13 Other—secular—health systems are increasingly appointing “chief empathy officers,” directors of “the patient experience,” and others in similar roles to focus on enhancing trust, communication, and healing relationships.
14 See K. B. Schwartz, “A Patient’s Story,” Boston Globe Magazine, 1995, 16; and Schwartz Center for Compassionate Healthcare, http://www.theschwartzcenter.org, for further information about the foundation.
15 B. A. Lown and C. F. Manning, “The Schwartz Center Rounds: Evaluation of an Interdisciplinary Approach to Enhancing Patient-Centered Communication, Teamwork, and Provider Support,” Academic Medicine 85(6) (2010): 1073–81.
16 Monash University, the largest medical school in Australia, and the University of Rochester, where I work, have been the pioneers. At Rochester, we offer five required mindful practice workshops in the third year of medical school. We also offer four- and five-day workshops for practicing physicians and educators who wish to develop their skills further. For information about Rochester’s mindful practice programs, see www.mindfulpractice.urmc.edu. Here are a few sample websites for programs that promote well-being in clinicians: http://www.medicine.virginia.edu/administration/faculty/faculty-dev/copy_of_home-page; http://www.ohsu.edu/xd/education/schools/school-of-medicine/gme-cme/gme/resident-fellow-wellness-program/index.cfm; http://www.tfme.org/regional-conferences/physician-well-being-conference; and http://www.mayo.edu/research/centers-programs/physician-well-being-program/overview. For general information about mindfulness and medical education, see P. L. Dobkin and T. A. Hutchinson, “Teaching Mindfulness in Medical School: Where Are We Now and Where Are We Going,” Medical Education 47(8) (2013): 768–79.
APPENDIX: ATTENTION PRACTICE
1 R. M. Epstein, “Mindful Practice,” JAMA 282(9) (1999): 833–39.
2 One accessible guide to different meditation practices for psychotherapists is S. M. Pollak, T. Pedulla, and R. D. Siegel, Sitting Together: Essential Skills for Mindfulness-Based Psychotherapy (New York: Guilford Press, 2014). For audio files from our programs, please go to https://www.urmc.rochester.edu/family-medicine/mindful-practice/curricula-materials/audios.aspx. On the Web, guided meditations can be found at http://www.mindfulness-solution.com/DownloadMeditations.html and https://www.tarabrach.com/guided-meditations. For shorter meditations, try http://marc.ucla.edu/body.cfm?id=22. A popular app for beginning meditators is “Headspace”—compelling and entertaining.
Reference List
Abramson, L. Y., M. E. Seligman, and J. D. Teasdale. “Learned Helplessness in Humans: Critique and Reformulation.” Journal of Abnormal Psychology 87(1) (1978): 49–74.
Adams, J. R., G. Elwyn, F. Legare, and D. L. Frosch. “Communicating with Physicians about Medical Decisions: A Reluctance to Disagree.” Archives of Internal Medicine 172(15) (2012): 1184–86.
Allen, T. J., J. W. Sherman, F. R. Conrey, and S. J. Stroessner. “Stereotype Strength and Attentional Bias: Preference for Confirming versus Disconfirming Information Depends on Processing Capacity.” Journal of Experimental Social Psychology 45(5) (2009): 1081–87.
Aristotle. The Nicomachean Ethics, trans. David Ross. Revised with an introduction and notes by Lesley Brown. New York: Oxford University Press, 2009.
Austin, J. H. Zen and the Brain: Toward an Understanding of Meditation and Consciousness. Cambridge, MA: MIT Press, 1998.
Baars, B. J., T. Z. Ramsoy, and S. Laureys. “Brain, Conscious Experience and the Observing Self.” Trends in Neurosciences 26(12) (2003): 671–75.
Babbott, S., L. B. Manwell, R. Brown, E. Montague, E. Williams, M. Schwartz, E. Hess, and M. Linzer. “Electronic Medical Records and Physician Stress in Primary Care: Results from the Memo Study.” Journal of the American Medical Informatics Association 21(e1) (2014): e100–e106.
Bachman, K. H., and D. K. Freeborn. “HMO Physicians’ Use of Referrals.” Social Science & Medicine 48(4) (1999): 547–57.
