A Fundamental Ingredient of Excellent Care

Excerpt from "Teaching Doctors to Be Mindful," by Tara Parker-Hope, Well blog, New York Times, Oct. 27, 2011:

“Mindful communication is one way for practitioners to feel more ‘in the game’ and to find meaning in their practice,” said Dr. Michael S. Krasner, an associate professor of clinical medicine at Rochester and one of the study authors. He, along with his co-author Dr. Ronald Epstein, a professor of family medicine, psychiatry and oncology at Rochester, developed the course in mindfulness.

But it takes training, and that training can be particularly challenging for physicians who are used to denying their personal responses to difficult situations. In addition to learning to meditate, doctors participate in group discussions and writing and listening exercises on topics like medical errors, managing conflict, setting boundaries and self-care. Small group discussions are meant to increase awareness of how one’s emotions or physical sensations influence behaviors and decisions...

...But the real challenge for these participants — and the growing number of advocates of such training — is not acquiring mindfulness. It is finding the time and support necessary to sustain their skills and teach others.

Once back in their work environments, many say it is easy to fall back into old patterns. Dr. Krasner and Dr. Epstein have had to close down some of their programs directed at interns and residents because of financial issues. And a frequent topic of conversation among several of last week’s participants who hoped to teach at their own institutions were how to best introduce these ideas to colleagues who might be skeptical or administrators who might be hesitant to set aside valuable clinical time for training courses or pay for a program that does not generate revenue.

Nonetheless, Dr. Krasner and Dr. Epstein remain optimistic, in large part because they believe that mindful communication is not just another optional skill or fringe fad in health care. “Mindfulness,” Dr. Epstein said, “and the self-awareness it cultivates, is a fundamental ingredient of excellent care.”

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