The Demystifying Physician Mindfulness Series

For many of my readers, the concept of mindfulness seems out of reach. We hear about mindfulness everywhere, but what does it mean for you? For many physicians, it can seem impractical and irrelevant. But I’ve found mindfulness to be key in helping physicians struggling with very real stressors and we now have over half a dozen studies demonstrating that mindfulness reduces physician burnout. I’ve developed this series to demystify mindfulness for you and to share bite-sized information through the stories of real-life physicians.

In each post, I’ll provide actions you can take to integrate a mindfulness approach into your practice. My goal is to transform mindfulness from an unapproachable ideal into a useful toolkit to have at your fingertips no matter the circumstances. Simply put, I want to help you be a happier, more productive version of yourself in the workplace and at home. 

Discover ways to improve your patients’ experience with the fourth installment of Demystifying Mindfulness.

Today’s Topic: Mindfulness, Patient Satisfaction, and Physician Burnout

Our physician, Dr. Q, is an emergency physician in California:

My patient satisfaction scores are in the gutter. I’ve tried everything. I’ve been shadowed by a Press Ganey auditor. I use AIDET scripts, I plaster a smile on my face and reduce myself to acting like a clerk asking, ‘Is there anything else I can help with today?’ But nothing has helped. I’m consistently in the bottom quartile of my group. This is never going to improve and it’s pushing my physician burnout through the roof!”

Dear Dr. Q,

I appreciate your honesty and humility in sharing your story. I know many physicians struggle with this same issue. It’s clear you’ve taken real steps to improve patient satisfaction, but there are a few things I’m wondering about that are likely to be helpful.

Let’s start with nonverbal language. Sometimes, no matter what we say or how we try to present ourselves, our impatience, judgments, or stresses are expressed in our body language. Ralph Waldo Emerson once said, “What you are shouts so loudly in my ears I cannot hear what you say.” Is it possible that, even though you’re saying all the right things, patients are responding to your nonverbal cues? When you go into a patient’s room, are you relaxed and receptive? Or are you holding a lot of tension, appearing rigid, or perhaps even braced for an argument? While it may seem like patients wouldn’t see all of this, they may be picking up on more than you realize.

Your body language may be the result of a busy day, a sleepless night, or other personal or professional stressors. But our body language may also relate to the judgments we make about patients. In my coaching, I see physicians get trapped by what they think are imperceptible judgments. Often, emergency physicians I’ve coached realize that, when it isn’t a code or an acute MI, there are a host of negative judgments: “Why are they wasting my time with this trivial matter?” Or they’re frustrated that the emergency room has become an access point for people seeking convenience rather than necessary care, breeding resentment: “This isn’t why I went into emergency medicine, dammit!”

Mindfulness involves cultivating a non-judgmental presence—something you can begin to practice. Simply paying attention to your thoughts and feelings is the key action step. The more you become aware of these, the more you’ll be able to leave autopilot and stressed reactivity and move into mindful response. You’ll find that you actually have more choice about your response than you may have realized. And responding mindfully gets easier with every bit of practice.

Mindfulness also involves questioning our assumptions and trying to understand the circumstances from different points of view. Let’s consider for a moment the lens of the patient sitting in front of you. Did they seek care to make your shift more difficult? Or are they here now because they’re working two jobs and finally found a moment while someone was home with the kids? The more you can look through their lens, the greater the likelihood that your patients will feel tended to and your patient satisfaction scores will improve.

Becoming curious about the patient vantage point is a helpful way to work with the judgments that make it difficult for us to actually fully attend to the person sitting in front of us. While it may sound trivial, what’s key here is to get back to the fact that there’s a suffering human being right in front of you.

Try this practical approach with patients this week:

Pay attention to the judgments that come up for you.

Pay attention to your body language, noticing as much as you can about your inner physical experience. Once you’ve done this, see if you can consciously open your body posture, even a little bit.

Make an effort to become curious about the patient’s experience. Challenge yourself to consider how a situation might look and feel through their lens.

Based on my work coaching physicians, I think you’ll be pleasantly surprised at the impact a mindful approach can have. I’d love to hear about your experience.

To your resilience,

Gail Gazelle, MD