Back, A. L., S. M. Bauer-Wu, C. H. Rushton, and J. Halifax. “Compassionate Silence in the Patient-Clinician Encounter: A Contemplative Approach.” Journal of Palliative Medicine 12(12) (2009): 1113–17.
Back, A. L., C. H. Rushton, A. W. Kaszniak, and J. S. Halifax. “ ‘Why Are We Doing This?’: Clinician Helplessness in the Face of Suffering.” Journal of Palliative Medicine 18(1) (2015): 26–30.
Baker, D. B., R. Day, and E. Salas. “Teamwork as an Essential Component of High-Reliability Organizations.” Health Services Research 41(4, pt. 2) (2006): 1576–98.
Balint, M. The Doctor, His Patient, and the Illness. New York: International Universities Press, 1957.
Banaji, M., and A. Greenwald. Blindspot: Hidden Biases of Good People. New York: Delacorte Press, 2013.
Barks, C. The Essential Rumi. London: Castle Books, 1997.
Baron, R. J. “An Introduction to Medical Phenomenology: I Can’t Hear You While I’m Listening.” Annals of Internal Medicine 103(4) (1985): 606–11.
Bartels, J. “Eloquent Silences: A Musical and Lexical Analysis of Conversation between Oncologists and Their Patients.” Patient Education & Counseling (forthcoming, 2016).
Bartz, J. A., J. Zaki, N. Bolger, E. Hollander, N. N. Ludwig, A. Kolevzon, and K. N. Ochsner. “Oxytocin Selectively Improves Empathic Accuracy.” Psychological Science 21(10) (2010): 1426–28.
Bassler, D., J. W. Busse, P. J. Karanicolas, and G. H. Guyatt. “Evidence-Based Medicine Targets the Individual Patient. Part 2: Guides and Tools for Individual Decision-Making.” ACP Journal Club 149(1) (2008): 2.
Batchelor, S. Buddhism without Beliefs: A Contemporary Guide to Awakening. New York: Riverhead Books, 1997.
Batson, D. C. “These Things Called Empathy: Eight Related but Distinct Phenomena.” In The Social Neuroscience of Empathy, edited by J. Decety and W. Ickes, chap. 1, 3–15. Denver, CO: Bradford, 2009.
Baumgarten, E. “Curiosity as a Moral Virtue.” International Journal of Applied Philosophy 15(2) (2001): 23–42.
Beach, M. C., D. Roter, P. T. Korthuis, R. M. Epstein, V. Sharp, N. Ratanawongsa, J. Cohn, et al. “A Multicenter Study of Physician Mindfulness and Health Care Quality.” Annals of Family Medicine 11(5) (2013): 421–28.
Beckman, H. B., K. M. Markakis, A. L. Suchman, and R. M. Frankel. “The Doctor-Patient Relationship and Malpractice: Lessons from Plaintiff Depositions.” Archives of Internal Medicine 154(12) (1994): 1365–70.
Beckman, H. B., M. Wendland, C. Mooney, M. S. Krasner, T. E. Quill, A. L. Suchman, and R. M. Epstein. “The Impact of a Program in Mindful Communication Primary Care Physicians.” Academic Medicine 87(6) (2012): 1–5.
Bereiter, C., and M. Scardamalia. Surpassing Ourselves: An Inquiry into the Nature and Implications of Expertise. Chicago: Open Court Publishing, 1993.
Berger, J. E., and R. L. Boyle Jr. “How to Avoid the High Costs of Physician Turnover.” Medical Group Management Journal 39(6) (1991): 80–82.
Berlyne, D. E. “Novelty and Curiosity as Determinants of Exploratory Behaviour.” British Journal of Psychiatry 41(1–2) (1950): 68–80.
Berry, D. L., D. J. Wilkie, C. R. J. Thomas, and P. Fortner. “Clinicians Communicating with Patients Experiencing Cancer Pain.” Cancer Investigation 21(3) (2003): 374–81.
Berwick, D. M., T. W. Nolan, and J. Whittington. “The Triple Aim: Care, Health, and Cost.” Health Affairs 27(3) (2008): 759–69.
