by clicking the "Next" arrow.
by clicking on the page.
the page around when zoomed in by dragging it.
the zoom using the slider when zoomed-in.
by clicking on the zoomed-in page.
by entering text in the search field, and select "This Issue" or "All Issues"
by clicking on thumbnails to select pages, and then press the print button.
displays sections with thumbnails and descriptions.
displays a slider of thumbnails. Click on a page to jump.
allows you to browse the full archive.
about your subscription?
Mindful : April 2018
A lmost two decades ago, a young family doctor named Ronald Epstein published a modest proposal in the prestigious Journal of the American Medical Associa- tion that would go on to spark a quiet revolution in medicine. The practice of mindfulness, Epstein argued in 1999, could help physicians weather the growing stresses of the pro- fession, rediscover the human element in the increasingly impersonal nature of high- tech medicine, and in short be better doctors. At the time, most physi- cians weren’t even aware of the term mindfulness. Those who were often dismissed it as New Age nonsense. But Epstein’s notion of “mindful practice” resonated. “Today, if you ask 100 physicians, 90 are familiar with mindfulness, and most have very positive associations,” Epstein says. “It’s mind-blowing, really, how much attitudes have changed.” Epstein continues to work as a family physician and palliative-care physician at University of Rochester Medical Center, where he and his longtime colleague Mick Krasner co-direct the Mind- fulness Practice program, which offers workshops to medical students, practicing physicians, and other health professionals and educators. Similar programs have sprung up at medical centers from coast to coast. One reason for the increasing interest: Many experts see mindfulness med- itation as a powerful antidote to burnout, which has become a serious crisis in the health- care profession. According to the latest statistics, more than half of all doctors report symptoms of burnout, defined as emotional exhaustion, depersonalization (treating others as objects), and feeling inadequate. Many cut their careers short. Shockingly, sui- cide among doctors is twice the national average. Healing the Healers “For many physicians, the pressures are becoming more and more intolerable,” says Epstein, who in 2017 put out the book Attending: Medicine, Mindfulness, and Humanity. Mindfulness can help them step back and become aware of how they are responding. By finding the space to reflect, they can reconnect with the impulses of caring and compassion that led them into medicine in the first place. “Mindfulness enables doctors to listen to a patient without judging,” Epstein explains, “ to be present, responding to what the patient is saying and feeling and also aware of what they’re feeling.” Growing evidence backs up these assertions. In a 2009 study of 70 health-care pro- fessionals who par ticipated in a mindfulness training program at the University of Rochester Medical Center, Krasner, Epstein, and their colleagues found that par- ticipants were less likely to experience signs of burnout and reported greater sense of personal accomplishment and empathy. A 2017 report published in the Journal of Clinical Medicine reviewed results from 115 studies and found that mindfulness improved physician–patient communication, enhanced physicians’ empathy, and improved quality of care. Mindfulness practice alone won’t heal a broken system, of course. Health-care sys- tems often reward doctors for performing procedures, not sitting and listening to a patient. The advent of elec- tronic medical records means many doctors end up having to spend more time staring at a computer screen than looking into a patient’s eyes. The day-to-day pressures on physicians’ time and attention remain daunting. Still, Epstein remains confident that mindfulness will be part of the solution. “Doctors who learn mindful practice feel differently about themselves. They learn that by making small choices, they can be more present—to attend to their patients and to themselves.” By finding the space to reflect, physicians can reconnect with the impulses of caring and compassion that led them into medicine in the first place. 56 mindful April 2018 health care