Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians
Michael S. Krasner,Ronald M. Epstein,Howard Beckman,Anthony L. Suchman,Benjamin P. Chapman,Christopher J. Mooney,Timothy E. Quill +6 more
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TLDR
Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care, and these findings warrant randomized trials involving a variety of practicing physicians.Abstract:
Context Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce. Objective To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients. Design, Setting, and Participants Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo). Main Outcome Measures Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months. Results Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Δ], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Δ = −6.8; 95% CI, −4.8 to −8.8; depersonalization, 8.4 to 5.9; Δ = −2.5; 95% CI, −1.4 to −3.6; and personal accomplishment, 40.2 to 42.6; Δ = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Δ = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Δ = −4.1; 95% CI, −1.8 to −6.4); total mood disturbance (33.2 to 16.1; Δ = −17.1; 95% CI, −11 to −23.2), and personality (conscientiousness, 6.5 to 6.8; Δ = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Δ = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = −0.39, P Conclusions Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.read more
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Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population
Tait D. Shanafelt,Sonja Boone,Litjen Tan,Lotte N. Dyrbye,Wayne Sotile,Daniel Satele,Colin P. West,Jeff A. Sloan,Michael R. Oreskovich +8 more
TL;DR: Burnout is more common among physicians than among other US workers, and Physicians in specialties at the front line of care access seem to be at greatest risk.
Journal ArticleDOI
Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014
Tait D. Shanafelt,Omar Hasan,Lotte N. Dyrbye,Christine A. Sinsky,Daniel Satele,Jeff A. Sloan,Colin P. West +6 more
TL;DR: Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014, resulting in an increasing disparity in burn out and satisfaction in physicians relative to the general US working population.
Journal ArticleDOI
Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population.
Liselotte N. Dyrbye,Colin P. West,Daniel Satele,Sonja Boone,Litjen Tan,Jeff A. Sloan,Tait D. Shanafelt +6 more
TL;DR: Training appears to be the peak time for distress among physicians, but differences in the prevalence of burnout, depressive symptoms, and recent suicidal ideation are relatively small.
Journal ArticleDOI
Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis
TL;DR: The literature indicates that both individual-focused and structural or organisational strategies can result in clinically meaningful reductions in burnout among physicians, and further research is needed to establish which interventions are most effective in specific populations.
Journal ArticleDOI
Empathy decline and its reasons: a systematic review of studies with medical students and residents.
Melanie Neumann,Friedrich Edelhäuser,Diethard Tauschel,Martin R. Fischer,Markus Wirtz,Christiane Woopen,Aviad Haramati,Christian Scheffer +7 more
TL;DR: The results of the reviewed studies suggest that empathy decline during medical school and residency compromises striving toward professionalism and may threaten health care quality.
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