Flourishing in Medicine: From Surviving to Thriving explores ways that health professionals- physicians, nurses and nurse practitioners, physician assistants, mental health providers, therapists, and others- can truly flourish in the complex and challenging world of health care.
The ability for physicians and other health professionals to practice high quality care and attain professio ...
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Our guest today is Helen Riess, M.D. is Chief Scientist and Chairman of Empathetics. Dr. Riess is Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of the Empathy and Relational Science Program at Massachusetts General Hospital. In addition, Dr. Riess is the author of The Empathy Effect and a core member of the Consortium for Research on Emotional Intelligence in Organizations (CREIO) and faculty of the Harvard Macy Institute. Dr. Riess is a psychiatrist who developed an empathy training approach based on research in the neurobiology and physiology of empathy that has been rigorously tested in pilot studies and a randomized, controlled trial at MGH. She completed her residency and Chief Residency at MGH and Harvard Medical School. Dr. Riess has devoted her career to teaching and research in the art and science of the patient-doctor relationship. Dr. Riess received her M.D. from Boston University School of Medicine and her B.A. From Wesleyan University. In this conversation Dr. Riess shared the influence of her family's experiences as refugees from war-torn Europe, which sensitized her to trauma and resilience. Her interest in psychiatry began during medical school when she was drawn to understanding the mind and healing through narrative and empathy. While a small percentage of people lack the neural mechanisms for empathy, for most, empathy is a mutable trait influenced by their environment and mental state, and burnout among healthcare professionals diminishes their capacity for empathy, not because empathy is inherently harmful, but due to the overwhelming demands and flawed systems they work within. To address this, Dr. Riess speaks of the importance self-regulation and self-care skills, recognizing the human needs of healthcare workers, and creating supportive, empathetic organizational cultures. Helen discusses four pillars of what she describes as institutional resilience- supporting healthcare workers with safe environments, caring communication, community cohesion, and mental health normalization. The personal anecdotes she shared illustrate the profound impact of empathetic interactions, both professionally and personally, and the importance of meaningful connections for self-care and fulfillment, all reflections of her infectious passion and inspiration as well as her deep humanity. Guest: Helen Reiss MD Chief Scientist and Chairperson of Empathetics, Director, and Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of the Empathy and Relational Science Program at Massachusetts General Hospital LinkedIn Page: https://www.linkedin.com/in/helen-riess/ Website for Empathetics: https://www.empathetics.com/ Resources/References: Dr. Riess’ TEDX Talk: https://www.youtube.com/watch?v=baHrcC8B4WM The Empathy Effect: https://rb.gy/96awc2 The Consortium for Research on Emotional Intelligence in Organizations (CREIO): https://eiconsortium.org/ Riess, Helen. Institutional Resilience: The Foundation for Individual Resilience, Especially During COVID-19. Glob Adv Health Med. 2021 Apr 6;10:21649561211006728. doi: 10.1177/21649561211006728. PMID: 33889440; PMCID: PMC8040559. About Heinz Kohut and Self-Psychology: https://en.wikipedia.org/wiki/Self_psychology
The guest for this podcast Ellen Langer, PhD, Professor of Psychology at Harvard University, a Fellow of The Sloan Foundation; The American Psychological Association, the American Psychological Society, The American Association for the Advancement of Science; Computers and Society; The Society for the Psychological Study of Social Issues; The Society of Experimental Social Psychologists. She has been awarded a Guggenheim and the Liberty Science Genius Award among many others. In addition to her many honors, she has been a guest lecturer in Japan, Malaysia, Germany, and Argentina. Langer has had a significant influence on the positive psychology movement. Along with being known as the “mother of positive psychology” her contributions to the study of mindfulness have earned her the moniker of the "mother of mindfulness." Her work helped to presage mind/body medicine, which has been regarded by many scientists to be an important intellectual movement and one that now has "considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment." She has co-authored experimental research indicating a connection between time perception and wound healing. She has published over 200 articles and academic texts, was published in The New York Times, and discussed her works on Good Morning America. Additionally, in many introductory psychology courses at universities across the United States, her studies are required reading. She is the author of numerous books including her most recent one, The Mindful Body. In this conversation, a rich exploration unfolds of the intersection between mindfulness and