Mindfulness for the Modern Self-Aware Physician

Recently, I read a wonderful post by Dr. Amy Pearlman in the Urology Times titled, “A urologists’ looking glass: Why self-awareness is vital.” Dr. Pearlman is a urology resident at the University of Pennsylvania, Philadelphia. Her post reminded me that, whether we find ourselves a medical student, resident, attending physician or a patient, becoming increasingly self-aware is something we all should be striving to do.

In my experience, self awareness is a lifelong journey. It is a fruit of living mindfully. Mindfulness itself, is cultivated, both individually and collectively, through the discipline of meditation.

Pam Ressler, Mindfulness Coach

To expand upon Amy’s post, I asked my friend and mindfulness guru, Pamela Ressler, to update us on the scientific basis of the ancient practices of mindfulness and meditation. Pam was also kind enough to provide us with some resources that we, as modern physicians, can use to become more self-aware in our daily lives and practices.

I hope you enjoy Pam’s guest post on mindfulness, and please share your practices in mindfulness and meditation in the comments. – Brian 

Why Mindfulness?

By Pamela Katz Ressler, MS, RN, HNB-BC

Founder, Stress Resources

From the cover of Time magazine to the Harvard Business Review, and even gracing the pages of the New England Journal of Medicine, “mindfulness” has become a ubiquitous term. Is this just a “new age” fad? For those of us in health care, we may wonder if there is evidence supporting the growing interest in mindfulness, and how might it impact our patients and ourselves.

While each of us may have our own definition of mindfulness, Dr. Jon Kabat-Zinn, founder of the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School, defines mindfulness as,

“Awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.”

While this may sound ridiculously simplistic, it may be one of the most difficult challenges for each of us on a daily basis. We may think we are bringing awareness to the present moment, but often we are ruminating about something that happened in the past (5 minutes ago or 5 years ago), or projecting into the future (the to-do lists of our lives).

In reality, very little of our lives is spent recognizing and observing the present moment. Mindfulness is a practice that can be cultivated. It is a form of meditation that can be practiced in both a formal and informal framework, and it is within our capacity to begin at any moment.

In the context of health care, business, and education, mindfulness is taught and discussed as a secular practice. However, many individuals also include mindfulness in their spiritual practices as well.

The Science of Mindfulness

A leader in the field of mindfulness, Dr. Kabat-Zinn recognized the correlation of the increasing demands of our fast paced society to the increasing reports of chronic stress-related health concerns. He was interested in understanding if using a framework of secular meditation strategies, which he called Mindfulness-Based Stress Reduction (MBSR), might have a beneficial impact on health conditions – improving well-being and decreasing burnout.

His early students were chronic pain patients, and because of the success of using mindfulness in this population, the use of mindfulness expanded into other areas of specialty including oncology, cardiology, dermatology, infertility, and sports medicine. However, until relatively recently, many of these uses of mindfulness in health care settings were based on case report and anecdotal evidence.

The game changer in the field of mindfulness came with the introduction of fMRI which enabled the ability to observe the brain during mindfulness meditation.

Research conducted by Sara Lazar and colleagues at Massachusetts General Hospital and Richard Davidson’s lab at the University of Wisconsin have observed not only activity changes in the brain, but also structural changes in the brain after only eight weeks of mindfulness training.

While mindfulness has long been studied as a method of pain relief for those with chronic pain for the past three decades, the mechanism of action has been elusive. A study recently published in the Journal of Neuroscience by researchers at Cincinnati Children’s Medical Center and Wake Forest Baptist Medical Center suggests that mindfulness meditation pain reduction is achieved by non-opioid pathways. While the exact biomolecular mechanism of the analgesic effect is unclear, the study suggests an opportunity to optimize more effective analgesia for patients in the future using mindfulness meditation.

Mindfulness and Physician Burnout

As we consider the high rate of burnout among health care professionals, mindfulness training may play a beneficial role in addressing this issue.

Studies by Dr. Michael Krasner and Dr. Ronald Epstein of the University of Rochester, also found that relatively short duration of mindfulness training – eight weeks – has a positive effect on physician well-being and empathy, and reduces psychosocial distress and burnout among physician study participants.

Similar results have been shown with mindfulness training for nurses. Beyond its role in reducing psychosocial distress, mindfulness may play a beneficial role in health quality. Dr. Melinda Ring and associates at Northwestern University’s Osher Center for Integrative Medicine, have been studying how mindfulness meditation could improve patient safety by strengthening physician and nurse decision making.

Beginning a Mindfulness Practice

Mindfulness is simple, but not easy to integrate into busy lives; however, its benefits are substantial. I am happy to share a simple introduction to mindfulness that many of my clients have found helpful in beginning to build mindfulness into their lives.

I call it the 1-5-7 plan – incorporating one mindful activity, for five minutes, seven days a week.

Even the busiest healthcare professionals have found that this is sustainable. More formal training is available both in person and online for many sources.

Mindfulness can no longer be described as a new age fad; it is now an area of evidence-based scientific inquiry. As we continue to examine its potential in health care for our patients, let’s begin with ourselves.