Practicing Mindfulness Can Bring Busy Physicians Back to ‘Now’

Mindfulness, the practice of being attentive to and accepting of experiences in the present moment, is fast becoming recognized as a way to mitigate stress, increase self-awareness and well-being, and promote more meaningful relationships. For physicians, too, it is a powerful tool for increasing resilience in the face of stress and countering burnout.

Mindfulness is both a natural capacity and a skill strengthened by mental practice. We all have spontaneous moments of noticing our breath while working out, being attentive to the sound of birds in the morning, or “tuning in” to our body’s reaction to a difficult encounter. But this kind of conscious awareness of the present moment in daily life is typically overshadowed by busy thinking or doing and the sense of “being on automatic.”

Fast-paced, multitasking environments, such as health care settings, tend to activate automatic pilot, not an awareness of the present moment. Moreover, our training as physicians often demands that we ignore our own well-being to meet the demands of caregiving. These are the conditions for becoming overextended, emotionally exhausted, and/or disconnected from one’s inner experiences—burnout.

One notable study published in JAMA (September 23, 2009) looked at the effects of an eight-week “mindful communication” course for primary care physicians at the University of Rochester followed by monthly follow-up sessions for 10 months. The study found that mindfulness training resulted in reductions in all scales of burnout, an increase in empathy, improved sensitivity to patients’ psychosocial history, better mood, and increased conscientiousness and emotional stability. A follow up qualitative study in Academic Medicine (June 2012) identified three salient themes in interviews of the physicians who completed the mindfulness training:

Mindfulness has been a core interest in my professional and personal life. As a UCLA research fellow, I developed a mindfulness-based intervention for teens and adults with ADHD. Mindfulness has also been the organizing principle of how I now work with patients or trainees and the main resource to which I turn during stressful moments in my own life. The practice has helped me to counteract my tendency to “suspend myself and plow through” a busy work day only to feel exhausted at the end of it.  

I have trained myself to notice my breath, deepen my inhalation, and relax whenever I notice myself being “locked in” automatic pilot or hyper-focused on doing. Mindfulness also helps me with processing difficult interactions with patients or colleagues: whenever I feel uneasy about an exchange or catch myself ruminating on it, I practice offering myself self-compassion and become curious what inner reactions, especially body sensations, I am noticing. This practice expands my self-understanding, and it also can reveal what needs to be accepted or let go and what needs to be proactively addressed.

In addition to managing stressful situations, mindfulness practice has helped me acknowledge my limitations. In the last two years, I have found myself running a busy psychiatry practice, teaching, writing, and being a mom to a young child. Having my first child at 43, in the midst of a busy career, has been an exercise in physical and mental endurance. The accumulation of sleep deprivation inherent in having an infant taxed the cognitive and physical reserves on which I always relied in pushing myself to get things done. It became harder than ever to force myself to attend to tasks, and I found myself working more slowly and less efficiently as I became more easily fatigued by encounters with patients or required documentation.

Mindfulness practice helped me recognize and accept the sense of accumulating exhaustion and to let go of nonessential commitments. This letting go is difficult for me because of the model of the “capable physician” to which we are all exposed during medical training. My perception of not meeting the standard of what I should be able to do created an inner struggle and kept me from taking on new projects and working too much for too long. But mindfulness practice has helped me work through anxiety and self-judgments associated with reducing work and turning down professional invitations and reminded me to take care of myself as I take care of others. ■

“Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians” can be accessed here. “The Impact of a Program in Mindful Communication on Primary Care Physicians” is available here.