Mindfulness in the Emergency Department

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Volume 2, Issue 2

Jeremy Liebman, MD

Emergency Medicine is frequently identified as a specialty with a particularly high degree of physician burnout. The etiology of burnout is multifactorial – but is there any evidence for a means of combatting it?

In 2009, Dr. Michael Krasner, an Associate Professor of Clinical Medicine at the University of Rochester School of Medicine and Dentistry, published a study in JAMA that demonstrated the effectiveness of a course in mindfulness in improving measures of physician well-being, burnout, psychological distress, and capacity for relating to patients.(1) Impressively, the effects of the intervention persisted not only in the short term, but also well after the end of the course.

In the study, Krasner defines mindfulness as “the quality of being fully present and attentive in the moment during everyday activities”. Some might relate mindfulness to being “in the zone”. In Pauline Chen’s New York Times column, Doctor and Patient, Krasner elaborates, describing mindfulness as a tool that “…allows us to be in a whole host of situations with a sense of equanimity. We don’t get sucked into how charged an experience is but are simply having that experience.”(2)

How, then, can we cultivate mindfulness and apply it to our clinical practice? Dr. Krasner’s intervention prescribed a two month intensive course, followed by a ten month maintenance phase, all involving mindful meditation, narrative medicine, and appreciative inquiry.

Though it may be challenging as residents to devote quite so much time to this pursuit, stay tuned for upcoming activities that the Wellness team  will highlight that may help foster this skill.

REFERENCES

  1. Krasner MS, Epstein RM, Beckman H,  et al.  Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians.  JAMA. 2009;302(12):1284-1293
  2. Chen PW.  How mindfulness can make for better doctors.  The New York Times. 10/15/20019. http://www.nytimes.com/2009/10/15/health/15chen.html.