healthcare, beginning with Dr. Langer’s personal journey into health studies, catalyzed by a miraculous recovery in their family. This narrative weaves through the profound influence of the mind-body connection, drawing on examples like the "Counterclockwise Study" to underscore the potential for psychological factors to significantly impact physical health. She advocates for a healthcare approach that recognizes the unity of mind and body, emphasizes the importance of mindfulness beyond meditation, and addresses the dynamic nature of health with a flexible, engaged attitude towards patient care. The discussion also highlights the challenges of conventional medicine's problem-focused approach, proposing a shift towards leveraging patients' strengths and capacities through mindful observation to variability. By illustrating how mindfulness can transform both personal experiences and professional practices, the conversation champions a healthcare paradigm that values meaningful connections and fosters an environment of non-judgment and safety, suggesting a communal shift towards a more mindful, holistic view of health and well-being. Guest: Ellen Langer, PhD Professor of Psychology, Harvard University Faculty Profile: https://scholar.harvard.edu/langer/home Website: https://www.ellenlanger.me/ LinkedIn Page: https://www.linkedin.com/in/ellenjlanger/ Book titles by Dr. Langer: see https://www.ellenlanger.me/home#book-s
This episode’s guest, Dr. Gail Gazelle, with 25 years as a practicing internist and hospice physician, combines practical, evidence-based strategies with her extensive medical and mindfulness expertise. She is a recognized figure in the media, featured in outlets like CNN, NPR, Oprah Magazine, and has been published twice in the New England Journal of Medicine as well as other leading medical journals. Her latest book, “Mindful MD: 6 Ways Mindfulness Restores Your Autonomy and Cures Healthcare Burnout,” underscores her significant contributions to wellness. Utilizing mindfulness to become the master of the mind, she shares the keys to reducing reactivity, decreasing burnout, and restoring the true autonomy that we can all retain. Using dozens of real-life stories, she helps readers see that they don’t have to hand over their happiness to a complex and dysfunctional healthcare system. In this podcast Dr. Gazelle shares insights into her work addressing physician burnout and fostering flourishing. Reflecting on her own journey, she discusses her initial interest in end-of-life care, shaped by complex family experiences. The conversation explores burnout roots in medical training, discussing self-critical thoughts, perfectionism, and the imposter syndrome among physicians. Dr. Gazelle advocates for mindfulness as a key tool in regaining autonomy, reconnecting with purpose, and challenging negative thought patterns. She introduces a coaching model incorporating mindfulness to help physicians find meaning and acknowledge positives, emphasizing individual empowerment and systemic healthcare challenges. Gail defines mindfulness in terms of awareness and mind training. In addressing health professional burnout, she stresses the need to focus on present moment experiences and work with what is-how things actually are- accepting the current state in healthcare as lived reality as an honest and workable starting point for transformation. She also explores the impact of stories in our professional lives, differentiating between helpful stories that add meaning and purpose to our work and unhelpful narratives that keep us stuck with an unrealistic and unworkable view of ourselves and our situations. Finally, the conversation touches on the transformative power of flourishing in healthcare, both as a recipient of healthcare and as a provider of care to others. Guest: Gail Gazelle, MD Website: www.gailgazelle.com Email: drgazelle@gailgazelle.com LinkedIn: @gailgazelle Facebook: facebook.com/groups/539466187211003 X: @gailgazellemd Other resources: Mindful MD: 6 Ways Restores Your Autonomy and Cures Healthcare Burnout- available at Amazon and free chapter download available at Dr. Gazelle’s website. Other resources available on Dr. Gazelle’s website: The Daily Dose of Calm; Imposter Syndrome Guide; Everyday Resilience Book; Leading in a Time of Crisis; and 10 Steps to Avoid Physician Burnout 3 Minute Guided Meditation with Dr. Mick Krasner
This episode continues an investigation of medical education that began with last episode’s interview with Dr. Bonvin, now with a 4th Year Medical Student, Malayna Hocker, who shares her journey into medicine as a career and evolution as a teacher. Initially resistant to the idea of pursuing medicine due to negative childhood experiences in hospitals, she explored various paths but eventually found her way back to medicine through teaching. Inspired by her love for science and a desire to serve the community, Before entering medical school Malayna taught in challenging environments, facing issues like student violence and family difficulties. As she navigated this non-traditional path to medical school, Malayna's teaching experiences continued to shape her perspective, as her teaching focus has evolved into an advocacy role, addressing discomfort and questioning