Inundated. Distracted. Focused on negative experiences. Exhausted. Disengaged. If these are familiar feelings in your work life, practicing mindfulness at work may offer a different approach to support your own well-being and curb the challenges of family medicine.
Ronald M. Epstein, MD, has dedicated part of his 30-plus-year medical career to researching the connection between mindfulness and medicine. He notes that the point of mindfulness isn’t relaxation or disconnection.
“[Mindfulness] is bringing greater awareness to each of the stresses that you have at work so that you can approach them in a more creative way,” Epstein says.
He has found that mindfulness makes for better physicians, as well as improved satisfaction, patient care, and safety. In addition, mindful physicians are able to recognize and address the symptoms of burnout, such as exhaustion, depersonalization, and lack of efficacy.
Family physicians can practice mindfulness at work on three levels: personal, team, and organizational.
There are two primary practices of personal mindfulness. The first is introspective, which involves finding an activity of interest—such as yoga, meditation, or journaling—that encourages reflection and deeper connection to your mind and body. For example, “Just Like Me” is an individual practice that involves looking beyond the differences between oneself and another person to try to find at least one commonality, such as the desire to be loved and appreciated. Epstein suggests this approach as a way to deliberately set aside biases so that you can connect with patients, or even colleagues. By engaging in introspective practices habitually, you can learn more about your whole self, identifying areas of strength and areas for improvement.
The second individual practice is prompted by the small actions that you do repeatedly as part of your daily routine. For example, Epstein does one of his personal mindfulness practices each time he touches the doorknob of an exam room. This action prompts him to pause, take a deep breath, and reset his mind so that he is able to be wholly present with the patient and his or her problems and concerns. Epstein says that if he didn’t do this, and he took thoughts about other patients into the exam room, he would be distracted, inefficient, and less effective, which could result in patient dissatisfaction or harm.
Beyond practices of personal mindfulness, forming and engaging with a community—whether it’s physical or virtual—is fundamental to being mindful. Your community can provide fellowship, hold you accountable, energize you personally and professionally, and encourage a more optimistic perspective.
One way to promote team mindfulness in your practice is to have a team-building exercise in which each person recalls a time at work that affected him or her. It can be positive, like helping a patient overcome pain or sorrow, or it can be negative, like a mistake that wasn’t caught in time. During this exercise, participants should be instructed to be present and listen to the person who is sharing—no judgments, interpretations, or recommendations allowed. This practice also applies to interactions with patients because it trains the care team to listen without immediately jumping ahead to a diagnosis, treatment, or definitive outcome.
Adopting mindfulness at the organizational level allows for targeted changes in process and perspective. For example, think about how your organization starts meetings or addresses conflict. Are individuals present and open, or distracted and judgmental? Does your organization’s culture encourage looking out for each other, your patients, and the advancement of family medicine rather than pushing an individual agenda? Are the organization’s outcomes collective or divided?
One simple way to foster organizational mindfulness is starting every meeting in silence, Epstein says. Instruct participants to spend one minute putting down what’s in their hands and setting aside what’s in their minds. Then, begin the meeting focused and prepared to work together. If a conflict arises, don’t rush to adjudicate it. Instead, recognize the conflict, reflect on it, and then resolve it cooperatively.
Participation in appreciative inquiry is another way to practice mindfulness at the organizational level. In appreciative inquiry, colleagues make a point to ask each other about their strengths, capabilities, successes, and good experiences at work, as well as about their aspirations for the organization’s future. Identifying and celebrating what is working well in an organization makes it easier to build on this positive potential.
“When you have lots of people within the organization discovering good things about each other, it creates a very different spirit than an organization that’s totally problem focused,” Epstein notes.
Personal, team, and organizational mindfulness all require dedication, intention, and consistency, but the reward for putting in the effort is increased well-being, in spite of the challenges of being a family physician. For many people, practicing mindfulness at work is life changing.
“Physicians who are more mindful probably are more sustainable,” Epstein concludes. “That is, they are able to ride the waves of clinical practice with greater aplomb. They don’t capsize very easily.”
There are no shortcuts to practicing mindfulness, but if you’re willing to put in the care, attention, and commitment, it can help enhance your well-being.
Written by the AAFP editorial staff.
Ronald M. Epstein, MD, is employed by University of Rochester School of Medicine and Dentistry in Rochester, New York. Epstein allocates his time as a professor of family medicine, psychiatry, oncology, and medicine; co-director of Mindful Practice Programs; and co-director of Deans Teaching Fellowship. To learn more about mindfulness, read his newly published book, Attending.
Epstein RM. Attending: Medicine, Mindfulness, and Humanity. Scribner. 2017.
Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600–1613.