Sometimes a new coinage can help communicate an issue better to a large audience. A recent issue of NEJM carries a piece (see attachment below for the full piece) by M Burden and L Dyrbye drawing attention to a harmful structural issue that needed such a new coinage to bring out in sharp relief its importance to healthcare. Quoting from their piece: "U.S. health care is at a critical juncture. The shift of physician practices to employment models, coupled with the growing corporatization of health care, has contributed to organizational decision making that often prioritizes short-term financial gains at the expense of patient care.This environment runs counter to the values of health care workers(HCWs) and fuels widespread workforce problems, including high rates of HCW burnout and moral injury and erosion of safety culture, and has contributed to the impetus for recent HCW unionization efforts. Many of these challenges stem from modifiable work structures, processes, and environments that originate from organizational decisions and are therefore preventable. “Administrative harm” — defined as adverse consequences of administrative decisions within health care that affect work structure, processes, and programs— is pervasive and often overlooked.
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