Mindfulness Training Improves Physician Performance
Douglas Ziedonis, MD, MPH
The Physicians Foundation awarded a grant to the University of Massachusetts Medical School in 2014 to launch an innovative physician leadership program focused on physician mindfulness. Douglas Ziedonis, MD, MPH, Professor and Chairman in the Department of Psychiatry at UMass Medical School & UMass Memorial Health Care, Director and developer of the Mindful Physician Leadership Program (MPLP), discusses the program and how it’s helping physicians utilize mindfulness approaches in their lives, practices, and leadership roles.
Q: Please tell us a bit about the grant and how it was utilized.
A: Through the grant from the Physicians Foundation, we established the Mindful Physician Leadership Program (MPLP) in collaboration with our team of mindfulness and leadership experts, including MPLP co-leader and the Institute for Mindful Leadership Founder, Janice Marturano, whose book, Finding the Space to Lead, provided a foundation for the curriculum.
MPLP offered 50 practicing physician leaders in Massachusetts the opportunity to join a community of their peers in learning mindful approaches (e.g., formal meditation practices, purposeful pauses, and reflections) to better address real-world leadership situations, stressors and successes in today’s rapidly changing healthcare environment. The 12-month MPLP, including a one-day retreat, six webinars, and 10 monthly small group meetings, helped physician leaders create more space to lead by enhancing the four leadership fundamentals of focus, clarity, creativity, and compassion. The outcomes demonstrated strong engagement and retention, improvements in personal mindfulness practices and skills, as well as leadership competencies. Many examples of profound changes were shared by program participants.
Q: Why is your physician leadership project important in today’s healthcare environment?
A: Healthcare is undergoing tremendous transformation due to healthcare reform, exploding technology, consumer scrutiny, and new discoveries. Over-scheduling and overworking has increased stress, physician burn-out, and disengagement while decreasing compassion and overall wellness amongst physicians. Physician leaders have limited time to reflect, be in the present moment, and let their natural skills, compassion, and creativity emerge.
As a testament to the need for this initiative, the MPLP was immediately filled to capacity. The program was credited with helping physician leaders enhance their personal, team, and organizational presence – a necessary skillset to lead in this volatile, uncertain, complex, and ambiguous (VUCA) time.
Physicians in the MPLP reported many personal benefits at home and work, which helped them to feel more connected to their patients and colleagues. Their increasing interest in mindfulness was largely attributed to both their positive personal experience with the practice as well as their recognition of the growing evidence-based literature supporting the role of mindfulness-based interventions in improving health outcomes and influencing corresponding neurobiological changes. Physicians in MPLP started to integrate mindfulness-based interventions in their own clinical work, including making more referrals to mindfulness training programs and supports. Several physicians even shared that this resulted in improvement in patient satisfaction.
Q: How has this program helped to re-engage physicians and inspire physician leadership?
A: Physicians in the MPLP shared many stories about how the program changed their lives, re-engaged them in their work, and inspired their leadership. Multi-tasking had become the norm. It was overwhelming physicians and increasing their sense of feeling disconnected from their colleagues and patients. Many reported being able to integrate the purposeful pauses throughout their day, which helped them to be more present and engaged. They shared that their colleagues, staff, and patients were noticing that something was different and that they felt better heard. Moreover, the physicians felt that creating even small spaces in their days made a big difference in their leadership focus and creativity.
Almost all physicians who participated in exit interviews reported how influential this year-long program was on their personal well-being in terms of increasing their sense of awareness, presence, and focus, especially with their families and colleagues. Many reported how the MPLP positively impacted their clinical abilities by enhancing their ability to focus and listen while being more present and compassionate. They described being better able to handle the high-stress atmosphere, the occasional tension with colleagues, and to stay attentive in the moment.
Mindfulness appears to be one of the helpful antidotes to the VUCA healthcare world and provided many of the physicians with a way to be more present, less self-critical and more open to new perspectives. Physicians also recognized mindfulness as a way to enhance the quality of their lives, which influences their roles as clinicians and leaders.
This training ultimately provided the groundwork for physicians to begin supporting more long-term and larger-scale systematic change. As a result of this program, there is a strong interest by many to continue to participate in this year’s new advanced track in the MPLP which includes more mindfulness training and mindful coaching.
Q: How have physicians implemented MPLP’s four leadership fundamentals (focus, clarity, creativity, and compassion) into their practice setting?
A: The MPLP helped physicians improve their self-awareness, emotional intelligence, empathy, communication skills, and leadership presence in areas that most other leadership training programs do not target. By bringing attention to the four leadership fundamentals (focus, clarity, creativity, and compassion) described well in Janice Marturano’s book, we observed that physicians quickly agreed these were important skills for their lives, clinical work, and leadership. Enhancing the four fundamentals resulted in both small and large changes in their practice setting and compared to baseline, participants were rated as being more compassionate and attentive with increased productivity, clarity, and overall leadership competence at the end of the 12 months.
Some physicians made a big impact on the broader systemic change in their organizations. For example, some described how they engaged patients in applying mindfulness-based practices (including training patients to do mindfulness exercises and use mindfulness resources during wait-time at office visits), changed work flow and patient flow structure, hired new staff with more wellness/mindfulness expertise, and even changed physical location of the organization to better accommodate mindfulness integration. MPLP physicians have taken wonderful small and large steps in enhancing their capacity to influence their lives, the quality of care they provide, the work of their teams and organizations, all while paving the way for the future of healthcare. We look forward to repeating the program and offering an advanced track.