Training physicians in mindfulness meditation and communication skills can improve the quality of primary care for both practitioners and their patients, University of Rochester Medical Center researchers report in a study published online this week in the journal Academic Medicine.
As ways to improve primary care, the researchers also recommend promoting a sense of community among physicians and providing time to physicians for personal growth.
"Programs focused on personal awareness and self-development are only part of the solution," the researchers stated. "Our health care delivery systems must implement systematic change at the practice level to create an environment that supports mindful practice, encourages transparent and clear communication among clinicians, staff, patients, and families, and reduces professional isolation."
Medical education can better support self-awareness programs for trainees while also promoting role models—preceptors and attending physicians—who exemplify mindful practice in action, they wrote.
The Academic Medicine article, which will be published in the journal's June print edition, is a follow-up to a study by the researchers published in the Journal of the American Medical Association in 2009. That study found that mindfulness meditation and communication training can alleviate the psychological distress and burnout experienced by many physicians and can improve their well-being.
Seventy physicians from the Rochester, N.Y., area were involved in the initial study. The physicians participated in training that involved eight intensive weekly sessions that were 2 ½ hours long, an all-day session and a maintenance phase of 10 monthly 2 ½-hour sessions. For the new report, the researchers conducted in-depth interviews with 20 of the physicians who participated in the mindfulness training program.
The findings in the new study include:
- For 75 percent of the physicians, sharing personal experiences from medical practice with colleagues was one of the most meaningful outcomes of the program.
- A nonjudgmental atmosphere helped participants feel emotionally safe enough to pause, reflect, and disclose their complex and profound experiences, which, in turn, provided reassurance that they were not alone in their feelings.
- Sixty percent reported that learning mindfulness skills improved their capacity to listen more attentively and respond more effectively to others at work and home.
- More than half of the participants acknowledged having increased self-awareness and better ability to respond non-judgmentally during personal or professional conversations.
- Seventy percent placed a high value on the mindfulness course having an organized, structured, and well-defined curriculum that designated time and space to pause and reflect—not something they would ordinarily consider permissible.
- Participants also described the personal struggles they have with devoting time and energy toward self-care despite acknowledging its importance.
The researchers have developed and implemented required mindful practice curricula for medical students and residents at the University of Rochester School of Medicine and Dentistry. They also are studying the effects of an intensive, four-day residential course for physicians.
The authors of the article are: Howard Beckman, M.D., clinical professor of Medicine and Family Medicine at the Medical Center and director of strategic innovation at Finger Lakes Health systems Agency; Melissa Wendland, associate director of research and planning at the Finger Lakes Health systems Agency; Christopher Mooney, M.A., senior information analyst in the Office of Curriculum and Assessment University of Rochester School of Medicine and Dentistry; Michael S. Krasner, M.D., associate professor of Clinical Medicine at the Medical Center; Timothy Quill, M.D., director of the Center for Ethics, Humanities, and Palliative Care at the Medical Center; Anthony Suchman, M.D., clinical professor of Medicine at the Medical Center; and Ronald Epstein, M.D., professor of Family Medicine at the Medical Center and director of the Center for Communication and Disparities Research at the School of Medicine and Dentistry.
Epstein and Krasner conduct mindfulness meditation and communication training programs. The research was supported by the Physicians Foundation.