Mindful Practice in Medicine – University of Rochester School of Medicine
By John A. Patterson, MD, MSPH, FAAFP, ABIHM
Founding co-chair LMS Physician Wellness Program
The Mindful Practice in Medicine program at the University of Rochester School of Medicine is the premier international training program for mindfulness-based approaches to physician well-being and clinical practice.
Mindful Practice in Medicine is described as 1) the capacity for lowering one’s own reactivity (paying attention to experiences without reacting to them), 2) the ability to notice and observe sensations, thoughts and feelings even though they may be unpleasant, 3) acting with awareness and intention (not being on auto-pilot, knee jerk reactivity) and 4) focusing on experience, not the labels or judgments we apply to them (feeling an emotion rather than wondering if it is OK to feel that emotion).
Mindful Practice in Medicine develops qualities of exemplary clinicians in medical students, residents and practicing physicians. These qualities include-
Attentive observation– Observing without making judgments that distort or diminish one’s understanding. This involves monitoring one’s own biases, thoughts and emotions.
Critical curiosity– By opening up to possibilities in each moment and with each patient, rather than premature closure and discarding disconfirming data, we avoid jumping to conclusions and making snap judgments.
Informed flexibility (“Beginner’s mind”)– Addressing the mind’s tendency to take only one perspective on a problem. By allowing a continually fresh perspective and taking more than one perspective simultaneously, more diagnostic and therapeutic options open up.
Presence– Involves “being there” physically, mentally and emotionally for patients, and accurately communicating an understanding of the patient’s concerns and feelings back to them (empathy and mindful communication). Narratives are shared about success at intentionally, mindfully “being there” in a noisy, fast paced, stressful clinical environment. Those speaking and listening in such narratives can experience increased confidence, self-efficacy, control and choice as internal antidotes to the stress of medical education and medical practice.
These skills can enhance the quality of life and decrease perceived stress in medical learners and practicing physicians. They can increase diagnostic accuracy and reduce medical errors while increasing the quality of care and the quality of caring. Mindful Practice in Medicine helps physicians increase self-awareness, resilience and well-being, while improving relationships with patients and colleagues.
Mindful Practice in Medicine programs include interactive presentations, workshops, and seminars for physicians, physicians-in-training and medical educators. They are built on a strong bio-psychosocial foundation and utilize narrative medicine, appreciative inquiry and mindfulness meditation to develop a capacity for personal and professional mindfulness.
Mindfulness is a naturally occurring human capacity, not just restricted to meditation or other “mindfulness-based” interventions such as mindfulness-based stress reduction (MBSR) or mindfulness-based cognitive therapy (MBCT). Mindfulness can be cultivated through various means including meditative exercises, physical activity, narrative, dialogue, poetry, and music. Learners are encouraged to find their own methods for cultivating mindfulness in their daily lives.
Ron Epstein MD is co-director of Mindful Practice in Medicine. His 1999 JAMA article, titled “Mindful Practice,” is a seminal publication in the field of mindfulness and self-awareness in medicine. He is also the author of Attending (Medicine, Mindfulness and Humanity) (2017), a book written for doctors, patients and their families. It highlights the importance of mindfulness in the caring and healing provided by exemplary physicians. Co-director Mick Krasner MD demonstrated enhanced empathy and diminished burnout in primary care physicians participating in a Mindfulness Based Stress Reduction (MBSR) intervention. Epstein and Krasner co-created Mindful Practice in Medicine to address the educational needs of medical students, residents, medical center faculty, and community-based physicians. They then began offering similar programs nationally and internationally. Intensive residential workshops are offered twice yearly. These retreat-like immersions promote compassion and healing for oneself and for others. The personal and professional impact is potentially life-changing and life-saving for physicians, as well as those they love and those they serve.
1) Mindful Practice in Medicine, University of Rochester School of Medicine
2) Epstein, RM. Mindful Practice. JAMA. 1999;282(9):833-839
3) Epstein, RM. Attending (Medicine, Mindfulness and Humanity), Simon and Schuster (2017)
4) Krasner, MS, 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
About the Author-
Dr. Patterson is a certified graduate of Mindful Practice in Medicine. He co-chairs the Lexington Medical Society’s Physician Wellness Commission, is past president of the Kentucky Academy of Family Physicians, is board certified in family medicine and integrative holistic medicine and is a certified Physician Coach. He teaches Mindfulness-Based Stress Reduction for the UK Health and Wellness Program and Saybrook College of Integrative Medicine and Health Sciences (Pasadena) and is senior faculty for the Center for Mind Body Medicine (Washington DC). He operates Mind Body Studio in Lexington, where he offers mindfulness-based individual consultations and group classes, specializing in stress-related chronic conditions and burnout prevention for health professionals, educators, non-profits, faith communities and businesses, . He can be reached through his website at www.mindbodystudio.org