Bilek, E., M. Ruf, A. Schafer, C. Akdeniz, V. D. Calhoun, C. Schmahl, C. Demanuele, et al. “Information Flow between Interacting Human Brains: Identification, Validation, and Relationship to Social Expertise.” Proceedings of the National Academy of Sciences 112(16) (2015): 5207–12.
Bodenheimer, T., and C. Sinsky. “From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider.” Annals of Family Medicine 12(6) (2014): 573–76.
Borrell-Carrió, F. “The Depth of a Smile.” Medical Encounter 15(2) (2000): 13–14.
Borrell-Carrió, F., and R. M. Epstein. “Preventing Errors in Clinical Practice: A Call for Self-Awareness.” Annals of Family Medicine
2(4) (2004): 310–16.
Brewer, A., and K. Garrison. “The Posterior Cingulate Cortex as a Plausible Mechanistic Target of Meditation: Findings from Neuroimaging.” Annals of the New York Academy of Sciences 1307(1) (2014): 19–27.
Brown, K. W., and R. M. Ryan. “The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being.” Journal of Personality and Social Psychology 84(4) (2003): 822–48.
Buber, M. I and Thou. New York: Scribner, 1970.
Buchbinder, S. B., M. Wilson, C. F. Melick, and N. R. Powe. “Estimates of Costs of Primary Care Physician Turnover.” American Journal of Managed Care 5(11) (1999): 1431–38.
Burgess, D. J. “Are Providers More Likely to Contribute to Healthcare Disparities under High Levels of Cognitive Load? How Features of the Healthcare Setting May Lead to Biases in Medical Decision Making.” Medical Decision Making 30(2) (2010): 246–57.
Burgess, D. J., S. S. Fu, and M. van Ryn. “Why Do Providers Contribute to Disparities and What Can Be Done about It?” Journal of General Internal Medicine 19(11) (2004): 1154–59.
Candib, L. M. “Working with Suffering.” Patient Education & Counseling 48(1) (2002): 43–50.
Caspi, A., and B. W. Roberts. “Personality Development across the Life Course: The Argument for Change and Continuity.” Psychological Inquiry 12(2) (2001): 49–66.
Cassell, E. J. “Diagnosing Suffering: A Perspective.” Annals of Internal Medicine 131(7) (1999): 531–34.
——— . The Nature of Suffering and the Goals of Medicine.” New England Journal of Medicine 306(11) (1982): 639–45.
——— . “The Phenomenon of Suffering and Its Relationship to Pain.” In Handbook of Phenomenology and Medicine, edited by S. K. Toombs, 371–90. Dordrecht, Netherlands: Kluewer Academic Publishers, 2001.
Catlin, A., C. Armigo, D. Volat, E. Vale, M. A. Hadley, W. Gong, R. Bassir, and K. Anderson. “Conscientious Objection: A Potential Neonatal Nursing Response to Care Orders That Cause Suffering at the End of Life? Study of a Concept.” Neonatal Network—Journal of Neonatal Nursing 27(2) (2008): 101–8.
Chabris, C., and D. Simons. The Invisible Gorilla: How Our Intuitions Deceive Us. New York: Crown, 2011.
Charlin, B., H. P. Boshuizen, E. J. Custers, and P. J. Feltovich. “Scripts and Clinical Reasoning.” Medical Education 41(12) (2007): 1178–84.
Charon, R. “Narrative Medicine: Form, Function, and Ethics.” Annals of Internal Medicine 134(1) (2001): 83–87.
——— . Narrative Medicine: Honoring the Stories of Illness. London: Oxford University Press, 2006.
Chatel-Goldman J., J. L. Schwartz, C. Jutten, and M. Congedo. “Non-Local Mind from the Perspective of Social Cognition.” Frontiers in Human Neuroscience 7 (2013): 107.
Cheng, Y., C.-Y. Yang, C.-P. Lin, P.-L. Lee, and J. Decety. “The Perception of Pain in Others Suppresses Somatosensory Oscillations: A Magnetoencephalography Study.” NeuroImage 40(4) (2008): 1833–40.
