By Douglas Ziedonis, M.D., M.P.H., Carl Fulwiller, M.D., PH.D., and Makenzie Tonelli
Recent studies have reported on the effectiveness and impact of training physicians on integrating mindfulness approaches into their personal lives and clinical practice. Mindfulness can help improve health, reduce physician burnout, and improve patient satisfaction and outcomes.
Surveys of physicians indicate that two-thirds experience burnout associated with making more errors, having less empathy, substance misuse, and leaving practice. Physicians’ daily routines are challenged by competing tasks, rapidly changing environments, and a flood of thoughts and feelings in the context of our decision-making and interpersonal relationships.
Mindfulness — the state of focusing one’s awareness on the present moment and monitoring the unfolding of experience without judgment — can help us cultivate awareness, compassion, and acceptance.
Mindfulness practice can be both informal and formal. Formal practices occur in structured time periods, similar to physical exercise, devoted to engaging in meditation, yoga, or other similar practices. The informal application of mindfulness to daily experience involves awareness of the present moment, whether pleasant, unpleasant, or neutral, with an attitude of curiosity and acceptance, allowing feelings or thoughts to arise and pass away again without judgment.
In the midst of a stressful clinical encounter, practical techniques can be used, such as taking a short (e.g., one-minute pause) between patients, in which one takes a few deep breaths and becomes aware of any tension in one’s body, without judgment or being critical of taking care of oneself for that moment. Mindfulness during the clinical session helps patients feel heard.
Through mindfulness practice, an enhanced appreciation of pleasant experiences and a greater acceptance of unpleasant experiences emerge. Focusing on the breath and other sensations arising in the body helps to anchor oneself in the present moment. As clinicians, when we are more present, we demonstrate patience, empathy, and an increased capacity to listen. We are also more self-compassionate, handle uncertainty better, and embrace all the moments of our life, including the catastrophic and challenging.
This practice allows for more meaningful interactions with our patients and for opportunities to engage in the patient’s sacred space. A mindful physician encountered by a nervous and concerned patient, is more aware of and empathetic toward the emotional state of the patient, and thus more likely to respond in a way that is most comforting for the patient, such as with eye contact, a calm demeanor, and with language that will resonate with the patient.
Physicians are also well-positioned to help staff and patients integrate mindfulness into their lives. As mindful leaders, we can enhance our ability to focus, be less reactive and more responsive, promote teamwork, and model compassion based on insight.
This article first appeared in the February 2014 edition of the Massachusetts Medical Society publication, Vital Signs.
Douglas Ziedonis, M.D., M.P.H., is professor and chair of the Department of Psychiatry at the University of Massachusetts Medical School and UMass Memorial Health Care. Carl Fulwiler, M.D., Ph.D., is associate professor of psychiatry and director of the Center for Mental Health Services Research at UMass Medical School. Makenzie Tonelli is a project coordinator in the Department of Psychiatry, at the University of Massachusetts Medical School.
Physician Health Services, Inc., is a non-profit corporation founded by the Massachusetts Medical Society. PHS provides confidential consultation and support to physicians, residents, and medical students facing concerns related to alcoholism, substance abuse, behavioral or mental health issues, or physical illness. PHS also provides a safe environment where physicians can talk to other physicians about the stress and demands of modern medical practices. For more information, visit the PHS website or call PHS at (781) 434-7404.