title: A multicenter study of physician mindfulness and health care quality.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Beach
authors.forename: Debra
authors.initials: D
authors.lastname: Roter
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Epstein
authors.forename: Victoria
authors.initials: V
authors.lastname: Sharp
authors.forename: Neda
authors.initials: N
authors.lastname: Ratanawongsa
authors.forename: Jonathon
authors.initials: J
authors.lastname: Cohn
authors.forename: Susan
authors.initials: S
authors.lastname: Eggly
authors.forename: Andrea
authors.initials: A
authors.lastname: Sankar
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.forename: Somnath
authors.initials: S
authors.lastname: Saha
mesh_terms: D000328:Adult; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D009722:Nurse Practitioners / Q000523:psychology; D009819:Office Visits; D017060:Patient Satisfaction; D010823:Physician Assistants / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D057566:Self Report; D013637:Tape Recording; D013997:Time Factors
keywords: HIV; acquired immunodeficiency syndrome; mindfulness; patient-physician communication; patient-physician relations
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