PURPOSE Religious traditions call their members to care for the poor and marginalized, yet no study has examined whether physicians' religious characteristics are associated with practice among the underserved. This study examines whether physicians' self-reported religious characteristics and sense of calling in their work are associated with practice among the underserved.METHODS This study entailed a cross-sectional survey by mail of a stratifi ed random sample of 2,000 practicing US physicians from all specialties. RESULTSThe response rate was 63%. Twenty-six percent of US physicians reported that their patient populations are considered underserved. Physicians who were more likely to report practice among the underserved included those who were highly spiritual (multivariate odds ratio [OR] = 1.7; 95% confi dence interval [CI], 1.1-2.7], those who strongly agreed that their religious beliefs infl uenced their practice of medicine (OR = 1.6; 95% CI, 1.1-2.5), and those who strongly agreed that the family in which they were raised emphasized service to the poor (OR = 1.7; 95% CI, 1.0-2.7). Physicians who were more religious in general, as measured by intrinsic religiosity or frequency of attendance at religious services, were much more likely to conceive of the practice of medicine as a calling but not more likely to report practice among the underserved.CONCLUSIONS Physicians who are more religious do not appear to disproportionately care for the underserved. INTRODUCTIONC odes of medical ethics have called physicians to care for the poor for centuries, from the birth of the Hippocratic tradition in ancient Greece, 1 through the middle ages in Europe, 2 and into modern America. 3 In spite of such ongoing moral exhortation, many poor patients and communities continue to be medically underserved. [4][5][6][7][8][9] Physicians have compelling reasons to avoid practicing among the poor. Physicians who choose to work in underserved settings often forgo academic opportunities, professional prestige, 7 and free time, 10 and accept reduced salaries, diminished control over the work environment, 4 and increased bureaucratic interference. 10 These and other extrinsic 11,12 and objective 13 workplace characteristics diminish the appeal of underserved settings.Although the poor are underserved, they are not unserved; many physicians choose to practice in underserved settings. Those who do tend to identify intrinsic and intangible rewards of their work, such as making a difference in society, having a positive impact on the lives of patients who are otherwise marginalized, and living in a way congruent with their personal hopes and aspirations. 10,14 These subjective rewards express ways in which physicians may relate to their work among the underserved more as a calling than as a job. R EL IGIOUS PHY SICIA NS A ND T HE UNDER SERV EDThe concept of calling is currently used in the work literature to refer broadly to work done with a sense of inner direction and aimed at improving the world. 13,15 In the words of...

Frontline health-care workers experienced moral injury long before COVID-19, but the pandemic highlighted how pervasive and damaging this psychological harm can be. Moral injury occurs when individuals violate or witness violations of deeply held values and beliefs. We argue that a continuum exists between moral distress, moral injury, and burnout. Distinguishing these experiences highlights opportunities for intervention and moral repair, and may thwart progression to burnout.

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Some medical students leverage their medical student status for profit as social media influencers on platforms such as Instagram. Depending on the size of their following and the brand they are promoting, students can make thousands of dollars per year by advertising products ranging from scrubs to protein powder to Please see the end of this article for information about the authors.

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