physician burnout & mindfulness training: an approach that works by floyd arthur ppt
TRANSCRIPT
Physician Burnout & Mindfulness Training: An Approach That Works
By Floyd Arthur
As virtually every doctor knows, physician burnout is a growing problem in the United
States. According to a 2015 Mayo Clinic study, over 54 percent of physicians experienced
at least one symptom of burnout in 2014, an increase of nearly 10 percent over 2011.
During the same period, the number of physicians who expressed dissatisfaction with
work-life balance also grew from 41 to 48.5 percent.
Physician Burnout and Mindfulness Training - An Approach That Works
The reasons given for the increasing rates of physician burnout vary, but increased
bureaucracy and regulatory demands are high on the list. According to Medscape’s 2016
Physician Lifestyle Report, the top five causes cited by physicians are:
* Too many bureaucratic tasks
* Spending too many hours at work
* Increased computerization of practice
* Income not high enough
* Feeling like "just a cog in the wheel”
Maintenance of certification, the impact of the Affordable Care Act and difficult patients were next on the list.
Issues not included in the survey that were mentioned anecdotally by many physicians
included insurance issues, the introduction of the 10th edition of the International
Classification of Diseases codes (ICD-10), the threat of malpractice suits and family stress.
The Impact of Physician Burnout
Burnout is a condition marked by emotional exhaustion (loss of enthusiasm)
depersonalization (loss of empathy) and a low sense of personal accomplishment (loss
of meaning and self-esteem.) Among physicians, the high rate of burnout is a serious
public health issue with widespread effects.
Not only are burned out physicians at higher risk for substance abuse, mental health
issues relationship stress and suicide, they are significantly more likely to make a critical
mistake. Additionally, many early and mid-career doctors are leaving the profession,
citing burnout and quality-of-life issues as the cause.
Mindfulness Training & Physician Burnout
Decades of research demonstrate a significant correlation between mindfulness
meditation and the reduction of stress. Additionally, several studies have shown that
physicians who receive training in mindfulness techniques show a marked improvement
in symptoms of burnout, quality of life measures and mood. More importantly, both
intensive training and modified, short-term instruction have achieved similar results.
Intensive Mindfulness Training
In a 2009 study from the University of Rochester Medical Center, Rochester, New York,
for example, physicians were enrolled in an intensive program of mindfulness education
over a period of 12 months. The training involved:
* Eight weekly 2.5 hour sessions of mindfulness training
* One eight-hour seminar between session six and seven
* Ten additional monthly sessions of 2.5 hours each.
The sessions were structured into three parts:
* A 15 minute didactic session in which specific topics were discussed. Topics included self-
awareness, dealing with unpleasant emotions, conflict resolution, setting boundaries and self-care.
* Mindfulness meditation involving four distinct mediation practices: guided meditation,
silent meditation, walking meditation and body movement exercise similar to yoga.
* Narrative and appreciative inquiry, in which physicians wrote short narratives that explored
ways in which they successfully worked through challenging clinical situations. They then
shared their experiences in pairs or small groups.
At the end of the eight and 12 weeks, participants were asked to complete a series of
surveys that measured burnout, empathy, beliefs, personality traits and mood. All of the
physicians who completed the surveys showed a significant reduction in symptoms of
burnout, depersonalization and negative mood states.
Abbreviated Mindfulness Training
In 2013, a study conducted at the School of Medicine and Public Health at the
University of Wisconsin in Madison, Wisconsin, evaluated the effects of an abbreviated
mindfulness training course on symptoms of burnout in 30 physicians. Participants
attended a 14-hour weekend course (Friday evening: 3 hours; Saturday: 7 hours;
Sunday: 4 hours) and two 2-hour evening follow up sessions. They were given access to
audio CDs and a training website specifically designed for the course, and instructed to
practice mindfulness meditation for 10 to 20 minutes each day.
After completing the course, all of the participants had achieved significant reductions
in symptoms of burnout, depression, anxiety and stress. Perhaps more importantly, the
reductions were maintained throughout a nine-month post-training period without any
further formal intervention.
