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ABOIM Founding Board Member and ABPS Diplomate Hilary McClafferty, MD, Discusses Mindfulness in Medicine

Hilary McClafferty, MDPhysician wellness is a notably complex issue. To best understand it, it’s important to acknowledge that several factors must be present for physicians to realize professional fulfillment and avoid burnout. According to researchers at Stanford University, these are:

  • A “culture of wellness,” or one that fosters good leadership, the alignment of values, a sense of community, and a feeling of being appreciated
  • Efficiency of practice, with regard to electronic health records, team-based care, scheduling, and triage
  • Personal resilience, which is related to self-care, compassion, meaning in work, work-life integration, and emotional flexibility

Although institutional and organizational factors play a critical role in burnout, it has been well-established that simply addressing personal resilience is not the solution to wellness. Mindfulness is a promising tool for individuals to explore.

The fact that an ancient meditative practice can reduce burnout may surprise physicians, who are classically trained to separate spirituality and medicine. But research shows that mindfulness can be used effectively in a variety of clinical settings.

In the late 1970s, John Kabat-Zinn, Ph.D., introduced mindfulness research to mainstream medicine in a program for patients living with chronic pain. Kabat-Zinn has described mindfulness as “paying attention with moment-to-moment awareness, on purpose, in a particular way, without judgment.” Today, his mindfulness-based stress reduction (MBSR) course is typically taught as an eight-week program that combines a variety of mind-body therapies such as breath work, progressive muscle relaxation, mindful eating, mindful movement, yoga, and meditation.

Studies involving pain and oncology patients reveal a correlation between mindfulness practice and improved quality of life, as well as decreased anxiety, depression, and use of prescription pain medication. Furthermore, MBSR has gained broad acceptance in the medical community, with nearly 80% of the 140 accredited medical schools or their associated university programs in the United States incorporating mindfulness practice into clinical treatment, as well as educational and research programs.

With regard to physician wellness, mindfulness practice seeks to enhance a sense of self-efficacy and cultivate an internal locus of control, both of which are traits closely associated with personal resilience. For physicians, mindfulness has been shown to:

  • Reduce stress
  • Increase self-awareness
  • Improve listening and attentiveness
  • Lead to more thoughtful decision-making
  • Increase adaptive reserves
  • Reduce rumination

To promote wellness, physicians can practice mindfulness in a number of ways, whether pausing to center themselves before entering a patient’s room, or using mindfulness techniques applicable to settings such as the surgical suite, emergency department, or the ICU.

The Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School in Worcester, MA, is an excellent resource for information about mindfulness. Click here to visit the center’s website.

As an evidence-based wellness practice, mindfulness is espoused by physicians certified in integrative medicine through the American Board of Integrative Medicine (ABOIM). To learn about certification with the ABOIM, a Member Board of the American Board of Physician Specialties® (ABPS), contact the ABPS today.

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Jeffrey B. Stricker, DO, MBA, FAASD
Dermatology
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Integrative Medicine
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Chris Kunis MD
Internal Medicine
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Disaster Medicine
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Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
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