How burned-out doctors can rediscover their inner healer
In part, it's a case of 'physician, heal thyself'. Mindfulness programmes are being incorporated into medical training to help health care professionals, whose increasingly heavy workload is leading to more burnout and blunders.
That's why the University of Hong Kong organised an eight-week pilot programme for medical students last summer and followed up with a two-day camp for health workers last month led by Michael Krasner, an associate professor in clinical medicine from the University of Rochester in New York state, who has conducted mindfulness training for health professionals in the US for more than a decade.
Such training is designed to give doctors and other health professionals a chance to decompress and review their roles as healers when endless streams of patients make them lose sight of meaning of their work, Krasner says. Many become emotionally exhausted and lose their sense of empathy and accomplishment.
'They never have time to reflect on how they are helping people as healers,' Krasner says. 'They just get through the day and are glad to get home ... still intact. Burnout has become a big issue among doctors.'
Chan Li-chong, chair professor of HKU's pathology department, says the current medical model is broken as burned-out doctors tend to treat patients as objects instead of human beings with emotions and feelings.
'Instead of labelling a patient as diabetic and saying goodbye, a doctor should listen to a patient and understand his suffering. Mindfulness can help doctors regain their strength and compassion. A good doctor should be highly skilled, up to date with knowledge but, at the end, humane and caring.
The training benefits doctors-in-waiting, too. For the pilot scheme, students took part in exercises including meditation, yoga, body scan (when participants focus on how energy courses through different parts of their body) and narrative medicine (when they reflect and write about a challenging theme such as patients' suffering).
'Students come with a lot of negative baggage. Instead of thinking about what they are eating, they think what they do after the meal or worry about upcoming exams. They are missing out on the wonderful experiences of life that are unfolding around them. We teach students to enjoy simple things day to day,' Chan says.
Ryan Ho Chi-wai is among the 18 medical students who signed up for the experience last year. Now in his second year, Ho says he was already feeling the pressure when he first joined up. 'I knew that medicine is more stressful than other disciplines. But the heavy workload made me exhausted,' he says. 'I didn't tell my parents about my stress as I didn't want them to worry. I lost motivation to study and just went through the motions. But the course gave me a chance to reflect.
'I now pay more attention to my inner self. I've continued with the exercises after the course and do mindful walking. Walking barefoot on the floor, I feel every step, the cold tiles and the texture on the surface. My life was always in a hurry before, whether sprinting to a lecture theatre or rushing to meet friends. I have learned to slow down and appreciate the moment.'
Of course, there's more to mindfulness than learning to stop and smell the coffee.
Simple gestures such as a few seconds' meditation on the wards and listening to patients can lead to closer rapport with them and better medical outcomes, Krasner says.
'When walking into a patient's room, doctors can grab a door handle and meditate for three seconds. They touch the door handle and feel it. The little contact can help them be present for whatever they are going to walk into.' He adds that by giving themselves little reminders and 'simply listening to what the patients have to say, doctors can discover things they don't even know to ask'.
If the emphasis on meditation and reflection makes the doctors' training seem a little mystical, Krasner says. 'Health care is itself a spiritual pursuit.
'Spiritual elements, like dealing with questions of life and death and illness, are very present.'