Attending: Medicine, Mindfulness, and Humanity

Epstein, a family physician and professor at the University of Rochester School of Medicine and Dentistry, expands on his landmark 1999 essay in the Journal of the American Medical Association, which called for “mindful practice” on the part of physicians. Here he makes the case for using mindful practice to save both a medical profession “in crisis” and patients who are falling victim to “the fragmentation of the health care system.” Citing examples from his own practice, Epstein shows how taking time to pay attention to patients can lead to better outcomes on both sides of the stethoscope. He writes of one woman whose deteriorating health left him feeling helpless; after her recovery, she confessed that his uncertainty was reassuring: “ ‘At least,’ she said, ‘I knew you were being honest.’ ” Being mindful, Epstein states, is “a moral choice” for physicians. He also condemns the health care system and a culture of medicine that puts “clinicians in morally compromising situations” with electronic health record systems that are “sculpted around billing rather than good patient care,” and increased pressure on doctors “to see more patients without regard to quality.” Epstein’s treatise should be required reading for physicians, and it is also of vital interest to the patients in their care. [em](Feb.) [/em]