Abstract
BackgroundPhysician burnout has significant adverse impacts on the wellbeing of individual physicians, and by extension the healthcare delivery systems of which they are part. Mindfulness is consistently cited as a pragmatic approach to effectively address burnout and enhance physician wellbeing. However, very few empirical studies have been published on Mindfulness Based Interventions (MBIs) for physicians. Moreover, the majority of these studies have been quantitative, leaving a gap in understanding the practical application of mindfulness in the context of physicians' daily lives.ObjectivesThis paper outlines the rationale, development and design of a novel prospective qualitative study examining the acceptability, feasibility, and pragmatic application of a mindfulness intervention for physician wellness.MethodsThe study will be conducted in three groups of at least 8 practicing physicians from a broad range of medical specialties at a tertiary care hospital in a large urban center in Eastern Canada. The intervention will consist of an innovative program based on the teachings of internationally renowned scholar and Zen Master Thích Nhãt Hạnh. It will include 5 weekly 2-h mindfulness sessions delivered by two health providers trained in mindfulness and in the teachings of Thich Nhat Hanh. The primary outcome measure will be an in-depth Thematic Analysis of post-program semi-structured interviews. Field data will also be collected through participant observation. The study will be theoretically grounded within the interpretive paradigm utilizing “the Mechanisms of Mindfulness Theory”. An external advisory committee formed by four senior members of Thích Nhãt Hạnh's community will provide guidance across all phases of the study.DiscussionOur innovative approach provides a new framework to further understand the mechanisms by which mindfulness interventions can impact physician wellbeing, and by extension their patients, colleagues, and broader healthcare systems. Through a clear articulation of the rigorous application of accepted procedures and standards used in our protocol, this paper seeks to provide a roadmap for other researchers who wish to develop further studies in this area. Lessons learned in the preparation and conduction of this study can be applied to other healthcare contexts including non-physician health provider wellbeing, clinical care, and population-level mental health.
Highlights
Physician wellness can positively impact the quality of patient care, frequency of medical errors, patient satisfaction and clinician professionalism [1,2,3,4,5,6,7]
The research question for this study, along with two guiding sub questions to help orient the process of analysis, are as follows: Research Question: How do physicians experience, make sense of, and engage with a 5 week Applied Mindfulness program and what is the impact of the program on their personal wellbeing in the context of their daily lives?
Studies on Mindfulness Based Interventions (MBIs) conducted with physicians, medical students and health care personnel (HCPs) show that, while there are some similarities across their experiences, there are several areas of significant differences [45,46,47,48,49]
Summary
Physician wellness can positively impact the quality of patient care, frequency of medical errors, patient satisfaction and clinician professionalism [1,2,3,4,5,6,7]. Calls have been made across the literature, and from international medical associations, for further research to be conducted on pragmatic approaches to effectively address physician burnout and enhance physician wellbeing [1, 4, 8,9,10,11]. Moderate investments spent on wellness programs have can directly reduce costs associated with medical leave and absenteeism [16, 17]. Physician burnout has significant adverse impacts on the wellbeing of individual physicians, and by extension the healthcare delivery systems of which they are part. Mindfulness is consistently cited as a pragmatic approach to effectively address burnout and enhance physician wellbeing. The majority of these studies have been quantitative, leaving a gap in understanding the practical application of mindfulness in the context of physicians’ daily lives
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