unit (ICU) due to worsening shock requiring vasopressors. Mr. A’s [...]

Background: Non-beneficial treatment can be defined as medical interventions that are ineffective in achieving a patient’s desired goals or subject patients to discomfort without significant clinical benefit. At times, critically-ill patients are declined Intensive Care Unit (ICU) admission due to perceived lack of benefit but continue to be medically managed on the general medical floor. [...]

Background: Physician burnout is associated with negative outcomes for physicians, patients, and organizations. In our urban, academic medical center, 32% of hospitalist faculty report experiencing burnout at least once weekly. Clinical practice as a hospitalist involves dealing with medical acuity, diagnostic and therapeutic uncertainty, and complex interpersonal interactions, all of which may contribute to emotional [...]