A Multicenter Study of Physician Mindfulness and Health Care Quality

• DOI: 10.1370/afm.1507
• Publication Date: 2013-09-09T22:44:14Z
• Authors: M. C. Beach; D. Roter; P. T. Korthuis; R. M. Epstein; V. Sharp; N. Ratanawongsa; J. Cohn; S. Eggly; A. Sankar; R. D. Moore; S. Saha
• Keywords: Adult; Male; mindfulness; Biomedical and clinical sciences; Time Factors; Office Visits; HIV Infections; Medical and Health Sciences; 7.3 Management and decision making; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; patient-physician communication; Health Services and Systems; General & Internal Medicine; Physicians; Health Sciences; Complementary and Integrative Health; Behavioral and Social Science; Humans; Nurse Practitioners; Quality of Health Care; Physician-Patient Relations; Biomedical and Clinical Sciences; Communication; HIV; Health sciences; acquired immunodeficiency syndrome; Human society; Middle Aged; 3. Good health; Good Health and Well Being; Cross-Sectional Studies; Physician Assistants; Studies in Human Society; Patient Satisfaction; Tape Recording; HIV/AIDS; Female; Management of diseases and conditions; Self Report; Infection; Mindfulness; patient-physician relations

Mindfulness (ie, purposeful and nonjudgmental attentiveness to one's own experience, thoughts, and feelings) is associated with physician well-being. We sought to assess whether clinician self-rated mindfulness is associated with the quality of patient care.We conducted an observational study of 45 clinicians (34 physicians, 8 nurse practitioners, and 3 physician assistants) caring for patients infected with the human immunodeficiency virus (HIV) who completed the Mindful Attention Awareness Scale and 437 HIV-infected patients at 4 HIV specialty clinic sites across the United States. We measured patient-clinician communication quality with audio-recorded encounters coded using the Roter Interaction Analysis System (RIAS) and patient ratings of care.In adjusted analyses comparing clinicians with highest and lowest tertile mindfulness scores, patient visits with high-mindfulness clinicians were more likely to be characterized by a patient-centered pattern of communication (adjusted odds ratio of a patient-centered visit was 4.14; 95% CI, 1.58-10.86), in which both patients and clinicians engaged in more rapport building and discussion of psychosocial issues. Clinicians with high-mindfulness scores also displayed more positive emotional tone with patients (adjusted β = 1.17; 95% CI, 0.46-1.9). Patients were more likely to give high ratings on clinician communication (adjusted prevalence ratio [APR] = 1.48; 95% CI, 1.17-1.86) and to report high overall satisfaction (APR = 1.45; 95 CI, 1.15-1.84) with high-mindfulness clinicians. There was no association between clinician mindfulness and the amount of conversation about biomedical issues.Clinicians rating themselves as more mindful engage in more patient-centered communication and have more satisfied patients. Interventions should determine whether improving clinician mindfulness can also improve patient health outcomes.