The Mindful physiciaNtm

Mindfulness in Medicine

 












The Mindful MD

with Bill Corin, MD

Bill Corin is a cardiologist who has been practicing in Sarasota, Florida since the early 1990‘s. He is the author of numerous peer-reviewed research articles, book chapters and abstracts, and is a published photographer.

Bill was first introduced to mindfulness practice through a Mindfulness-Based Stress Reduction (MBSR) workshop and has been practicing mindfulness meditation since the early 1990's. He currently practices Vipassana Buddhist meditation with SaraSangha a meditation group in Sarasota that he co-founded.

Bill is married to Lisa. They have two sons, Daniel and Jonathan.

Physicians are generally outcome-oriented individuals. As we travailed through the pre-med years our goal was gaining acceptance into medical school. In medical school, in order to match in the program of our choice, we studied extremely hard to get the necessary grades in the pre-clinical years and on our rotations. In residency, our goal was to master both the literature and to achieve the technical skills necessary to become an excellent practicing physician. Now, as practitioners, we retain this goal orientation in our day-to-day professional lives. As I’ll share with you, this valuable trait that has served us well for many years can, at times, become an impediment to our effectiveness in the practice of medicine and overall well-being.  Mindfulness can help transform this impediment into a source of insight and relief. 


Medicine is a curious business. Patients come to us with symptoms and expect us to figure out what is causing them and to “make them go away.” Our years of training empower us with an extraordinary understanding of anatomy and physiology that contribute to our internalizing our patients’ expectations that we will indeed be able to significantly (if not completely) help mitigate their ailments and diseases.

Medicine is an outcome-based profession. A patient presents with an infection and the physician prescribes an appropriate antibiotic; the patient develops heart failure and the practitioner uses a combination of medications to relieve the symptoms; a patient with right-lower quadrant pain presents to the ER and the general surgeon removes the inflamed appendix. In each situation, both the patient and physician “expect” a successful outcome. 


But what happens when this doesn’t happen? Either because the patient is too ill, the disease cannot be cured, there is a mistake in judgment, or a complication occurs? In many cases, the doctor feels that he has failed the patient. This “failure” becomes a source of both professional and personal dissatisfaction.


Mindfulness offers an alternative perspective to view our work. There is a significant difference between the expectation of a certain outcome and an inclination or aspiration to that very same end. Using a mindful approach, our work with a patient orients us to improve her situation, but does not demand a specific result within a specified time.  This is not to say that we are able to promptly jettison this result-oriented mindset.  But, we begin to pay attention to it when it arises.  And, in so doing, we find ourselves responding differently to challenging medical situations.  


Mindfulness is an approach that enables us to meet the flow of changing conditions, embrace uncertainty, and helps us to continually adjust to new circumstances.  Rather than focusing exclusively on the outcome, we remain receptive, in an open-hearted manner, to the evolving needs of our patient. Mindfulness emphasizes the journey inclining us in a direction, but does not demand a specific outcome or result.


When we approach patient care in this manner, we can more easily adjust our course of therapy because we are focused less on the outcome and more on the process. We derive the professional satisfaction of mindfully observing our patient improve and we allow for the possibility that despite our best efforts, not all patients “get better.”  While we may not always achieve our goal, with a mindful approach we can more often experience the fulfillment of intervening to make a positive difference in the life of our patient to the best of our ability.

Finding Balance in the Shift from Outcome to Inclination