Reframing the Conversation Around Physician Burnout and Moral Injury: “We’re Not Suffering From a Yoga Deficiency

My major area of scholarly interest is in the field of Narrative Medicine.  I am particularly interested in exploring how this approach to practice can enhance both the care that clinicians provide to their patients as well as their sense of professional agency and satisfaction.  

As Director of Student Health, I am dedicated to maximizing the health and well-being of every member of the Duke student community through the delivery of professional, patient-centered and innovative health care.

I am a movement disorders specialist with a clinical practice focused on the care of people with Parkinson disease (PWP) and other movement disorders. I am interested in ways to improve the quality of care for patients with chronic neurodegenerative conditions, particularly translating clinically effective treatments and lifestyle modifications (e.g. exercise) into the “real world.”  While a growing body of evidence demonstrates that physical activity, including high-intensity exercise, is feasible for PWP and leads to improved motor and non-motor outcomes, translating that knowledge into practice has been challenging. My research in this area focuses on the impact of patient/doctor communication and social determinants of health on promoting or preventing physical activity among PWP.

 In addition to my clinical training, I hold a Master of Science in Narrative Medicine from Columbia University. This unique program, which grew out of the larger field of medical humanities, expands the conceptual framework of clinical medicine to incorporate patient perspective and social experience. I conduct mixed-methods research to design and implement interventions that are actually meaningful to the target population(s). As an example, in my study of Veterans with PD, I was able to conduct qualitative cluster analysis of Veterans’ self-reported barriers and motivators of adherence to exercise recommendations, reporting for the first time the unique barriers faced by this patient population. Additional funded projects using a narrative medicine approach have included (1) exploring the lexicon of burnout among clinical and non-clinical employees; (2) understanding the experience of fatigue and psychosis among PwP and their care-partners; (3) exploring the interactions between border-crossing in literature and border-crossing in medical education/practice.

In particular, narrative medicine offers guideposts toward a revitalized practice of medicine and medical education. In 2020, I was appointed Director of Medical Humanities at Duke, leading a team of clinician scholars in understanding moral injury and structural inequities in medicine. Under this umbrella, I co-direct the interprofessional course Moral Movements in Medicine; teach in the first-year Clinical Skills Immersion, the second-year Cultural Determinants of Health Disparities, and the fourth-year Medical Humanities courses; and mentor third-year students in the Medical Humanities study track.

Karen Jooste, MD, MPH is a palliative care physician and pediatrician at Duke University. She works on the Pediatric Quality of Life team at Duke Children’s Hospital and Health Center, and with adults in both palliative care and hospice care. She completed her residency in Pediatrics at the Children’s Hospital of New York at the Columbia University Irving Medical Center, her Master of Public Health at the Mailman School of Medicine, Columbia University and her Hospice and Palliative Medicine Fellowship at Duke. She trained as an Integrative Health Coach at Duke Integrative Medicine in 2012. Her passion as both a clinician and an educator, is the intersection between communication, racial and gender equity, ethics and medical humanities (narrative medicine). 

Dr. Jooste teaches narrative medicine to interprofessional students (Medicine, Nursing, PT and PA students) through the Trent Center at Duke and co-leads annual workshops at Duke Integrative Medicine in Leading Others in Writing for Health.  She is a Faculty leader and educator in the Clinical Skills Foundation Course at the Duke School of Medicine.  She is trained as a VitalTalk trainer and facilitator in Advanced Communication Skills and teaches as part of the PEACCE Corps Education Team (Promoting Equity and Alignment of Care via Communication Education).  Dr Jooste is the Vice Chief of Diversity, Equity and Inclusion of the Division of Palliative Care. She facilitates workshops at Duke called Conversations with Colleagues to promote and strengthen diversity, inclusion , antiracism and belonging.  

One of her favorite roles is as a coach for the Duke Residency Professional Development Coaching Program.  She also serves as an Ethics Consultant at Duke University Hospital and as a member of the Professional Accountability (PACT) team, promoting professionalism.

Physician provides primary care services only. Interests include medical humanities, climate change and health, integrative medicine, transdisciplinary collaboration, underserved communities. Member of inaugural group of Climate Change Faculty Fellows, 2022