Professional Documents
Culture Documents
1 Mindfulness in Medicine
1 Mindfulness in Medicine
http://www.deloitte.com/assets/Dcom-
UnitedStates/Local%20Assets/Documents/us_chs_2013Surv
eyofUSPhysicians_031813.pdf
“Nearly 6 in 10 physicians… are concerned about the future of
medicine, pointing to declining clinical autonomy and income.
Pessimism among physicians resulted in nearly 75% agreeing
that "the best and brightest" may avoid a career in medicine…
Still, 7 in 10 physicians reported they were satisfied with their
careers. The most satisfied… were the nonsurgical specialists
(67%) and physicians aged 25 to 39 (80%).
Primary care physicians were the least satisfied…at 59%.”
A Survey of America’s Physicians:
Practice Patterns and Perspectives
http://www.physiciansfoundation.org/uploads/de
fault/Physicians_Foundation_2012_Biennial_Surve
y.pdf
“Over half of physicians surveyed have reached a
tipping point and plan to make changes to their
practices. Many intend to take one or more steps
likely to reduce patient access to their services,
limiting physician availability at a time when
doctors already are in short supply.”
Wolters Kluwer Health 2013 Physician
Outlook Survey
http://www.wolterskluwerhealth.com/News/Document
s/White%20Papers/Wolters%20Kluwer%20Health%20P
hysician%20Study%20Executive%20Summary.pdf
More than one-third of physicians say they are likely to
leave their practice in the next 1-2 years, including 15%
who are very likely to do so. The top two reasons for
leaving among all physicians surveyed is that it is hard to
make practice profitable and time to retire. Not
surprisingly, those who have been practicing more than
20 years say the top reason is time to retire versus those
who have been practicing 20 years or fewer, who cite
difficulty in making their practice profitable.
Medscape Physician Compensation
Report 2014
http://www.medscape.com/features/slideshow/compensati
on/2014/public/overview
specialists who ranked among the highest paid in 2013
reported the lowest levels of satisfaction with the profession.
For example, anesthesiologists, radiologists and
orthopedists… Among the three specialties, the percentage
who said they would still choose to go into medicine if given a
second chance ranged from 44 percent to 47 percent.
Conversely, 67 percent of family physicians said they would
choose medicine again as a career. Yet despite being satisfied
with the medical profession overall, the survey indicated they
do not feel the same about their specialty. Only 32 percent of
family physicians said they would stay in the same medical
specialty.
Signs and Symptoms of Burnout
Physical and emotional exhaustion
Cynicism and detachment
A sense of ineffectiveness
Overidentification or overinvolvement
Irritability, hypervigilance, sleep problems
Social withdrawal
Poor judgment
Perfectionism
Kearney JAMA 2009
Signs and Symptoms of Burnout
Questioning the meaning of life
Questioning prior religious beliefs
Interpersonal conflicts
Avoidance of emotionally difficult clinical situations
Addictive behaviors
Numbness and detachment
Difficulty in concentrating
Frequent illness:
HA, GI disturbances, immune system impairment
Kearney JAMA 2009
Burnout
“Hallmark Symptom”
A loss of interest in
one’s work and personal life
and a feeling of
“just going through the motions”
Measures that may help prevent burnout
• Mindful meditation
• Reflective writing
• Training in communication skills
• Development of self-awareness skills
• Practice of self-care activities
Jon Kabat-Zinn
Founder, Center for Mindfulness in Medicine, Health Care and Society,
Creator of Mindfulness-Based Stress Reduction MBSR
What is mindfulness?
The capacity for lowering one’s own reactivity
(paying attention to experiences without reacting
to them)
Contemplative Eating
Eating Meditation
“Raisin Meditation”
University of Wisconsin
School of Medicine and Public Health
Department of Family Medicine
Exclusion criteria-
• Lifestyle issues (language, active substance dependency)
• Psychological issues (suicidal, psychosis, acute/subacute PTSD, social anxiety, severe
depression)
• Those in chemical recovery less that a year- deemed to be possible relapse candidates due to
the nature of introspective work.
• Those with fragile emotional status from whatever cause- trait or state
• Attitudinal issues (“quick fix”, attendance)
• Physical issues (attendance)
Mindfulness Practice
Neth, J of Pastoral Care and Counseling, Spring-Summer 2008 v
62, no 1-2, 143-144
Mindfulness in Your Workday
Take half a minute of silence
Before going into the next patient’s room, pause
and bring your attention to the sensation of your
breathing for 2 to 5 breaths
Use the suggested 20 seconds of hand washing in
creative ways, pay attention to the sensation of
the water on your skin and allow yourself to sink
into this experience; make this an act of
conscious receiving by acknowledging to yourself
“I am worthy of my own time”
Self-care of Physicians Caring for Patients at the End of Life:
“Being Connected . . . A Key to My Survival”
Kearney MK et al, JAMA 2009, 301(11), 1155-64
Mindful Reflection
Contemplating hands-
Rubbing palms until warm
Placing palms over eyes
Using fingertips-
Massage face, neck and shoulders
Contemplating hands again-
Recalling how they have been used in healing
Imagining how they will be used for healing
Healing ourselves, healing our patients