Be Mindful to Maintain Job Satisfaction

Physician burnout and job dissatisfaction are concerning as physicians in the United States have more patients to see in less time with fewer resources. Physician burnout is associated with job absenteeism, leaving the profession altogether, poor quality of care, and medical errors. Now, a recent study published in the Journal of the American Medical Association claims that meditation and mindfulness can decrease physician burnout.

The study followed 70 primary care physicians — the physicians that have recently experienced the largest decrease in job satisfaction — through an intense continuing education program in mindful communication. The course included secular meditation, self-awareness exercises, narratives about meaningful clinical experiences, and appreciative interviews. The original course was an intense 8-week program that included 2.5 hours per week of didactic and discussion-based exercises and a 7-hour retreat. The intensive phase was followed by a 10-month (2.5 hours per month) maintenance phase. The authors of the study measured improvement in physicians’ well-being, levels of distress, burnout, and ability to relate to patients at baseline and at 2, 12, and 15 months. The authors concluded that participation in an intense educational program in mindful communication resulted in short- and long-term improvements in physician well-being and attitudes toward patient-centered care, including empathy and compassion.

More than half of practicing physicians and medical students report burnout, which includes emotional exhaustion, depersonalization of patients, and a low sense of accomplishment.  The qualities of using mindful communication and being fully present in physician duties leads to better interpersonal relationships and less anger, frustration, and depression. The physicians evaluated in the JAMA study also reported more vigor after completing the mindful communication training. They also promoted patient participation in care, improved patient trust, and reduced disparities in the provision of health care.

Many factors contribute to physician burnout and job dissatisfaction: age, specialty, job demands, professional autonomy, collegial support, income, and benefits.  Many of these factors are modifiable, at least to some extent. But, mitigating physician burnout is still not a high priority, even with the substantial personal and professional consequences. So, can physicians take it upon themselves to be more mindful and improve their own, and their patients’, well-being?

Being fully present in daily activities and making the choice to be an active contributor to one’s family, friends, and profession is a seemingly overwhelming task. Sometimes, people cope with difficult or stressful situations by emotionally withdrawing from the situation and becoming merely a passive observer. The JAMA study shows that being mindful may not be as difficult as it seems. By learning a little self-awareness and practicing meaningful communication, physicians — and likely many other professionals — can improve the quality of their relationships. The authors of the study assert that it may be as simple as taking a deep, cleansing breath before moving from one patient to another.

To paraphrase ancient Chinese wisdom, live simply, do what you enjoy, and be completely present.

References

Bragard I, Libert Y, Etienne AM, et al. Insight on Variables Leading to Burnout in Cancer Physicians. J Cancer Educ. Jan 16.

Krasner, M., Epstein, R., Beckman, H., Suchman, A., Chapman, B., Mooney, C., & Quill, T. (2009). Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians JAMA: The Journal of the American Medical Association, 302 (12), 1284-1293 DOI: 10.1001/jama.2009.1384

McCray LW, Cronholm PF, Bogner HR, Gallo JJ, Neill RA. Resident physician burnout: is there hope? Fam Med. Oct 2008;40(9):626-632.

Scheurer, D., McKean, S., Miller, J., & Wetterneck, T. (2009). U.S. physician satisfaction: A systematic review Journal of Hospital Medicine, 4 (9), 560-568 DOI: 10.1002/jhm.496

Utsugi-Ozaki, M., Bito, S., Matsumura, S., Hayashino, Y., Fukuhara, S., & , . (2009). Physician Job Satisfaction and Quality of Care Among Hospital Employed Physicians in Japan Journal of General Internal Medicine, 24 (3), 387-392 DOI: 10.1007/s11606-008-0886-4