Chou, C. M., K. Kellom, and J. A. Shea. “Attitudes and Habits of Highly Humanistic Physicians.” Academic Medicine 89(9) (2014): 1252–58.
Cicchetti, D., and F. A. Rogosch. “Gene × Environment Interaction and Resilience: Effects of Child Maltreatment and Serotonin, Corticotropin Releasing Hormone, Dopamine, and Oxytocin Genes.” Development and Psychopathology 24(2) (2012): 411–27.
Clance, P. R. The Impostor Phenomenon: When Success Makes You Feel Like a Fake. New York: Bantam Books, 1986.
Connelly, J. “Being in the Present Moment: Developing the Capacity for Mindfulness in Medicine.” Academic Medicine 74(4) (1999): 420–24.
Connelly, J. E. “The Guest House (Commentary).” Academic Medicine 83(6) (2008): 588–89.
——— . “Narrative Possibilities: Using Mindfulness in Clinical Practice.” Perspectives in Biology and Medicine 48(1) (2005): 84–94.
Cooperrider, D. L., and D. Whitney. Appreciative Inquiry: A Positive Revolution in Change. San Francisco: Berrett-Koehler, 2005.
Corbetta, M., and G. L. Shulman. “Control of Goal-Directed and Stimulus-Driven Attention in the Brain.” Nature Reviews Neuroscience 3(3) (2002): 201–15.
Costa, P. T., and R. R. McCrae. “NEO PI-R: Professional Manual, Revised Neo Personality Inventory (NEO PI-R), and Neo Five-Factor Inventory (NEO-FFI).” Odessa, FL: Psychological Assessment Resources, 1992.
Coulehan, J. “Compassionate Solidarity: Suffering, Poetry, and Medicine.” Perspectives in Biology and Medicine 52(4) (2009): 585–603.
Coulehan, J. L. “Tenderness and Steadiness: Emotions in Medical Practice.” Literature and Medicine 14(2) (1995): 222–36.
Croskerry, P. “Clinical Cognition and Diagnostic Error: Applications of a Dual Process Model of Reasoning.” Advances in Health Sciences Education 14(1) (2009): 27–35.
——— . “Context Is Everything or How Could I Have Been That Stupid?” Healthcare Quarterly 12 (2009): e171–e76.
——— . “From Mindless to Mindful Practice—Cognitive Bias and Clinical Decision Making.” New England Journal of Medicine 368(26) (2013): 2445–48.
——— . “The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them.” Academic Medicine 78(8) (2003): 775–80.
——— . “A Universal Model of Diagnostic Reasoning.” Academic Medicine 84(8) (2009): 1022–28.
Croskerry, P., A. A. Abbass, and A. W. Wu. “How Doctors Feel: Affective Issues in Patients’ Safety.” Lancet 372(9645) (2008): 1205–6.
Croskerry, P., and G. R. Nimmo. “Better Clinical Decision Making and Reducing Diagnostic Error.” Journal of the Royal College of Physicians of Edinburgh 41(2) (2011): 155–62.
Croskerry, P., and G. Norman. “Overconfidence in Clinical Decision Making.” American Journal of Medicine 121(5) (2008): S24–S29.
Damasio, A. R. Descartes’ Error: Emotion, Reason, and the Human Brain. New York: G. P. Putnam’s Sons, 1994.
——— . The Feeling of What Happens: Body and Emotion in the Making of Consciousness. New York: Harcourt Brace, 1999.
Darley, J. M., and C. D. Batson. “ ‘From Jerusalem to Jericho’: A Study of Situation and Dispositional Variables in Helping Behavior.” Journal of Personality and Social Psychology 27(1) (1973): 100–108.
Davidson, R. J. “Anterior Cerebral Asymmetry and the Nature of Emotion.” Brain and Cognition 20(1) (1992): 125–51.
Davidson, R. J., J. Kabat-Zinn, J. Schumacher, M. Rosenkranz, D. Muller, S. F. Santorelli, F. Urbanowski, et al. “Alterations in Brain and Immune Function Produced by Mindfulness Meditation.” Psychosomatic Medicine 65(4) (2003): 564–70.
