Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

How Mindfulness Can Improve Doctor-Patient Relationships (Part 1 of 2)

1/6/2014 5:07:59 PM | 6 comments

Welcome to Mindfulness in Medicine, a monthly column by best-selling author Anne Bruce designed to cultivate leadership and collaborative relationships among hospital leaders, nurses, providers and ancillary staff. Mindfulness is a powerful leadership tool that enhances emotional intelligence in medicine. It is a tool that, when practiced, can help us develop and implement relational coaching skills and illuminate various ways to improve hospital operations and cross-departmental performance. Mindfulness also improves our capacity for decision-making and participatory medicine, all while enhancing our own health and well-being. Your comments and insights on these postings are greatly valued.

Anne Bruce has provided training and performance coaching for MedAmerica, CEP America and MBSI. She is also a bestselling author of more than 20 books.

In this month's column, Anne welcomes Dawa Tarchin Phillips, the renowned expert on mindfulness and leadership, and his timely contribution to Perspectives on Acute Care Continuum: "How Mindfulness Can Improve Doctor-Patient Relationships, Part 1."

The multifaceted relationship between doctor and patient traditionally meets its mark when it is one of mutual respect, professionalism and trust. Even Consumer Reports, the independent consumer agency, continually has reported that openness, respect and trust are critical to a successful doctor-patient relationship.

In order for the healthcare collaboration to be an effective and satisfying experience — whether it's the full restoration of the patient's health; the ongoing, effective treatment of the patient's condition; or simply a patient's prescribed treatment compliance — both doctor and patient need to be equally committed and engaged to give the crises at hand their very best.

But what if a doctor's very best becomes less and less available? What if stress levels, mood variances, burnout and increased distraction on both sides are undermining the quality of "the very best" to a point where it's anything but?

How can openness, respect and trust between doctor and patient be kept from atrophying? Or how can it be rebuilt once lack of attention and the lack of quality in human presence have eroded its underpinnings?

Mindfulness May Hold Keys

Mindfulness, an evidence-based practice for cultivating focus, attention and presence, could hold keys to significantly improving the doctor-patient relationship.

Mindfulness is classified in most scientific literature as focused attention free from distraction and open, nonjudgmental attention to direct, present-moment experience. Mindfulness is the foundation of focus and our ability to be present no matter what.

Several studies recently have illustrated the effects and benefits that physician mindfulness can have on doctor-patient relationships.

A pilot study at the University of Wisconsin-Madison School of Medicine and Public Health recently examined the effects of a condensed introductory course in mindfulness on 30 primary care clinicians. Results showed that even after a rudimentary course, not only did the physicians show decreased levels of burnout, anxiety, depression and distress, but effects persisted and were measurable almost a year later without any additional mindfulness training sessions.

In another collaborative study between Johns Hopkins University, Oregon Health Science University, University of Rochester, St. Luke's Roosevelt Medical Center, University of California San Francisco, Wayne State University and Portland VA Medical Center, researchers found patients were more profoundly satisfied and more open when relating with the more mindful clinicians (when compared to their less mindful physician peers).

The more mindful clinicians showed greater positivity during interactions with patients, exhibited greater focus during conversations and showed more consistent attempts at strengthening the doctor-patient relationships and asking about the patient’s feelings. Not only did they accomplish just as much clinically as their least mindful peers, but they did so while still relating with patients about nuanced personal experiences and important relationships.

In the study's extreme cases, less mindful clinicians failed to pay attention to their patients altogether and frequently missed important opportunities to be empathic.

As ongoing research into the job pressures of trained physicians reveals that two-thirds of trained doctors suffer from emotional, mental and physical exhaustion even resulting in burnout, the question arises how these conditions affect the doctor-patient relationship and what mindfulness training might offer to mediate those trends? Both doctors and patients stand to benefit.

Cultivate Discernment

Here is how you can start to explore what mindfulness is and how it can affect your everyday interactions:

  • Investigate and acknowledge that what you control in your life boils down to what you think, imagine, say, do and how you choose to respond to life's daily events and challenges.
  • Investigate and acknowledge that all of the above takes place during the present moment experience, each day, every day.
  • Investigate and acknowledge that if you are not present in this moment, you subsequently have little or no control in your life right now.
  • Resolve that well-intended attempts to gain greater control by not being fully present are not only irrational but generally prove to be counterproductive.

Once you have identified the simple truth of this reflection, you can take next steps and develop a few simple disciplines that make being present easier and being mindful feel natural.

So how can you cultivate greater mindfulness in your practice of medicine? Tune in Feb. 4 for Part 2 of this insightful article from our Mindfulness in Medicine series.

