Burned-Out Doctors Seek Help

Sept. 23, 2009— -- Primary care physicians who took part in a continuing medical education program emphasizing reflection about their clinical experiences reported improvements in burnout and mood, researchers found.

The participants also indicated positive changes in empathy and psychosocial beliefs, suggesting they were practicing a more patient-centered approach to care, according to Dr. Michael Krasner, of the University of Rochester in N.Y., and colleagues.

The program centered on improving physicians' mindfulness, or the state of being fully attentive, when interacting with patients.

Krasner and his colleagues thought such a program would combat burnout, which they characterized as emotional exhaustion, depersonalization, and a feeling that work is not meaningful in the most current issue of the Journal of the American Medical Association.

They said "the skills cultivated in the mindful communication program appeared to lower participants' reactivity to stressful events and help them adopt greater resilience in the face of adversity."

Still, the authors recommended a randomized study "to investigate the effects on practice efficiency, patients' experience of care, and clinical outcomes."

Burnout affects up to 60 percent of physicians, according to the researchers, and it has been associated with poorer quality of care, decreased patient satisfaction, increased medical errors and lawsuits, a reduced ability to express empathy, and a variety of personal problems.

Although the problem is well known, they said, few interventions for preventing it have been tested.

So the researchers tested an intervention designed to improve physician well-being through enhanced mindfulness.

The course involved an eight-week intensive phase comprising a weekly, two and a half hour session followed by a seven-hour retreat. Physicians learned techniques of mindfulness meditation, narrative medicine, and appreciative inquiry aimed at increasing attention and awareness.

The initial phase was followed up with a 10-month maintenance phase consisting of a monthly two and half hour session.