Burnout

Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians 

Krasner, M.S.; Epstein, R.M; Beckman, H.; Suchman, A.L., Benjamin Chapman, B., Christopher J. Mooney, C.J, Quill, T.E. (2009) , JAMA. 302:12, 1284-1293. doi:10.1001/jama.2009.1384

“Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Burnout may be related to lack of a sense of control and loss of meaning. In an investigation of internists, the capacity of “being present” with their patients correlated more strongly with finding meaning in their work than diagnostic and therapeutic triumphs. This quality of being present for the physicians included an understanding of their patients as not merely objects of care but as unique and fellow humans and an awareness of the patients’ (and their own) emotions, often brought out during challenging clinical encounters.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. This study used a continuing medical education (CME) course to improve physician well-being. The program aimed to enhance the physician-patient relationship through reflective practices that help the practitioner explore the domains of control and meaning in the clinical encounter. We hypothesized that intensive training in attention, awareness, and communication skills would increase physician well-being, reduce psychological distress and burnout, and promote positive changes in physicians’ capacity to relate to patients as indicated by increased empathy and patient-centered orientation to care.”

The Impact of a Program in Mindful  Communication on Primary Care Physicians

Beckman, H.B., Wendland, M., Mooney, C., Krasner, M.S., Quill, T.E., Suchman, A.L., and  Epstein, R.M. (2012) , Academic Medicine, 87: 6, 1-5. doi: 10.1097/ACM.0b013e318253d3b2

The purpose of this  research was to understand what aspects  of a successful continuing education  program in mindful communication  contributed to physicians’ well-being and  the care they provide. In 2008, the authors conducted in- depth, semistructured interviews with  primary care physicians who had  recently completed a 52-hour mindful  communication program demonstrated  to reduce psychological distress and  burnout while improving empathy.  Interviews with a random sample of  20 of the 46 physicians in the  Rochester, New York, area who  attended at least four of eight weekly  sessions and four of eight monthly  sessions were audio-recorded,  transcribed, and analyzed qualitatively.  The authors identified salient themes  from the interviews.

Participants reported three main themes:  (1) sharing personal experiences from  medical practice with colleagues reduced  professional isolation, (2) mindfulness  skills improved the participants’ ability  to be attentive and listen deeply to  patients’ concerns, respond to patients  more effectively, and develop adaptive  reserve, and (3) developing greater  self-awareness was positive and  transformative, yet participants struggled  to give themselves permission to attend  to their own personal growth.

Conclusions: Interventions to improve the quality of  primary care practice and practitioner  well-being should promote a sense of  community, specific mindfulness skills,  and permission and time devoted to  personal growth.

A Mindfulness course decreases burnout and improves well-being among healthcare providers,

Goodman, M.J., Schorling, J.B., International Journal of Psychiatry in Medicine, Vol. 43:2, January 2012, 119-128

Conclusion: A continuing education course based on Mindfulness-based stress reduction was associated with significant improvements in burnout scores and mental well-being for a broad range of healthcare providers.