Creating a Culture of Mindfulness in Medicine.

BACKGROUND: Well-documented challenges faced by primary care clinicians have brought growing awareness to the issues of physician wellness and burnout and the potential subsequent impact on patients. Research has identified mindfulness as a tool to increase clinician well-being and enhance clinician characteristics associated with a more patient-centered orientation to clinical care. OBJECTIVE: The overall goal of our intervention was to promote the cultivation of mindful awareness throughout our health system, creating a culture of mindfulness in medicine. METHODS: We developed a systems-level strategy to promote health and resilience for clinicians and patients by preparing a group of clinician leaders to serve as catalysts to practice and teach mindfulness. The strategy involved 3 steps: (1) select 5 primary care leaders to help foster mindfulness within both health care delivery and education; (2) provide funds for these leaders to attend advanced mindfulness training designed specifically for clinicians; and (3) foster mindfulness within our health system and beyond via collaborative planning meetings and seed money for implementation of projects. RESULTS: All 5 leaders endorsed the personal value of the mindfulness training, with some describing it as life-changing. Within 8 months, 4 of the leaders fostered a wide variety of mindfulness activities benefitting colleagues, medical students, and patients across our state and beyond. CONCLUSION: We found that the value received from our investment in mindfulness far exceeded our relatively low cost, although further evaluation is needed to prove this.

Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study.

PURPOSE: Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians. METHODS: A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures. RESULTS: Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales-Emotional Exhaustion (P =.009), Depersonalization (P = .005), and Personal Accomplishment (P <.001); (2) on the Depression (P =.001), Anxiety (P =.006), and Stress (P = .002) subscales of the Depression Anxiety Stress Scales-21; and (3) for perceived stress (P = .002) assessed with the Perceived Stress Scale. There were no significant changes on the 14-item Resilience Scale and the Santa Clara Brief Compassion Scale. CONCLUSIONS: In this uncontrolled pilot study, participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.