November 12, 2026
Moral Injury is a Distinct Threat to Physician Well-being | American Medical Association
Transcript
Elizabeth McMahon
Coming up, meet the Mississippi pathologist who has big plans for CAP's residence forum. Plus, the American Medical Association puts a name to one of the toughest ethical challenges for physicians. Welcome to CAP News for Thursday, November 12th. I'm Elizabeth McMahon of the College of American Pathologists. Here's what's making news in pathology and laboratory medicine. The CAP Residence Forum is welcoming a new leader for Pathology's future ranks. Dr. Katelyn Provine, a third-year resident at the University of Tennessee Health Science Center, is the new chair of the Forum's executive committee. The Mississippi native says she came to pathology late in medical school, but found a natural connection.
Dr. Katelyn Provine
There's just something so inherently beautiful about it. And I just realized I'm more of a diagnostician than a clinician. I love the aha moment of figuring out a diagnosis. It's so satisfying.
Elizabeth McMahon
As an alternate to the CAP House of Delegates last year, Dr. Provine dug into advocacy. She also led a survey action group exploring barriers to national conference participation for residents. The project yielded more than 300 responses and made her realize how powerful the more than 200 member residence forum can be.
Dr. Katelyn Provine
It's the biggest opportunity I can think of to reach everyone across the nation as far as pathology residency goes. And that's just so powerful to me. And I had a lot of ideas of what I would do. And that made me consider becoming chair. What we want to avoid is basically ticking off all the boxes of all the possible types of lab tests that could present in a patient with slightly abnormal bleeding factors and or a suspected bleeding history. So this year I have a lot planned.
Elizabeth McMahon
So what's topping Dr. Provine's list for residents in 2027? Among other priorities, using clinical informatics to improve pathology residency programs.
Dr. Katelyn Provine
One of my big plans for next year is starting an internal review system through the delegates. What we want to avoid is basically ticking off all the boxes of all the possible types of lab tests that could present in a patient with slightly abnormal bleeding factors and or a suspected bleeding history. So the residence form delegates would fill out a survey about their program, see how it compares nationally, and then confidentially have a conversation with, you know, a standardized protocol and everything with their program director. And so their program directors can see this is where we are sitting compared to everyone else.
Elizabeth McMahon
As Residence Forum nears its fifth decade, Dr. Provine says she's looking forward to guiding energized residents in an organization that's quickly becoming a professional home.
Dr. Katelyn Provine
I feel like it's like a home for every pathologist, regardless if you're academic or your private or your industry. Like everyone belongs here.
Elizabeth McMahon
There are the moments that rattle you as a physician, the times you can't do what's right for patients because of constraints in the medical system. Now, the American Medical Association has classified this moral injury as a threat to physician well being. The new policy, passed this week, classifies moral injury as distinct from burnout and moral distress, though there is an overlap. Burnout is associated with exhaustion and diminished professional fulfillment. Moral distress occurs when physicians feel they can't pursue what they believe is ethically right. Moral injury results when those conflicts persist. Quote, at a time when the nation needs a strong and stable physician workforce to meet growing health care needs, recognizing and addressing moral injury is essential to retaining physicians, protecting access to care, and advancing our nation's health goals, AMA Board Secretary Pauline Huynh said. When clinicians find monoclonal gammopathies in a patient's blood work, characterized by the appearance of M proteins, it could be a sign of several disorders, including amyloidosis or multiple myeloma. For clinicians to determine how to monitor and treat each disorder, pathologists must accurately subclassify the protein types involved.
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Elizabeth McMahon
Megan Nakashima, a member of the CAP's Quality Practices Committee, is author of the CAP's testing module on the initial diagnosis of monoclonal gamopathies. She says that while both serum and urine protein electrophoresis have long been used to detect and subclassify monoclonal protein, broader testing may sometimes be needed.
Dr. Megan Nakashima
When someone has a suspected AL amyloidosis, so a caprolamolite chain amyloidosis, it's really recommended that you do kind of broad spectrum testing, SPEP, IFE, free light chains, and urine testing, just because the paraproteins in those diseases can be very small. But making the correct diagnosis is actually essential to getting the patient treatment in these very kind of systemic and catastrophic, in some cases, diseases.
Elizabeth McMahon
Testing for monoclonal gamopathies is one of more than two dozen testing modules available for CAP customers. The modules provide examples, questions, and insights about the proper application of the tests. That's all for today. Be sure to check the show notes for more information on today's stories. Got a story you'd like to hear on the podcast? Write to us at stories at CAP.org. We're back at 5 AM Eastern for another episode of CAP News. I'm Elizabeth McMahon. Have a great day.