Dave Chokshi is a clinical professor of population health at the NYU Grossman School of Medicine and a primary care internist at Bellevue Hospital. As commissioner of the New York City Department of Health and Mental Hygiene Chokshi led the city’s response to the COVID-19 pandemic, including its campaign to vaccinate over 6 million New Yorkers. He agreed to speak to us before he takes the stage at Aspen Ideas: Health.

Are there practices or policies that medical schools, hospitals, and other institutions could put in place to help those who are struggling?
First, let’s not mince words in describing how serious of a crisis health workers are facing. Rather—we should think of it as multiple, intersecting crises. Growing demands amidst an ebbing of support; less time on care and more time on paperwork; confronting racism, poverty, trauma, and an assault on fundamental rights of our patients; and threats of violence to ourselves and our colleagues. So my first thought for leaders of these institutions is to “turn the spotlight inward” and think about what practices or policies may be worsening these trends and change them, before layering on new programs.

Moral injury is a common thread across the threats to the well-being of health workers. Moral injury refers to the sense of powerlessness and confinement within systems that keep health workers from healing the people we aim to serve. It is about failing to meet our patients’ needs. For instance, being unable to address the core issue leading to a deterioration of the health of a person experiencing homelessness: a lack of housing. To address moral injury, we will need more fundamental changes to our systems of health and social care. I’m grateful that Surgeon General Vivek Murthy’s recent advisory on health worker burnout catalogs ways for different organizations to act on these systemic issues.

What is one thing you wish the public understood about health workers?
The last two years have been particularly tough for health workers. Navigating the pandemic has been isolating, frightening, exhausting, and humbling. But that struggle can bring about change—if we will it to. Now is the time to be investing in human resources for health, and building the resilience of systems that support them. We have a once-in-a-generation opportunity to resource and reimagine our health workforce, and to shift our “sick care” system to one that preserves and promotes health.

Read the full article about health care workers in crisis at The Aspen Institute.