Physician Burnout & Mindfulness Training: An Approach That Works By Floyd Arthur PPT
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Transcript of Physician Burnout & Mindfulness Training: An Approach That Works By Floyd Arthur PPT
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Physician Burnout & Mindfulness Training: An Approach That Works
By Floyd Arthur
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As virtually every doctor knows, physician burnout is a growing problem in the United
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States. According to a 2015 Mayo Clinic study, over 54 percent of physicians experienced
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at least one symptom of burnout in 2014, an increase of nearly 10 percent over 2011.
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During the same period, the number of physicians who expressed dissatisfaction with
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work-life balance also grew from 41 to 48.5 percent.
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Physician Burnout and Mindfulness Training - An Approach That Works
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The reasons given for the increasing rates of physician burnout vary, but increased
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bureaucracy and regulatory demands are high on the list. According to Medscape’s 2016
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Physician Lifestyle Report, the top five causes cited by physicians are:
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* Too many bureaucratic tasks
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* Spending too many hours at work
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* Increased computerization of practice
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* Income not high enough
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* Feeling like "just a cog in the wheel”
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Maintenance of certification, the impact of the Affordable Care Act and difficult patients were next on the list.
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Issues not included in the survey that were mentioned anecdotally by many physicians
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included insurance issues, the introduction of the 10th edition of the International
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Classification of Diseases codes (ICD-10), the threat of malpractice suits and family stress.
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The Impact of Physician Burnout
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Burnout is a condition marked by emotional exhaustion (loss of enthusiasm)
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depersonalization (loss of empathy) and a low sense of personal accomplishment (loss
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of meaning and self-esteem.) Among physicians, the high rate of burnout is a serious
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public health issue with widespread effects.
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Not only are burned out physicians at higher risk for substance abuse, mental health
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issues relationship stress and suicide, they are significantly more likely to make a critical
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mistake. Additionally, many early and mid-career doctors are leaving the profession,
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citing burnout and quality-of-life issues as the cause.
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Mindfulness Training & Physician Burnout
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Decades of research demonstrate a significant correlation between mindfulness
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meditation and the reduction of stress. Additionally, several studies have shown that
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physicians who receive training in mindfulness techniques show a marked improvement
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in symptoms of burnout, quality of life measures and mood. More importantly, both
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intensive training and modified, short-term instruction have achieved similar results.
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Intensive Mindfulness Training
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In a 2009 study from the University of Rochester Medical Center, Rochester, New York,
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for example, physicians were enrolled in an intensive program of mindfulness education
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over a period of 12 months. The training involved:
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* Eight weekly 2.5 hour sessions of mindfulness training
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* One eight-hour seminar between session six and seven
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* Ten additional monthly sessions of 2.5 hours each.
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The sessions were structured into three parts:
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* A 15 minute didactic session in which specific topics were discussed. Topics included self-
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awareness, dealing with unpleasant emotions, conflict resolution, setting boundaries and self-care.
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* Mindfulness meditation involving four distinct mediation practices: guided meditation,
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silent meditation, walking meditation and body movement exercise similar to yoga.
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* Narrative and appreciative inquiry, in which physicians wrote short narratives that explored
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ways in which they successfully worked through challenging clinical situations. They then
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shared their experiences in pairs or small groups.
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At the end of the eight and 12 weeks, participants were asked to complete a series of
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surveys that measured burnout, empathy, beliefs, personality traits and mood. All of the
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physicians who completed the surveys showed a significant reduction in symptoms of
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burnout, depersonalization and negative mood states.
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Abbreviated Mindfulness Training
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In 2013, a study conducted at the School of Medicine and Public Health at the
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University of Wisconsin in Madison, Wisconsin, evaluated the effects of an abbreviated
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mindfulness training course on symptoms of burnout in 30 physicians. Participants
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attended a 14-hour weekend course (Friday evening: 3 hours; Saturday: 7 hours;
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Sunday: 4 hours) and two 2-hour evening follow up sessions. They were given access to
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audio CDs and a training website specifically designed for the course, and instructed to
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practice mindfulness meditation for 10 to 20 minutes each day.
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After completing the course, all of the participants had achieved significant reductions
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in symptoms of burnout, depression, anxiety and stress. Perhaps more importantly, the
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reductions were maintained throughout a nine-month post-training period without any
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further formal intervention.