TY - JOUR T1 - If not now, when? Enhancing cardiologists’ psychological well-being as a COVID-19 gain JF - Heart JO - Heart SP - 593 LP - 595 DO - 10.1136/heartjnl-2020-318852 VL - 107 IS - 7 AU - Rishi K Patel AU - Mark D Sweeney AU - Christopher S R Baker AU - Neil Greenberg AU - Susan E Piper AU - Sukhi S Shergill AU - Derek K Tracy AU - Carla M Plymen Y1 - 2021/04/01 UR - http://heart.bmj.com/content/107/7/593.abstract N2 - COVID-19 has highlighted potential shortcomings in our approach to psychological health that had perhaps become the accepted status quo within cardiology. Importantly, the pandemic may offer a unique opportunity to redress them. During 2020, physicians have had to question their ability to deliver optimal care with scarce resources, limited knowledge, concerns about personal safety and, by extension, the safety of one’s family. For some, these challenges may have a lasting psychological impact. Encouragingly, many staff have acknowledged the potential effect of these pressures on their mental health, making short-term adaptations and promoting staff camaraderie. However, achieving long-lasting changes in our approach to supporting those affected could create a positive legacy to this pandemic.The idea of ‘moral injury’, originally recognised within the military, describes the psychological distress which may follow ethical or moral beliefs being challenged. Such situations can lead to overwhelming feelings of culpability, shame or anger, which increase someone’s vulnerability to develop, or exacerbate, mental ill health including post-traumatic stress disorder (PTSD) and depression.1 The attribution of moral injury to healthcare workers during the pandemic is increasingly recognised.2 Equally important is the concept of post-traumatic growth,3 which recognises that most people will survive and psychologically develop following these unwished-for experiences. Evidence shows that good organisational structures, management and psychologically savvy teamwork can calibrate this and push the needle more towards growth and away from injury.Although moral injury in cardiology has yet to be substantiated, evidence suggests that cardiologists report some of the highest levels of burn-out and work longer hours than other physicians. However, only 23% report being willing to seek professional help for feelings of depression or suicidality.4 This may result from a stoicism existing within cardiology where a culture of appearing impervious to pressure prevails and is lauded, suggesting that many … ER -