aspects of medical culture. Malayna emphasizes the need to break the stereotypes in medicine, challenging the notion of perfection and the acceptance of toxic aspects within the profession. She believes that open conversations about challenges, doubts, and well-being are essential in reshaping the culture of medicine. Malayna also sees teaching as a means to advocate for both patients and fellow trainees, fostering a culture of empathy, understanding, and collaboration. Malayna emphasizes the need to break the cycle of isolation and shame ingrained in medical training and advocates for fostering a culture of support and openness. She believes that finding connection and breaking out of isolation are crucial for addressing burnout in the future. Malayna expresses joy in learning, helping patients live the lives they want, and engaging in teaching. She highlights the importance of maintaining one's personhood and finding fulfillment both in and outside of the medical profession. Guest: Malayna Hocker, 4th Year Medical Student University of Rochester School of Medicine and Dentistry Other resources: America Reads Program: existing in amny institutions of higher education, this website describes the program at Arizona State University: https://communityengagement.education.asu.edu/programs/america-reads Shame in Medical Education: Bynum WE 4th, Varpio L, Lagoo J, Teunissen PW. 'I'm unworthy of being in this space': The origins of shame in medical students. Med Educ. 2021 Feb;55(2):185-197. doi: 10.1111/medu.14354. Epub 2020 Sep 13. PMID: 32790934. The Shame Conversation: A short documentary film created by Dr. Will Bynum depicting conversations about experiences with shame in healthcare. https://www.theshamespace.com/film
This episode’s guest is Dr. Raphäel Bonvin, Vice President of Education, Section of Medicine at Université de Fribourg - Universität Freiburg and Professor of Medical Education, Fribourg, Switzerland. Raphäel discusses his journey into medicine, highlighting his initial interest in physics, biochemistry, and medicine, ultimately choosing medicine for its humanistic dimension. His early training in traditional Chinese medicine and parallel training in acupuncture and homeopathic medicine influenced his decision to continue his studies, as he recognized early on a disconnect between how he was being taught and the educational elements and approaches necessary to become a skilled physician. His interest in this topic deepened, and through a series of events, his career path turned toward a central focus on medical education. He has been an influential and effective leader in shifting the focus of assessments in medical education from knowledge-centric assessments to a system of formative assessments, ones that are designed as truly learning tools, and emphasizing the role of student reflection and the development of critical competencies beyond only knowledge and skills. In his work at the University of Fribourg medical school, Raphäel discusses the programmatic assessment approach in medical education, emphasizing the importance of considering multiple sources of information rather than relying solely on grades. The speaker explains the concept of measuring points as pieces of information, like how we use multiple data sources in the clinical setting such as lab data, clinical interpretation, and personal experience to influence clinical decision-making. Here, multiple data points and sources are used to provide a holistic view of a student's progress. The program aims to move away from traditional grading and focus instead on providing this assessment information openly to students, with the expectation that they reflect on those data and use them to build learning plans to address key competencies necessary to be successful as a physician, including self-awareness skills and self-care. Guest: Raphäel Bonvin MD Professor, Faculty of Medicine Vice President of Education, Section of Medicine University of Fribourg, Switzerland PHD Candidate, Maastricht University, The Netherlands Faculty Page, University of Fribourg https://www.unifr.ch/med/de/section/staff/prof/people/229455/d8dea Other resources: Bonvin R, Bayha E, Gremaud A, Blanc PA, Morand S, Charri I, Mancinetti M. Taking the Big Leap: A Case Study on Implementing Programmatic Assessment in an Undergraduate Medical Program.Educ. Sci. 2022, 12:425. https://doi.org/10.3390/educsci12070425 Rey A, Bonvin R, Cantin B. Étudiant-e-s en médecine face à la mort: chassez le spectre, il revient au galop [Medical students facing death: death is the only certainty in life]. Rev Med Suisse. 2023 Dec 20;19(855):2399-2401. French. doi: 10.53738/REVMED.2023.19.855.2399. PMID: 38117109. Walker M, Grandmaison G, Bonvin R, Mancinetti M. Pédagogie de l’incertitude en médecine [How To Teach Uncertainty Management]. Rev Med Suisse. 2023 Feb 8;19(813):264-266. French. doi: 10.53738/REVMED.2023.19.813.264. PMID: 36753342. Gustin MP, Abbiati M, Bonvin R, Gerbase MW, Baroffio A. Integrated problem-based learning versus lectures: a path analysis modelling of the relationships between educational context and learning approaches. Med Educ Online. 2018 Dec;23(1):1489690. doi: 10.1080/10872981.2018.1489690. PMID: 29966510; PMCID: PMC6041782.