By Marshall Fleurant, M.D. and Jack Bernard
Corpus Christi Caller-Times, June 26, 2026
We are here to warn you of an invisible actor that is hurting Texas and national healthcare at its core. Itâs call Moral Injury. As you read this column, moral injury is directly affecting Corpus Christi residentsâcontributing to the shortage of physicians in the area via burn out.
Moral Injury happens when a doctor or nursesâ moral compass has been damaged. When they find that despite their best efforts, they are incapable of doing the right thing for someone else or are put in a position where their actions cause harm despite best intentions. Moral Injury happens every time a Corpus Christi doctor prescribes a treatment plan, and an insurance company denies that plan. When a Nueces County nurse is stuck caring for more patients than she knows she can reasonably care for.
Physicians and nurses are among Texasâ most trusted professionals. Three fourths of Americans believe nurses have very high honesty and ethical standards. But we are seeing Texas nurses and physicians quit the healthcare field at an unprecedented rate. Moral injury is hurting our healthcare workforce and, therefore, hurting the quality of patient healthcare in Corpus Christi as pointed out in the Callerâs 2025 column cited above.
Per the author of that column (Olivia Garrett), by 2030 in Nueces County there will âbe a deficit of about 130 primary care physicians⊠in areas like family medicine, internal medicine, OB-GYNsâ. She also indicated that patients are fed up with driving in excess of two hours for an appointment with physicians in San Antonio or Houston due to the MD shortage.
Even before the Covid 19 pandemic at least 54% of MDâs and nurses and 60% of students had symptoms of burnout (i.e., a symptoms of emotional exhaustion, weariness, and eventual numbness for their job). Many of these highly regarded physicians and nurses are leaving their profession due to moral injury. These numbers should concern all Nueces County residents as the area is already facing a shortage of healthcare workers just for present needs.
In fact, a recent study by Physicians for a National Health Program (PNHP) of over 1200 MDâs showed that nearly half believed that they did not spend enough time with patients. And, therefore, didnât provide the highest level of care. Many were forced to recommend treatments that their patients could not afford due to cost and insurance barriers.
Per Diljeet K. Singh, M.D., President of PNHP- âOur research shows that the system is failing both physicians and patients. Doctors enter medicine to care for people but are increasingly forced to navigate barriers that delay or deny treatment to generate profit. When clinical judgment is overridden by financial priorities, patient care suffers.â
Burnout is linked to increased medical errors, lower patient satisfaction and suboptimal care. Nationally, physicians have reported self-perceived diagnostic errors or care deficiencies due to burnout. Moral injury is the fuel to this phenomenon.
In the opinion of the authors, a cure is simpler than you might expectâsystemic national reform via single payer, otherwise known as Medicare for All. Like in other developed nations, doctors and nurses can then focus on care rather be stretched by corporate incentives and regulation. Simple expansion of traditional Medicare, phased in by age groups starting with those 55-64, would eliminate the profit motive.
Corporate healthcare (big pharma and big insurance) is causing US healthcare to cost much more than in other nations while we have higher mortality and morbidity rates. Congress should have acted⊠but did not. Why is clear.
Both parties rely on lobbyistsâ campaign contributions, which are substantial. For example, in just the 2024 election cycle, Democrats received $224 million from health lobbyists, while the GOP got $131 million. Clearly, PAC money going to politicians of both parties is buying them off.
This situation can only be changed by nonpartisan public pressure on our elected officials in Texas and nationally. That is the only way we can get Medicare for All, decreasing health provider burn out and improving patient care.
Marshall Fleurant, MD, is Associate Professor of Medicine at Emory School of Medicine.
Jack Bernard was a VP with NME (now Tenet) in Dallas and the first Director of Health Planning for Georgia; heâs now on the Executive Board of the Georgia Public Health Association.
