How physicians draw satisfaction and overcome barriers in their practices: “It sustains me”

Branch, William T.; Weil, Amy; Gilligan, Mary Ann; Litzelman, Debra K.; Hafler, Janet P.; Plews-Ogan, Margaret; Rider, Elizabeth A.; Osterberg, Lars; Dunne, Dana; Derse, Arthur R.; Pittman, John R.; Frankel, Richard M.

doi:10.1016/j.pec.2017.06.004

Cited by 32 publications

(38 citation statements)

References 57 publications

(86 reference statements)

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“…Because it highlighted discordances between individual physicians’ goals to build therapeutic relationships with their patients, and prevailing system barriers and bureaucratic requirements, the study suggests the need for transforming organizational culture to make it more sustaining of humanistic practice. Strategies to reinforce the humanistic and relational aspects of care and their alignment with an organization’s values 12 , 23 , 27 , 38 , 39 , 41 , 42 , 44 – 46 are needed if an organizational culture of humanism is to flourish. 43 , 47 – 49 …”

Section: Discussionmentioning

confidence: 99%

Healthcare at the Crossroads: The Need to Shape an Organizational Culture of Humanistic Teaching and Practice

et al. 2018

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BackgroundChanges in the organization of medical practice have impeded humanistic practice and resulted in widespread physician burnout and dissatisfaction.ObjectiveTo identify organizational factors that promote or inhibit humanistic practice of medicine by faculty physicians.DesignFrom January 1, 2015, through December 31, 2016, faculty from eight US medical schools were asked to write reflectively on two open-ended questions regarding institutional-level motivators and impediments to humanistic practice and teaching within their organizations.ParticipantsSixty eight of the 92 (74%) study participants who received the survey provided written responses. All subjects who were sent the survey had participated in a year-long small-group faculty development program to enhance humanistic practice and teaching. As humanistic leaders, subjects should have insights into motivating and inhibiting factors.ApproachParticipants’ responses were analyzed using the constant comparative method.Key ResultsMotivators included an organizational culture that enhances humanism, which we judged to be the overarching theme. Related themes included leadership supportive of humanistic practice, responsibility to role model humanism, organized activities that promote humanism, and practice structures that facilitate humanism. Impediments included top down organizational culture that inhibits humanism, along with related themes of non-supportive leadership, time and bureaucratic pressures, and non-facilitative practice structures.ConclusionsWhile healthcare has evolved rapidly, efforts to counteract the negative effects of changes in organizational and practice environments have largely focused on cultivating humanistic attributes in individuals. Our findings suggest that change at the organizational level is at least equally important. Physicians in our study described the characteristics of an organizational culture that supports and embraces humanism. We offer suggestions for organizational change that keep humanistic and compassionate patient care as its central focus.Electronic supplementary materialThe online version of this article (10.1007/s11606-018-4470-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Healthcare at the Crossroads: The Need to Shape an Organizational Culture of Humanistic Teaching and Practice

et al. 2018

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“…While bio-psycho-social-spiritual models of patient care have been described [ 22 , 23 ], implementing such models in clinical practice remains a challenge. Recognized challenges include time constraints, work-related and personal stress, organizational culture, and episodic burnout [ 24 ]. Burnout impairs the quality of patient care through clinician detachment from their work [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…The humanistic behaviours and attitudes reported by clinicians in our study helped them feel connected to patients and their families, and to learners. This research adds to the discourse around the notion that humanism may reduce burnout and enhance patient care through helping clinicians find meaning in their work and fostering resilience [ 24 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

How clinicians integrate humanism in their clinical workplace—‘Just trying to put myself in their human being shoes’

Ordons¹,

J²,

Rosenal³

et al. 2018

Perspect Med Educ

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IntroductionHumanism has been identified as an important contributor to patient care and physician wellness; however, what humanism means in the context of medicine has been limited by opinion and a focus on personal characteristics. Our aim was to describe attitudes and behaviours that enable clinicians to integrate humanism within the clinical setting.MethodsWe conducted semi-structured individual interviews with ten clinical faculty to explore how they enact and experience humanism in patient care and clinical teaching. Interpretive description was used to analyze the data qualitatively.ResultsHumanism in medicine was described through five themes representing core attitudes and behaviours: whole person care, valuing, perspective-taking, recognizing universality, and relational focus. Whole person care involved recognizing the multiple dimensions of personhood and sensitivity to others’ needs; valuing involved respecting and appreciating others; perspective-taking consisted of considering others’ perspectives, suspending judgment, and listening; recognizing universality involved acknowledging the shared human condition, finding common ground, transcending roles, and humility; and relational focus was described through multiple relationships between patients, families, clinicians and learners, becoming part of another’s story, reciprocal influence, and accompaniment.ConclusionsWhereas previous descriptions of humanism have focused on clinicians’ personal qualities, our research describes a number of attitudinal and behavioural foundations of humanistic care and teaching, grounded in the experiences of clinical faculty. In drawing attention to the holistic and relational elements of humanism, our work highlights how these foundational elements can be more explicitly integrated into patient care, workplace culture, and clinical education.

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“…8 In addition, Branch et al have reported on the interconnectedness of organizational and personal domains in building and maintaining well-being among health-care professionals. 9 A growing body of literature demonstrates that mindfulness-based interventions, including mind-body medicine skills, support the well-being of health-care professionals. 10 Mindfulness practices such as meditation are known to balance the autonomic nervous system and promote neurophysiologic changes in the hypothalamic-pituitary axis that among other effects also enhance focus and calm.…”

Section: Introductionmentioning

confidence: 99%

Mindful Opportunity to Reflect on Experience: Interdisciplinary Mind–Body Medicine Skills Training for Health-care Professionals

Barnhill

Gerkin

Moura

et al. 2020

Glob Adv Health Med

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Interventions that support employee wellness and resilience hold potential to improve patient care, increase staff engagement, and decrease burnout. This repeat-measures study evaluated whether an abbreviated version of mind-body medicine skills training could decrease stress and improve mindfulness among an interdisciplinary cohort of health-care professionals. The study also assessed whether participants incorporated the mind-body medicine skills into their personal and professional lives. Aggregate results from this unpaired cohort showed decreased stress and increased mindfulness. Postcourse surveys demonstrated increased personal and professional use of mind-body medicine skills. There was high favorability among participants. These preliminary results suggest that a modest investment of time and resources to learn mind-body medicine skills may positively affect employee wellness among health-care professionals. In addition, skills learned could translate into improved patient care and increased staff engagement. Further study with larger cohorts and a paired design is needed.

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How physicians draw satisfaction and overcome barriers in their practices: “It sustains me”

Abstract: Fostering fully mature professional development among physicians will require new skills and opportunities that reinforce time-honored values while simultaneously partnering with others to nurture, sustain and improve patient care by addressing system issues.

Cited by 32 publications

References 57 publications

Healthcare at the Crossroads: The Need to Shape an Organizational Culture of Humanistic Teaching and Practice

Healthcare at the Crossroads: The Need to Shape an Organizational Culture of Humanistic Teaching and Practice

How clinicians integrate humanism in their clinical workplace—‘Just trying to put myself in their human being shoes’

Mindful Opportunity to Reflect on Experience: Interdisciplinary Mind–Body Medicine Skills Training for Health-care Professionals

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