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Mindfulness Helps Physicians

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    Program For Physicians Emphasizing Self-Awareness Associated With Improvements In Burnout, Mood And Patient Empathy 23 Sep 2009 Primary care physicians who
    Message 1 of 1 , Sep 23, 2009
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      Program For Physicians Emphasizing Self-Awareness
      Associated With Improvements In Burnout, Mood
      And Patient Empathy
      23 Sep 2009

      Primary care physicians who participated in an
      educational program that included an emphasis
      on mindful communication reported improvement
      in personal well-being, emotional exhaustion,
      empathy and attitudes associated with patient-centered
      care, according to a study in the September 23/30
      issue of JAMA, a theme issue on medical education.

      "Primary care physicians report alarming levels
      of professional and personal distress. Up to 60 percent
      of practicing physicians report symptoms of
      burnout, defined as emotional exhaustion,
      depersonalization (treating patients as objects),
      and low sense of accomplishment. Physician burnout
      has been linked to poorer quality of care, including
      patient dissatisfaction, increased medical errors,
      and lawsuits and decreased ability to express empathy,"
      according to background information in the article.

      The authors add that another consequence of physician
      burnout is a decline in the percentage of graduates
      entering careers in primary care in the last 20 years,
      with reasons related to burnout and poor quality
      of life. "Even though the problem of burnout in
      physicians has been recognized for years, there
      have been few programs targeting burnout before it
      leads to personal or professional impairment and very
      little data exist about their effectiveness."

      Michael S. Krasner, M.D., of the University of
      Rochester Medical Center, Rochester, N.Y., and
      colleagues designed a continuing medical education
      (CME) course to improve physician well-being. "One
      proposed approach to addressing loss of meaning and
      lack of control in practice life is developing
      greater mindfulness-the quality of being fully
      present and attentive in the moment during everyday
      activities," the researchers write.

      The course is based on 3 techniques: mindfulness
      meditation, narrative medicine, and appreciative inquiry. "Mindfulness meditation is a secular
      contemplative practice focusing on cultivating
      an individual's attention and awareness skills.
      Both narrative medicine and appreciative inquiry
      involve focusing attention and awareness through
      telling of, listening to, and reflecting on
      personal stories."

      Seventy primary care physicians participated in
      the course, which included an 8-week intensive phase
      (2.5 hours/week, 7-hour retreat), followed by a
      10-month maintenance phase (2.5 hours/month). The
      course included mindfulness meditation, self-awareness
      exercises, narratives about meaningful clinical
      experiences, appreciative interviews, didactic
      material and discussion. Physicians were surveyed
      before, during and after the course regarding levels
      and measurements of mindfulness, burnout, empathy,
      psychosocial orientation, personality and mood.

      "Our study demonstrated that primary care physicians
      participating in a CME program that focused on
      self-awareness experienced improved personal
      well-being, including burnout (emotional exhaustion, depersonalization, and personal accomplishment)
      and improved mood (total and depression, vigor,
      tension, anger, and fatigue). They also experienced
      positive changes in empathy and psychosocial beliefs,
      both indicators of a patient-centered orientation to
      medical care that has been associated with patient-centered
      behaviors such as attending to the patient's
      experience of illness and its psychosocial context
      and promoting patient participation in care," the
      authors write.

      "The skills cultivated in the mindful communication
      program appeared to lower participants' reactivity
      to stressful events and help them adopt greater
      resilience in the face of adversity," they add.
      "Further study will be necessary to investigate
      the effects on practice efficiency, patients' experience
      of care, and clinical outcomes."

      JAMA. 2009;302[12]:1284-1293.

      Journal of the American Medical Association
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