Family physicians’ moral distress when caring for patients experiencing social inequities: a critical narrative inquiry in primary care

Monica L Molinaro; Katrina Shen; Gina Agarwal; Gabrielle Inglis; Meredith Vanstone

doi:10.3399/BJGP.2023.0193

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The moral distress of physicians who cannot provide adequate care as a result of systemic deficits is seldom heard in contemporary discussions about healthcare access and quality. Family physicians’ stories of moral distress in relation to structural and systemic factors such as racism, colonialism, and drug, mental health, and housing policy, generate seemingly novel and vital understanding of the clinical work of primary care providers. The findings of this study are some of the first to illustrate family physicians’ experiences of moral distress, contributing to the limited body of literature on moral distress in primary care.

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Table 1.

Demographics of participants, including work location, practice structure, and areas of focused practice

Variable	n
Sex
Male	7
Female	13

Age, years
25–29	1
30–34	4
35–39	3
40–44	4
45–49	1
50–54	2
55–59	4
60–64	1

Work location
Urban	12
Rural	3
Both	5

Practice structure^a
Family health team	7
Family health organisation	1
Community health centre	3
Indigenous primary healthcare organisations	2
Independent solo	2
Independent group	3
Locum	3
Outpatient	2
Hospitalist	2

Areas of focused practice^b
Addiction medicine	4
Mental health	5
Unhoused patient care	4
Incarceration care	3

Years of experience
>1–4	6
5–9	3
10–14	3
15–19	1
20–24	0
25–29	5
30–34	0
35–39	2

↵a Family practice structures total more than 20 as some participants worked in more than one type of practice structure.
↵b Areas of focused practices where there were any.

Supplementary Data

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