The phone rang at 2 a.m. A patient was sick with a sinus infection and heading to the emergency room. The doctor hung up the phone and let loose a string of profanities.
Dr. J, who asked to remain anonymous to protect her reputation, was eight months pregnant with a more-than-full load of patients at her short-staffed, rural South Dakota clinic. “I was angry that this patient was sick and in the ER, and got me out of bed,” the 35-year-old doctor said.
This wasn't the first time she found herself furious with a sick patient. She was overwhelmed with work, constantly distracted and her patients were losing out. If someone came in with an earache, but tried to ask for help with weight loss, “I just didn’t care,” she said.
After the emergency room call outburst, Dr. J’s husband looked at her and told her she needed a different job. She agreed. “I was like, this is not me. Something’s got to give.”
Dr. J was one of the many doctors in the United States experiencing "burnout" -- a high level of physical, mental and emotional exhaustion that can lead to a deadly range of problems for physicians and their patients.
Nearly 40 percent of doctors experience at least one burnout symptom, according to a 2012 survey from Medscape, a medical news website. That can put them at greater risk of problems like substance abuse, depression and even suicide.
For patients, doctor burnout can be deadly. Burnt-out physicians score lower on tests measuring empathy and are more likely to make mistakes, research shows. One prominent example is Libby Zion, an 18-year-old who died in 1984 under the care of overworked residents within 24 hours of entering the emergency room. Her death sparked a movement to change laws limiting resident hours -- including provisions that prevent them from working more than 80 hours a week.
“We make medical errors, we miss important things,” said Dr. Luke Fortney, a family physician at Meriter hospital in Madison, Wis., of doctors who are burnt out.
A growing number of studies are finding a surprisingly simple solution: mindfulness. Simple schedule fixes that streamline a doctor's day and quick breathing exercises help them become more mindful -- or present -- in the moment. Mindful doctors are more apt to focus on the patient in front of them, rather than getting distracted by the next task.
“Physicians who are more mindful are actually more present with their patients; they don’t miss things, potentially life threatening things,” Fortney said.
Fortney and a group of other researchers published a paper in September showing that doctors who participated in brief mindfulness training experienced higher levels of job satisfaction, quality of life and compassion for the next nine months.
Fortney said he became interested in studying the effects of mindfulness on doctors in part because his experience with breathing exercises, yoga and meditation helped him focus on patients and distance himself from stresses, like complaints and keeping up with medical records outside of normal work hours.
Another recent study found that doctors who are more mindful tend to have more satisfied patients. Dr. Mary Catherine Beach, the lead researcher on the study, said her experience of “not being the most mindful person,” inspired her to look into the relationship between doctor mindfulness and patient satisfaction.
“It actually surprised me that there were people who say they don’t find themselves walking places and forget where they’ve been,” she said. “It is hard as a doctor, when you’re seeing patients, to not be distracted.”
Dr. J found her way to mindfulness during her maternity leave. Poking around online she found Dr. Dike Drummond, aka "The Happy M.D.", a former doctor who says he burnt out practicing medicine 11 years ago. He now helps others avoid the same fate by counseling them on the best ways to let go of stress before it wears them down, and more simple fixes -- like reorganizing their calendars to include personal time and taking a minute to breathe before seeing patients.
With Drummond’s help, Dr. J landed in a better-staffed family practice with more doctors who are available when she’s not there and who can advise her when she is.
At her new gig, Dr. J checks in twice a day with nurses to make sure she knows what to expect with each patient so she stays on schedule -- a trick she learned from Drummond. And most importantly, she takes a deep breath before entering the room to see a patient.
“The amazing thing is that those extra few moments when you are present with a patient [don't] really slow down your day, it actually makes it go smoother,” she said.
Before Drummond quit his medical practice in 1999, he had no idea that the queasiness that came with the idea of going to the office could be cured with simple fixes like those he gave Dr. J. He was scared to tell colleagues what he was feeling for fear they'd see him as weak. So he went with what appeared to be the only option available: quitting medicine for good.
"Even if you had somebody to talk to, there’s no way they could understand unless they’re a doctor, and the last person you talk to would be one of your colleagues," Drummond said. "I felt like there was only one thing I could do and that was just quit. If this 'me' could have had a cup of coffee with that 1999 'me', it would have changed my life.”