• Monica L Molinaro, Katrina Shen, Gina Agarwal, Gabrielle Inglis, and Meredith Vanstone.
• Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
• Br J Gen Pract. 2024 Jan 1; 74 (738): e41e48e41-e48.

BackgroundFamily physicians (GPs) working with patients experiencing social inequities have witnessed patients' healthcare needs proliferate. Alongside increased workload demands fostered within current remuneration structures, this has generated concerning reports of family physician attrition and possible experiences of moral distress.AimTo explore stories of moral distress shared by family physicians caring for patients experiencing health needs related to social inequities.Design And SettingA critical narrative inquiry, informed by the analytic lens of moral distress, conducted in Ontario, Canada.MethodTwenty family physicians were recruited through purposive and snowball sampling via word of mouth and email mailing lists relevant to addictions and mental health care. Physicians participated in two narrative interviews and had the opportunity to review the interview transcripts.ResultsFamily physicians' accounts of moral distress were linked to policies governing physician remuneration, scope of practice, and the availability of social welfare programmes. These structural elements left physicians unable to get patients much needed support and resources.ConclusionThis study provides evidence that physicians experience moral distress when unable to offer crucial resources to improve the health of patients with complex social needs resulting from structural features of the Canadian health and social welfare system. Further research is needed to critically interrogate how health and social welfare systems around the world can be reformed to improve the health of patients and increase family physicians' professional quality of life, potentially improving retention.© The Authors.

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