Perspectives on the Acute Care Continuum

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Mindfulness in Medicine Combats Provider Burnout — And Patients Kind of Dig It Too

3/15/2017 4:04:00 PM | 2 comments

mindfulness in medicineWelcome to Mindfulness in Medicine, an ongoing 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. It is a tool that, when practiced, can help us develop and implement 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.

It's tough to comfort, diagnose, and heal others when you're exhausted, disconnected, and losing faith in yourself. But research suggests that one in three physicians feels burned out at any given time.
 
While healthcare reform has raised issues around cost and quality, it's only more recently that experts have advocated for making workforce wellness a top priority. This is especially urgent considering that burned-out providers make more medical errors and feel less empathy and compassion for patients. (In addition, patients of burned-out providers are less likely to comply with treatment recommendations.)
 
So how can we keep our workforce strong and resilient in environments fraught with emotional situations, fears, failures, and death? Research suggests that mindfulness practices like meditation can help exhausted providers regain a sense of balance, control, and purpose.
 
In today's post, I'll discuss some of the research around mindfulness in medicine, plus some ways to get started.
 

Doing All The Right Things — And Still Feeling Sick

 
Healthcare providers tend to be smart, driven people. Does that predispose them to burnout? I don't have a scientific answer. But here's an anecdote I think is pretty telling.
 
A decade ago, my cousin went into practice as an integrative health coach. Her goal was not only to treat distress but also to promote a sense of overall well-being. Her practice encompassed not just the physical aspects of health, but also the emotional, social, spiritual, and environmental.
 
It should have been easy. Her clients were some of the healthiest people she’d ever seen. Practically no one ate meat or drank excessively. If a food wasn’t organic, they didn't touch it. Everyone exercised, and many were vegetarian or vegan. They all took loads of supplements and did cleanses.
 
And yet, many of them seemed to always be sick.
 
If it wasn’t one thing, it was another. Chronic headaches, gastrointestinal issues, fatigue, aches, pains, you name it. She referred a few clients with worrying symptoms to primary care providers. But most of them just felt generally unwell.
 
My cousin was beyond curious as to why these yoga-practicing, hiking, non-smoking folks always seemed to be sick with some mysterious ailment. It appeared that their healthy habits simply weren’t enough to actually live healthy lives.
 
She wondered if the answer might not be their diet and exercise habits, but their habits of mind.
 

What Research Says About Mindfulness

 
Over the past few years, the mind-body connection has been a hot topic in medicine, psychology, and public health. Researchers have begun to pinpoint thought patterns, practices, and behaviors that promote wellness and resiliency. Among the most promising of these are mindfulness practices.
 
If you're a provider, you've probably had days when you walked into a room to see a patient but were distracted by other worries. By contrast, mindfulness is the state of being aware and focused in the present. It's achieved through practices that involve:
 
  • Focus on an object or action (for example, focusing on breathing during meditation)
  • Awareness in the present moment
  • Nonjudgmental acknowledgement of your own feelings and thoughts
 
The more often and consistently you engage in mindfulness practice, the greater the benefits. But these reflections don't have to be long or complicated. Taking just a few seconds to focus before walking into the exam room can make a big difference.
 
Now, I totally get that when you're looking at this from the perspective of medicine and science, it all may seem a bit soft. But a growing body of research suggests it can be life changing.
 
For example, researchers have noted the following clinical benefits of mindfulness practice:
   
And here are some positive social and emotional effects demonstrated by studies:
   
Research also suggests the following benefits specifically for healthcare providers:
   
And mindful awareness isn't just beneficial for providers. In 2009, physician Tom Hutchinson, MB, and professor Patricia Dobkin, PhD, wrote eloquently about the importance of healing in medicine:
 

We would point out that healing is an ancient part of the health care mandate that involves patients moving from suffering to a sense of integrity and wholeness, whether or not their disease is cured or even improving. Clinical experience suggests that health care practitioners facilitate healing by being open, accepting, and focused in the present moment.

 
Mindfulness, they suggest, is one way physicians can create the optimum conditions for healing.
 

Digging Down

 
So back to my cousin for a minute. She was so curious about what she was observing among her clients that she decided to make a questionnaire for them. Here are a few of the questions she asked:
 
  • Do you worry about money?
  • What type of work do you do? Is it satisfying?
  • Do you get enough affection?
  • Do you have a passion in life?
  • Are you in touch with your inner compass, or True North?
  • How do you express yourself creatively?
  • If you could change anything in your life, what would it be?
 
When her clients shared their answers, it became clear that many of her "healthy" clients were also the stressed, disconnected, and disillusioned. It seemed that the same personality traits that made them perfectionistic about their bodies also led to a general dissatisfaction and endless pursuit of "more" and "better."
 
She concluded that all of these people, no matter how much they avoided processed foods and slept eight hours each night, might as well be drinking beer and eating pizza until 2 a.m.
 
By contrast, a few clients did report abundant life satisfaction and well-being. They had happier home lives, lots of family and friends, and some sort of spiritual connection (not necessarily religious). They also had a lot of fun and used various ways of expressing their creative sides.
 
Interestingly, there was no correlation between better health habits and greater life satisfaction. If anything, the satisfied clients tended to be more relaxed about diet and exercise. Rather than chasing perfection, they focused their energy on living according to their values and deepest principles.
 
Were the satisfied clients more naturally mindful? Maybe. But the great thing about mindfulness practices is that they can help all of us achieve this same sense of balance and intentionality.
 

Mindfulness In Medicine: Resources

 
So how can you start becoming more mindful as a healthcare provider? There are literally hundreds of techniques to learn, read, and try:
 
  • Breathing techniques
  • Meditation
  • Books
  • Classes
  • Videos
  • Podcasts
  • Mindfulness-Based Stress Reduction
  • Mindfulness-Based Cognitive Therapy
  • Yoga
  • Silent Retreat
  • Mindful Eating (sounds strange, but you won't believe how good your food can taste!)
 
Mindfulness can be a little intimidating when you're just getting started. There really is no set, step-by-step path that's ideal for everyone. To ease yourself in, check out the following websites, which are especially geared to healthcare professionals.
   
Above all, stick with it. Sometimes it takes a while to dial in a mindfulness routine that works for you. But once you get the hang of it, you might be surprised how easy it can be. And how much you look forward to it.
 

Do you engage in mindfulness practice? How do you find it helpful? Comment below to share.

 

About the Author

 
Anne Bruce has provided training and performance coaching for MedAmerica and CEP America. She also serves as MBSI's Employee Development Coach. 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, or visiting her on LinkedIn or Fans of Anne Bruce on Facebook.
 

Topics: Resources

Comments
Courtney Proffitt
This is a wonderful article, and it comes at Spring Time - a time for renewal. Time to remember to stop, breath, be mindful, and be in the moment. I like the information you shared in this, and in thinking of going to my physician, knowing when she is really looking at me, really listening to me (being mindful) it FEELS so much better to me, as a patient. Knowing she is present, and listening makes all the difference / compared to going to another doctor, and having him/her ask brusque questions, rush through the exam (maybe they wanted to go home early after the appointment?).... and then brush me off, or hand me to the nurse quickly as they left. HUGE difference! And they say only 10 minutes a day is what it takes. When I miss my meditation time, it's like I hunger for the quiet. Great article. Love the resources you put at the end! Thanks so much!
3/30/2017 3:24:31 PM

Tif hackett
Great article! Thank for the resources too.
3/27/2017 4:24:22 PM