About the Authors

Anne Bruce has provided training and performance coaching for MedAmerica and CEP America. She also serves as MBSI's Employee Development Coach and Leadership Facilitator. Anne is a bestselling author with more than 20 books published by McGraw-Hill Publishing, New York. She considers her award-winning life-coaching book, Discover True North: A 4-Week Approach to Ignite Passion and Activate Potential (McGraw-Hill Publishing) to be one of her most "mindful" books to date. She also leads a popular Discover True North Expedition group on LinkedIn. Anne can be reached at 214-507-8242 or by writing to her at Anne@AnneBruce.com.

Dawa Tarchin Phillips is President/CEO of Empowerment Holdings, a leadership development and consulting firm that trains hundreds of professionals every year in mindfulness-based leadership and professional skills and interventions. Dawa is also a research specialist at the Department of Psychological and Brain Sciences at UC Santa Barbara and the founder and executive director of The Institute of Compassionate Awareness (TICA). You can read more about Dawa's work at www.empowermentholdings.com, and you can email him at dtp@empowermentholdings.com or phone 805-680-3988.


Comments
Perspectives on the Acute Care Continuum
Trackback from Perspectives on the Acute Care Continuum<br /><br />
By Anne Bruce
Welcome to Mindfulness in Medicine, a monthly column by best-selling author Anne Bruce designed to cultivate leadership and collaborative relationships among hospital leaders, nurses, providers and ancillary staff. Mindfulness is a powerful... ...
3/5/2014 6:51:30 PM

Dawa Tarchin Phillips
TIna, Yes, it is. We are dealing with a flow of thoughts, attitudes, words and actions in ourselves and others and ultimately are 100% responsible for the ripples these create. This does not mean we are responsible for other people's choices but fully for our own. Holding ourselves accountable, with genuine self acceptance and kindness, is a first step to realizing the tremendous opportunity we have to evolve our own wellbeing and the quality of our relationships. <br /> <br />Looking forward to hearing what you think of Part 2. <br /> <br />Best, <br />Dawa
1/30/2014 6:05:50 PM

Anne Bruce
Tina, thank you for sharing your insights on this new monthly "Mindfulness in Medicine" column. I really like your comment about being accountable for our daily actions, along with being mindful of how we respond to circumstances, good or difficult. I have shared this belief in several of my "Communications Excellence" training programs. Reacting and responding can provide two very different results. <br /> <br />If I go to my doctor and she prescribes a medication that causes me to have a bad "reaction," that is not good. She would then prescribe a new medication and, if it worked, she would say, "You are 'responding' well to this medication!" When we are mindful of our circumstances, we choose to think things through and then take time to respond, which often presents a more positive outcome. <br /> <br />I hope you will share your thoughts on Part 2 of this column, which will be posted next week. Dawa and I appreciate you taking time to "respond" to our thoughts on mindfulness. <br /> <br />Warm regards, Anne
1/28/2014 12:20:38 AM

Anne Bruce
Jim, your input and comments on the debut of this monthly column, "Mindfulness in Medicine," is greatly appreciated. And yes, various mindfulness techniques and concepts around this practice will be shared in months to come. You seem to have a firm handle on how mindfulness and meditation expand our consciousness and our ability to be more effective, not just in healthcare, but in all professions. When we take time to expand our consciousness, we expand the opportunities and possibilities in our lives—a powerful tool indeed. <br /> <br />Dawa and I hope that you will contribute more of your thoughts in response to Part 2 of this column, which will post next week. We look forward to reading what you have to say. Know that your insights are valued and welcome at anytime. <br /> <br />Best, Anne
1/27/2014 11:57:50 PM

Jim
Very intersting. I have been a meditater for 41 years, and it does work. I'm guessing you will be getting into midfulness techniques in upcoming installments. But it is a simple practice, basically effortless. But interetingly high achiever types like ED docs will tell me that they just can't meditate as if it is another learning curve they have to conquer. It's actually the opposite as I'm sure you will descrbe. <br />I've worked on site at hospitals often usually doing work for hectic EDs. Every hospital has a quiet room or chapel. and I've used them to meditate for 15-25 minutes. The effect on me is the feeling that my frazzled left and right brain have been reattached. It doesn't remove the stress of the ED. But the ability to focus in a mindful way is enhanced. <br />Also, my cousin wrote on article back in the 80s about mindfulness for patients in recovery. Her name is Maureen Strafford MD. <br /> <br />Jim Strafford
1/17/2014 8:48:15 PM

Tina
Great article! Mindfulness is then also about holding ourselves accountable for our own attitudes, habits and choices. I agree that even if the only thing that we control in our daily life is our reaction to our circumstances, that is still very powerful and life altering.
1/14/2014 1:30:54 PM