This book is phenomenal, and will be phenomenally useful to physicians and to all of us who are desperately in need of true health care and caring. It is hard for me to imagine a doctor reading it and not immediately recognizing, taking to heart, and implementing its messages in any number of different ways, being so commonsensical, clear, innately transformative, and healing. And it is equally hard for me to imagine that it will not energize all of us, when we find ourselves in the role of ‘the patient,’ to demand greater mindfulness from our care-givers across the board, and know what we mean by that.”—Jon Kabat-Zinn, author of Full Catastrophe Living and Mindfulness for Beginners
“As a student admissions committee member reviewing Ron Epstein's application to medical school, I knew he was special, a view surpassed by his visionary achievements illuminating the important nature of how physicians care for their patients, and how they can best care for themselves. Attending is the book every medical caregiver needs to strengthen their minds and harness their resilience to care for others—and every patient needs to understand how doctors think. This is a work of heart and head, a beautiful synthesis of inner wisdom and hard earned scientific empirical findings that point the way to proven methods for improving the lives of both giver and receiver of medical care. With clear explanations, captivating stories, and well-described challenges and approaches to their solutions, this book is exactly what the field of medicine needs.”—Daniel J. Siegel, M.D., author of Mind and The Mindful Brain and Executive Director, Mindsight Institute Founding Co-Director, UCLA Mindful Awareness Research Center
“I recommend Attending for anyone interested in health. In a most accessible way, Epstein makes a very convincing case for how doctors and patients would prosper from doctors becoming more mindful.”—Ellen Langer, PhD, Professor of Psychology, Harvard University, author of Mindfulness and Counterclockwise: Mindful Health and the Power of Possibility
"This powerful and inspiring book opens the pathway to bringing care, wisdom, and mindfulness into practice of medicine. A must-read for all clinicians and for lay readers as well."—Joan Halifax, PhD, author of Being With Dying
"Ronald Epstein cuts through the cacophony and illuminates the heart of the medical enterprise—the attentive and compassionate connection between doctor and patient. In a world awash with medical error, patient dissatisfaction, and burned-out doctors, this attention to mindfulness is much needed balm. Attending is at once penetrating, counterintuitive, and profoundly humbling."—Danielle Ofri, MD, PhD, author of What Patients Say, What Doctors Hear
"Attending got my attention from the opening paragraphs. Beautiful, compelling, and wise stories of how medicine and care-taking can be, (should be) when approached with common sense, a fierce sense of what is best for both the doctor and patient, and a compassionate heart. A timely and important book!"—Marc Lesser, CEO of Search Inside Yourself Leadership Institute (SIYLI) and author of Know Yourself, Forget Yourself and LESS: Accomplishing More By Doing Less
"Ronald Epstein truthfully and powerfully describes the challenging and changing worlds of both the physician and and the patient. Attending will encourage the recognition that mindfulness and compassion training contribute to effective medicine. The book clearly demonstrates how these contemplative practices can help enrich the lives of everyone involved in health care."—Sharon Salzberg, author of Lovingkindness and Real Happiness
"Epstein presents for general readers a concise guide to his view of what mindfulness is, its value, and how it is a skill that anyone can work to acquire."—Library Journal
"A deeply informed and compassionate book...[Dr. Epstein] tells us that it is a 'moral imperative' to do right by our patients. And he shows why and how."--Lloyd Sederer, New York Journal of Books
"Vivid... Epstein’s candor and courage...that makes the book so compelling."—Pharos
12/19/2016
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. (Feb.)
12/01/2016
An anxious patient and a seemingly harried health-care professional sit in a small room talking, but little real communication occurs. Epstein (family medicine, psychiatry, & oncology; codirector, mindful practice programs, Univ. of Rochester Sch. of Medicine and Dentistry) says this scenario is all too common. Skilled professionals who avoid this use the practice, in some cases unknowingly, of mindfulness. Epstein's fascination with the topic and its application began in medical school and was affected by his time at the San Francisco Zen Center. He offers numerous anecdotes, both his own and those of others, and research looking at how becoming more mindful can improve communication and help to reduce errors, burnout, debilitating worry, and guilt. Heavily footnoted chapters include descriptions of exercises to enhance mindfulness and describe the difficulty of dealing with another's suffering and of showing compassion in ways that don't become overwhelming. Finally, he provides suggestions for physicians and other caregivers to become more mindful and for health-care systems to create structures that allow for that to happen. VERDICT While focusing primarily on health-care professionals, Epstein presents for general readers a concise guide to his view of what mindfulness is, its value, and how it is a skill that anyone can work to acquire. [See Prepub Alert, 8/1/16.]—Richard Maxwell, Porter Adventist Hosp. Lib., Denver
2016-12-05
Can the encounter between doctor and patient be improved? A renowned family physician thinks so, and he explains how in this compendium of a lifetime of experience. In chapters with titles like Being Mindful, Beginner's Mind, Curiosity, Being Present, and Responding to Suffering, Epstein (Family Medicine, Psychiatry and Oncology/Univ. of Rochester School of Medicine and Dentistry) reminds us that "attending" is shorthand for the chief physician in charge of a specific case, but he also emphasizes how it describes a way of being present in the moment, sensitive to the thoughts and feelings of the patient. If that patient is suffering, the doctor must show compassion but also keep in mind the importance of avoiding burnout. Epstein contrasts this kind of attending with the hurried 15-minute encounter so common today, in which the doctor pronounces a diagnosis and a prescription while turning away to another case or the computer. Taking the time to truly engage can make all the difference in arriving at the correct diagnosis, gaining trust and compliance from the patient, and, over time, becoming a master in the field. In difficult terminal cases, for example, when the doctor hears the dreaded question, "what would you do if you were me?" it means pausing, not saying anything right away, and then asking more questions to arrive at what Epstein calls a "shared mind." Much of the meaning of "attending," as the author uses it, relates to the practice of meditation, and he offers some guidance on how to concentrate attention so the mind is not distracted or wandering. But Epstein is no spiritual preacher, and this is no New Age text. The author richly illustrates his arguments with case histories and stories of near mishaps in surgeries. Worthy reading for medical students and practitioners but also applicable to other fields: artists, writers, musicians, teachers et al. can also fall into formulaic ruts and autopilot behavior and need literally to change their minds.
