Wednesday May 18, 2016
Can Mindfulness Meditation Deliver Us From Burnout?
What do you do for fun? This is an important question I have started to ask patients so I can get to know them better and assess whether they find joy in their lives. I appreciate that the absence of joy can be a significant contributor to absence of personal health and sense of wellness.
I often wonder if we should be asking our physician colleagues the same question. A recent survey of nearly 36,000 physicians found that 63 percent of family physicians suffer from at least one symptom of burnout, an increase of 12 percent in just three years.
Not surprisingly, the same survey, which was published in December in Mayo Clinic Proceedings(www.mayoclinicproceedings.org), found that physician satisfaction with work-life balance was falling nearly as fast as burnout was rising. The percentage of family physicians who were satisfied with their work-life balance in this survey was roughly 35 percent, which was down from 50 percent in the previous study done three years earlier.
Although the AAFP, its constituent chapters and other physician organizations are working hard to address the many drivers of burnout that exist in our external environment -- including electronic health records, reimbursement and administrative burden -- it also is important that we, as physicians, ask ourselves what else we can do to survive and thrive amidst the current chaos.
A growing body of evidence points to mindfulness meditation and practicing the principles of mindfulness-based stress reduction(www.webmd.com) as a key answer to this important question.
Back in 2013, there already was ample evidence that mindfulness meditation could help people reduce stress when researchers at Carnegie Mellon University used MRI scans to show that the process, after just eight weeks, appeared to shrink the amygdala and thicken the prefrontal cortex(journals.plos.org). In other words, participants' connection to their fight-or-flight response got weaker as their attention and concentration improved. Researchers reported that the scale of these changes correlated with the amount of time spent on meditation.
Earlier this year, a research team that included the authors of that 2013 study found that mindfulness meditation stimulated areas of the brain that may help control emotional reaction and attention and decreased blood levels of interleukin-6, which is associated with inflammatory disease risk, meaning the process may protect participants' from emotional distress and decrease inflammation(www.biologicalpsychiatryjournal.com).
Yet another study published last fall in the Journal of Continuing Education in the Health Professions(journals.lww.com) found that participants' heart rate, blood pressure and Maslach Burnout Inventory scores improved after eight weeks of mindfulness meditation, and results continued during a 10-month followup period with low attrition and high compliance rates.
Not surprisingly, I'm hearing more and more about mindfulness wherever I go. Daniel Friedland, M.D.(supersmarthealth.com) recently gave a presentation on how mindfulness can play a role in leadership during the AAFP's Annual Leadership Conference. And Renee Crichlow, M.D., an assistant professor in the department of family medicine and community health at the University of Minnesota in Minneapolis, recently presented the evidence for using mindfulness meditation to prevent burnout at the Minnesota AFP's annual meeting.
Skeptics might be reluctant to invest time on something they aren't sure about, and maybe you aren't comfortable with the idea of sitting in the lotus position and getting in touch with yourself. The good news is there are plenty of free resources to help you get started(itunes.apple.com) and you can practice mindfulness meditation in whatever position is comfortable for you in just few minutes a day.
As this short video on the basics of meditation from Happifyhealth.com says, meditation is simple, secular, scientifically validated exercise for your brain(www.youtube.com). Another short YouTube video from Happify explains why mindfulness is a powerful tool for your well-being(www.youtube.com).
If meditation isn't for you, there are other options to reduce stress and build resiliency. A Minnesota community that lost two physicians in a short time period -- including one to suicide -- started a Bounce Back campaign(www.bouncebackproject.org) that aims to improve physician and public health by making the community a happier place. The initiative encourages people of all ages to perform random acts of kindness.
Family Practice Management recently published a three-part series by family physician and burnout expert Dike Drummond, M.D., that covers recognizing symptoms and causes of stress, reducing stress and work-life balance. All three articles are eligible for AAFP Prescribed CME credit for one year from the date of publication.
I appreciate that none of these tools is going to improve reimbursement, make payers more reasonable about prior authorizations or improve the interoperability of our electronic health records systems. However, these tools can help us be the best we can be in our "inner space" while we struggle to eliminate the challenges and burdens that occupy the "outer space" of our practice of medicine. After all, if we can't take care of ourselves, we won't have anything left to care for others.
Lynne Lillie, M.D., is a member of the AAFP Board of Directors.
Posted at 03:48PM May 18, 2016 by Lynne Lillie, M.D.