Smithers Lecture: Use Mindfulness to Avoid Burnout, Improve Treatment

Because of the life-and-death pressures of the job, burnout has long been a problem for physicians. Those working in fields of addiction medicine and psychiatry face the additional challenge of dealing with patients who have behavioral issues, where burnout can in turn affect treatment.

Joseph Westermeyer, MD, PhD, MPH, will address these issues when he presents the R. Brinkley Smithers Distinguished Scientist Award and Lecture, “Symmetry and Asymmetry in Addiction Medicine: The Balance Between You, Your Patient, and Your Setting.” Dr. Westermeyer will deliver his lecture during the Opening Scientific Plenary, from 8:30 to 10 am today the Grand Ballroom on the second floor of the Hilton Chicago.

“This talk is about the symmetry between us and our patients, and between us and the systems for which we work and in which we operate,” said Dr. Westermeyer, Professor of Psychiatry and Adjunct Professor of Anthropology at the University of Minnesota, and now a staff psychiatrist, and former Medical Director, of the Addictive Disorders Service at the Minneapolis VA Medical Center. “The focus will be more on the patients.”

The lecture took shape for Dr. Westermeyer as he saw an increase in physician burnout. He saw physicians quitting practice in their 40s and 50s because of issues ranging from dealing with third-party payers and licensure to treating patients with drug and alcohol addictions.

“I got to thinking about why that might be happening, why I’m not burning out at 76. I work 100 percent of the time during the 75 percent of the time while I’m in town,” he said. “I love my work; why was I not burning out?”

What Dr. Westermeyer saw was longstanding problems of dealing with behavioral problems in patients, and that is complicated by substance abuse becoming a greater societal problem, as well as institutions and third-party payers making decisions affecting physicians without consulting physicians.

“The decisions are sometimes good, sometimes bad, and sometimes terrible,” he said. “I will focus on patients, but also talk about these system issues. I want to focus on how we can tap into symmetry or asymmetry with patients using a new mindfulness approach, which is being used with patients as well as in clinicians with training.

“There is even a fair amount of research about being mindful—another term is ‘mentalizing’—about teaching patients to do that. Some clinicians may see patients who have these skills. The mindfulness leaves them with free-floating emotions or ideas, but without a concept of knowing what to do about them.”

In his lecture, Dr. Westermeyer will discuss three models to achieve mentalizing/mindfulness and channel it into interactions with patients.

“These three concepts are not only cognitive, but are also experiential,” he said. “I hope people can walk away with the ability to use at least one of them. I have been using all th three for the last 40 years, but it took several years to acquire them.”