Davidson, R. J., and A. W. Kaszniak. “Conceptual and Methodological Issues in Research on Mindfulness and Meditation.” American Psychologist 70(7) (2015): 581–92.
Decety, J., and C. Lamm. “Empathy Versus Personal Distress: Recent Evidence from Social Neuroscience.” In The Social Neuroscience of Empathy, edited by J. Decety and W. Ickes, chap. 15, 199–213. Denver, CO: Bradford, 2009.
Decety, J., C. Y. Yang, and Y. Cheng. “Physicians Down-Regulate Their Pain Empathy Response: An Event-Related Brain Potential Study.” NeuroImage 50(4) (2010): 1676–82.
Deci, E. L., and R. M. Ryan. Intrinsic Motivation and Self-Determination in Human Behavior. New York: Plenum Press, 1985.
De Dreu, C. K. “Oxytocin Modulates Cooperation within and Competition between Groups: An Integrative Review and Research Agenda.” Hormones and Behavior 61(3) (2012): 419–28.
De Jaegher, H., and E. Di Paolo. “Participatory Sense-Making: An Enactive Approach to Social Cognition.” Phenomenology and the Cognitive Sciences 6(4) (2007): 485–507.
de Vignemont, F., and T. Singer. “The Empathic Brain: How, When and Why?” Trends in Cognitive Sciences 10(10) (2006): 435–41.
Dewey, J. Experience and Nature. New York: Dover, 1958.
DeYoung, C. G., D. Cicchetti, F. A. Rogosch, J. R. Gray, M. Eastman, and E. L. Grigorenko. “Sources of Cognitive Exploration: Genetic Variation in the Prefrontal
Dopamine System Predicts Openness/Intellect.” Journal of Research in Personality 45(4) (2011): 364–71.
Dimsdale, J. E. “Reflections on the Impact of Antihypertensive Medications on Mood, Sedation, and Neuropsychologic Functioning.” Archives of Internal Medicine 152(1) (1992): 35–39.
Dixon, C. A. J., C. N. E. Tompkins, V. L. Allgar, and N. M. J. Wright. “Abusive Behaviour Experienced by Primary Care Receptionists: A Cross-Sectional Survey.” Family Practice 21(2) (2004): 137–39.
Dobkin, P. L., and T. A. Hutchinson. “Teaching Mindfulness in Medical School: Where Are We Now and Where Are We Going.” Medical Education 47(8) (2013): 768–79.
Dovidio, J. F., K. Kawakami, C. Johnson, B. Johnson, and A. Howard. “On the Nature of Prejudice: Automatic and Controlled Processes.” Journal of Experimental Social Psychology 33(5) (1997): 510–40.
Drew, T., M. L. Vo, and J. M. Wolfe. “The Invisible Gorilla Strikes Again: Sustained Inattentional Blindness in Expert Observers.” Psychological Science 24(9) (2013): 1848–53.
Dreyfus, H. L. On the Internet (Thinking in Action). New York: Routledge, 2001.
Dyche, L., and R. M. Epstein. “Curiosity and Medical Education.” Medical Education 45(7) (2011): 663–68.
Dyrbye, L. N., F. S. Massie, A. Eacker, W. Harper, D. Power, S. J. Durning, M. R. Thomas, et al. “Relationship between Burnout and Professional Conduct and Attitudes among US Medical Students.” JAMA 304(11) (2010): 1173–80.
Dyrbye, L. N., M. R. Thomas, F. S. Massie, D. V. Power, A. Eacker, W. Harper, S. Durning, et al. “Burnout and Suicidal Ideation among US Medical Students.” Annals of Internal Medicine 149(5) (2008): 334–41.
Dyrbye, L. N., P. Varkey, S. L. Boone, D. V. Satele, J. A. Sloan, and T. D. Shanafelt. “Physician Satisfaction and Burnout at Different Career Stages.” Mayo Clinic Proceedings 88(12) (2013): 1358–67.
Dyrbye, L. N., C. P. West, D. Satele, S. Boone, L. Tan, J. Sloan, and T. D. Shanafelt. “Burnout among US Medical Students, Residents, and Early Career Physicians Relative to the General US Population.” Academic Medicine 89(3) (2014): 443–51.
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