A Framework for Managing Moral Challenges Related to Health Policy for the Surgeon

Surgeons of all specialties are impacted by health policies, primarily written and executed by nonmedical parties. The sequelae of policy change may limit the patient-physician relationship across numerous surgical disciplines, including general and acute care surgery, OB/GYN surgery, pediatric and fetal surgery, and others. The discordance between a surgeon's imperative to provide excellent patient care and legislative limitations that hinder patient care can impact surgeon wellness, career longevity, and attrition as well as reduce access and outcomes for patients, across specialties. Limited literature addresses this presage to physician wellness and patient outcomes. Combatting moral distress requires a framework that considers a multifactorial approach including open communication and respect among colleagues, free discussion of challenges related to health policy, resources for coaching and therapeutic counseling, and organizational actions promoting surgeon wellness. In this article, we present strategies, curated and executed by our subspecialty advocacy group, for navigating moral challenges secondary to health policy. This framework may be implemented across specialties to promote discussion of controversial or difficult topics in the professional setting and help prevent distress and attrition.