There is a basic irony in our health care system (well, probably more than one!). Our doctors, nurses, and physician assistants are some of the most stressed professionals.
Medical resident training only recently instituted a rule limiting the number of work hours per week to 80. Can you imagine. Physicians are faced with numerous challenging, if not impossible tasks. These include needing to remember a vast and ever growing body of clinical knowledge and applying this knowledge during time-limited visits in systems that have fragmented information. They may also being doing this under conditions of sleep deprivation.
In 1979 Jon Kabat-Zinn started a quiet revolution by introducing mindfulness meditation to the patients of the University of Massachusetts Medical Center. The revolution continues now to include the providers of health care.
This ground breaking work is being conducted by Dr. Mick Krasner and his colleagues at the University of Rochester Medical School They are bringing the practices and benefits of mindfulness to physicians. A study published in the Journal of the American Medical Association in 2009 demonstrated the benefits of this training for reducing burnout and increasing empathy for primary care doctors.
A recent New York Times blog provides an update on this work. Dr. Pauline Chen notes:
There has been a growing awareness among doctors that being mindful, or fully present and attentive to the moment, not only improves the way they engage with patients but also mitigates the stresses of clinical practice.
But it takes training, and that training can be particularly challenging for physicians who are used to denying their personal responses to difficult situations. In addition to learning to meditate, doctors participate in group discussions and writing and listening exercises on topics like medical errors, managing conflict, setting boundaries and self-care. Small group discussions are meant to increase awareness of how one’s emotions or physical sensations influence behaviors and decisions.
It takes much effort and time to change cultures, especially in medicine. It may be easier to teach wellness than to practice. Highly trained physicians may feel they are exempt. Yet the evidence suggests that this not the case. We are all vulnerable to the ravages of stress. It’s difficult to stop and take the time for self-care. As physicians, we may feel invulnerable, super-human, but this can’t persist.
Mindfulness teaches us to attend and respond in ways that promote wholeness. Our physical, mental, and spiritual integrity depend on our ability to pay attention and direct attention to the most skillful place in any given moment.
The revolution is coming and it started in the unassuming places of Worcester and Rochester. I extend my heartfelt appreciation to my mindfulness colleague Mick Krasner for his courageous work.