Patient Satisfaction In Healthcare, Physician Burnout, and Mindfulness

by | Sep 12, 2018 | Physician Mindfulness

Demystifying Physician Mindfulness – A Mindfulness In Medicine 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 and patient satisfaction in healthcare.

In each post, I’ll provide actions you can take to integrate a mindfulness approach into your practice to assure patient satisfaction in healthcare. 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: Patient Satisfaction In Healthcare, Physician Burnout, and Mindfulness

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

My patient satisfaction in health care 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 and patient satisfaction in healthcare 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 in healthcare 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. I hope now you will achieve a good patient satisfaction score.

To your resilience,

Gail Gazelle, MD

  1. Embrace uncertainty

When you stop and think about it, uncertainty and change are the only things that are certain. Impermanence is one of the basic laws of our world.

After all, everything changes. Our relationships change. Our kids grow up and change. Our bodies age and change. Our environments change. Our planet changes.

All too often, however, we forget this basic truth. We somehow expect things to be predictable and stable.

The problem is that this expectation sets us up for difficulty. It leaves us struggling unnecessarily when something shifts. It adds a layer of suffering above and beyond that caused by all the VUCA around us.

What I’m getting at is that we have a choice. We can meet uncertainty with reactivity or we can meet it with mindful understanding.

More than meditating on a remote mountainside, mindfulness helps us have the calm, steadiness, and clarity we need to work constructively with all the change and uncertainty.

At the same time, while we can find ourselves resisting change, we can remind ourselves that it does not have to mean something bad! Just take a moment right now to think of all the difficulties you have faced in your life and work that are now resolved and far behind you. This can help you see how change has actually been quite the positive.

  1. Respond to complexity with compassion

Even knowing that change is the only thing that is certain, it can still be difficult to weather. Living in such a VUCA time is difficult. You deserve compassion for managing all the challenges.

With mindful awareness, we can bring ourselves compassion for what we’re going through. There is increasing evidence that self-compassion is a powerful antidote to stress and even burnout. From where I sit, I think that it is actually one of the most powerful medicinals available to us.

  1. Take purposeful pauses

With mindfulness, we are aware of what is going on within and around us. We tune in and pay attention to our experience. We learn to utilize our breath to take us out of the fears, worries, stories, and preoccupations our minds are so good at generating about what might come next, and bring us back to the present moment. Here in the present, we leave that overly activated limbic state and can experience a sense of calm.

A pause also serves to allow our prefrontal cortex to come online. It creates a critically important space between our emotional response and conscious, intentional action.

Once we have paused, we can then see more clearly that fear had taken hold. 

With a pause, we become the witness of our experience as opposed to the one trapped by it.

  1. View VUCA as opportunity

I don’t know about you, but I can find myself reacting to the VUCA environment with something of a fixed mindset. With a fixed mindset, I am telling myself things like ‘it shouldn’t be this way’ and ‘why is this happening?’

When I can utilize mindful awareness, I can see that I’ve boxed myself in with a fixed mindset. I can challenge myself to grow. By grow, I mean challenging myself to see whatever difficulty I’m experiencing as an opportunity to learn.

Here again, mindfulness again throws us a lifeline. Mindful awareness involves leaning into curiosity.

I can flip the script and ask myself:

What can I learn from this experience?

How can I use this to be a better version of myself?

How can I help others cope in this VUCA environment?

What do I want to look back and see about how I acted?

In summary, while VUCA is definitely the order of the day in healthcare and beyond, you don’t have to succumb. You don’t have to live in fear. There are constructive actions you can take to help you cope with uncertainty, build calm in chaos, and even thrive in chaos and VUCA. While we can’t control much that is contributing to the VUCA time, with mindfulness we can control how we respond to it.

I hope you’ll try out these 4 mindfulness strategies as I have seen them help countless people. I’d love to hear how it goes.

_____

To learn more about how mindfulness coaching can help you cope with this VUCA time, please reach out for a complimentary consult.

6 Free Resources To Help You During COVID19 And Beyond.

  1. 14-day meditation series 
  2. Imposter No More PDF
  3. Resilience Book Chapter
  4. Leading In Crisis PDF
  5. Balance To Burnout PDF
  6. 30-minute consult

Take advantage of one or more of these valuable resources created for clinicians and non-clinicians.