8
|
SUMMER 2017
SUMMER 2017
|
9
A
s a psychiatrist, department chair,
spouse and parent, SBH’s Dr.
Lizica Troneci has become increasingly
mindful of the effects of stress and
burnout. Dr. Troneci started to raise
the issue and discuss interventions at
her departmental meetings, at times by
suggesting that participants take a few
minutes of quiet time to meditate or take
in their surroundings.
“Some enjoy it, and yet some are clearly
uncomfortable, sitting on the edge of
their seat waiting for those minutes to
end,” says Dr. Troneci, chair of SBH’s
Department of Psychiatry. “It’s as if they’re
saying, ‘I don’t have time for this.’”
At a time when fatigue, burnout and lack
of self-satisfaction are growing concerns
within the physician community, research
into meditation and mindfulness has
shown important physical and mental
benefits. What is mindfulness? UCLA
Mindful Awareness Research Center
defines mindful awareness as “paying
attention to present moment experiences
with openness, curiosity, and a willingness
to be with what is . . . It invites us to stop,
breathe, observe, and connect with one’s
inner experience.”
Leading advocates of the mindfulness
technique argue that by learning to pay
attention to each moment, physicians
can ease burnout, reduce stress, enhance
attention and concentration, grow self-
awareness and emotional regulation
skills, and improve both the quality
and quantity of the attention clinicians
give to their patients. According to
a narrative review in the Journal of
Clinical Medicine, “Mindful efforts
to improve the healthcare culture and
develop personal support systems can
help physicians become more resilient
and provide higher quality patient care.”
Recognizing the increased personal and
professional demands and expectations
of its employees, SBH started offering
hospital clinicians and staff free, weekly
30-minute meditation sessions. The goal
is two-fold: to offer staff additional skills
to cope with stress and pressure and, by
experiencing the benefits, have them help
promote meditation and mindfulness to
patients once the hospital’s Bronx Center
for Healthy Communities opens in 2019.
“The rate of physician burnout continues
to increase as the demands continue
Meditation, Mindfulness Can Reduce
Physician Burnout
Studies support benefits of mediation and mindfulness for physician well-being
By Steven Clark
DOC TO DOC
to increase,” says Dr. Troneci. “While
the electronic medical record, for
example, has made sharing information
readily and efficiently available, it also
has contributed to burnout by further
isolating us and restricting human
interaction. Everything is so rushed
today, and pressure from insurance
companies, regulatory and licensing
agencies, all adds to a busier, more
stressful day.
“Mindfulness meditation helps us
become more centered, caring and
empathic by teaching us to become
more conscious of the present moment.
We can only give as much as we have.
In addition, how can we promote these
techniques to our patients if we have not
experienced their benefits?”
A new book, “Attending: Medicine,
Mindfulness and Humanity” examines
the problem of physician burnout and
champions the benefits of meditation
and mindfulness. “Even the most
compassionate doctors are being
pressured to see more patients, do
more paperwork, and juggle more
responsibilities every single day,”
writes the author, Dr. Ronald Epstein,
professor of Family Medicine, Psychiatry,
Oncology and Medicine at the University
of Rochester School of Medicine
and Dentistry. “Not only are those
requirements exhausting, but they are
also socially isolating.”
He goes on to write, “Burned-out
physicians are more likely to take
shortcuts, make diagnostic errors, and
prescribe recklessly. They order too
many tests and refer more, just because
it takes too much effort to think through
problems themselves.”
While in agreement with Dr. Epstein’s
findings, Dr. Troneci appreciates the
challenges of teaching and practicing
meditation and mindfulness to
physicians while not making it yet
another task. This is why she strongly
believes that rather than feel pressure
to incorporate meditation mindfulness
per se, physicians could adopt the
techniques that work for them. For
example: “pay attention to your breath,
the sky, the trees, and the smell of
freshly trimmed grass as you walk
through the campus; decide not to play
the radio while driving and simply be
with yourself; at the end of the workday,
try to remember the day’s activities
and congratulate yourself for the
accomplishments.”
Physical Brain Changes
A recent study by Massachusetts General
Hospital and Harvard Medical School
found that meditation can physically
change the brain. Researchers found that
long-time meditators have an increased
amount of gray matter in the auditory
and sensory cortex and the frontal
cortex, which is associated with working
memory and executive decision making.
While it has been well-documented
that the cortex shrinks in size as one
ages, they discovered that 50-year-old
meditators had the same amount of gray
matter as healthy 25-year-olds.
Additionally, researchers found
thickening in five regions of the brain
among those in the group who had
completed eight weeks of meditation.
This included the posterior cingulate,
which is involved in mind wandering
and self-reliance; the left hippocampus,
which assists in learning, cognition,
memory, and emotional regulation;
the temporo-parietal junction, which
“Researchers found that
long-time meditators have
an increased amount of
gray matter in the auditory
and sensory cortex and
the frontal cortex, which
is associated with working
memory and executive
decision making.”
