Research 3
Mind-Body Approaches to Physician Well-Being: A Talk by Dr. Michelle Dossett
by Dr. Michelle Dossett1
1General Internal Medicine, University of California, 95816, Sacramento and USA
Cite as: Dossett, M. (2025). Mind-Body Approaches to Physician Well-Being: A Talk by Dr. Michelle Dossett. THE MIND Bulletin on Mind-Body Medicine Research, 9(3), X. X
The Scope of the Problem
Dr. Dossett began by grounding the discussion in scientific data on physician wellbeing. Burnout among physicians has been tracked for more than a decade in the United States, with rates rising significantly, especially during the COVID-19 pandemic. Surveys conducted by Dr. Tait Shanafelt and colleagues show that physician burnout peaked around 18 months into the pandemic before returning somewhat toward pre-pandemic levels. Yet, burnout remains far higher among physicians than in the general working population. Similarly, satisfaction with work-life integration is significantly lower for physicians compared to other professions.
In Europe, the picture looks remarkably similar. A systematic review of 56 studies across 41 countries found an average burnout prevalence of 43%, very close to U.S. data. These figures underscore that burnout is not confined to one country or health system, but rather represents a widespread challenge in modern medicine.
Recognizing this, the U.S. National Academy of Sciences, Engineering, and Medicine convened a working group in 2017 to conceptualize clinician well-being. Their model highlighted the complex interplay of individual factors (personal traits and skills), organizational factors (workplace structures and support), and systemic factors (societal and regulatory conditions). Burnout is not simply a matter of individual weakness but reflects multi-layered pressures that demand multi-layered responses.
Mind-Body Approaches: Why They Matter
Despite the complexity, Dr. Dossett argued that mind-body practices are a vital piece of the solution. Stress, she explained, has profound neurobiological consequences. When stress activates the amygdala, it suppresses the prefrontal cortex, impairing memory, decision-making, empathy, and self-regulation. Clinicians under stress are more likely to make errors, struggle with complex tasks, and experience cynicism and disengagement.
Mind-body practices such as meditation and yoga help restore prefrontal regulation, enhancing clarity, compassion, and self-control. Beyond the brain, stress also affects cellular biology. High stress accelerates telomere shortening—a marker of cellular aging. Studies show that medical trainees, especially interns working long hours, experience telomere loss six times greater than expected for their age. Encouragingly, meditation has been linked to increased telomerase activity, suggesting a potential buffer against stress-induced biological wear.
Evidence for these benefits is steadily accumulating. Meta-analyses of mindfulness-based interventions in physicians show moderate reductions in stress and small-to-moderate reductions in burnout. While many studies are small and short-term, the consistency of results points to real promise. Moreover, mind-body practices appear to enhance empathy, prosocial behavior, and even reduce implicit bias—factors with direct relevance to patient care and health equity.
Healing the Culture of Medicine
Dr. Dossett then turned to the cultural dimensions of medical practice. She highlighted the concept of “moral distress,” long discussed in nursing but increasingly recognized across medicine. Moral distress arises when clinicians feel unable to deliver the care they know patients need, leading to anger, guilt, and frustration. Cynthia Rushton and others have advanced the idea of “moral resilience” as an antidote—defined as the ability to sustain integrity in the face of moral complexity. Key characteristics of moral resilience—self-regulation, self-awareness, discernment—are precisely the skills cultivated through mind-body practice.
She also noted that medicine’s noble ideals—service, compassion, excellence—can become distorted under extreme demands. A relentless focus on self-sacrifice can lead to burnout, compassion fatigue, or entitlement. Practices like gratitude, mindful self-compassion, and cognitive reframing can help restore balance, allowing physicians to serve others without depleting themselves.
The SMART Program
Central to Dr. Dossett’s work has been the development and adaptation of the SMART program—Stress Management and Resiliency Training. Originally designed for patients, the program includes eight sessions teaching a wide range of tools: meditation (mindfulness, mantra, imagery, loving-kindness), yoga, breathing techniques, gratitude practices, cognitive-behavioral skills for reframing thoughts, sleep hygiene, physical activity, nutrition, humor, and social support. The breadth of approaches allows participants to find practices that resonate with them.
Beginning over a decade ago at Massachusetts General Hospital, Dr. Dossett and colleagues adapted SMART for clinicians. Sessions were shortened and spread out to accommodate busy schedules. Three pilot groups demonstrated promising outcomes: reductions in perceived stress, improvements in mental and physical health, and increased job satisfaction. Qualitative feedback highlighted the value of community, safe space, and ripple effects on patient care and personal relationships. Some physicians even reported profound changes in their lives, such as resolving marital challenges, discontinuing unnecessary medication, or approaching medical errors with greater composure and compassion.
During the pandemic, the program was further adapted for online delivery. At Mass General, 17 online groups reached more than 100 frontline clinicians in a matter of months. Despite condensed sessions, participants reported meaningful reductions in stress, distress, and loneliness, along with increased mindfulness and self-compassion.
At UC Davis, Dr. Dossett implemented a weekly online format open to multiple specialties. This version showed significant improvements in well-being, stress, resilience, and self-compassion, with many benefits persisting at six months. Importantly, two-thirds of participants continued practicing meditation or mini-relaxations months after the program, demonstrating durable uptake of skills.
Challenges and Realities
Despite these successes, challenges remain. High dropout rates are common, largely because physicians are not given protected time to participate. Those most in need often lack the bandwidth to attend. Additionally, some clinicians resist such programs, viewing them as attempts to “fix doctors” rather than fix broken systems. Dr. Dossett acknowledged these concerns but emphasized that mind-body practices are not substitutes for systemic reform. Instead, they are akin to survival gear for a climber facing harsh mountain conditions. While the weather (the system) cannot be changed instantly, having proper tools can mean the difference between despair and resilience.
Conclusion
Dr. Dossett closed by summarizing key takeaways:
- Mind-body tools reduce stress, support resilience, and enhance well-being in clinicians.
- Effect sizes vary, but evidence shows real benefits, including improved empathy, patient care, and reduced bias.
- These practices are not about fixing people, but equipping them with tools to sustain their inherent resilience while broader cultural and systemic changes evolve.
- The SMART program offers a comprehensive, evidence-based framework that has demonstrated durable impact in multiple settings.
- Challenges include high dropout rates and limited institutional support, highlighting the need for both individual and systemic solutions.
Ultimately, she argued, physician wellness requires a dual approach: systemic reforms to reduce unnecessary burdens, and personal tools to enhance adaptability and resilience. Mind-body practices are not a cure-all, but they are a valuable, evidence-based component of a broader strategy to heal clinicians and the culture of medicine itself.
With that, Dr. Dossett invited questions and discussion, leaving her audience with both scientific evidence and a vision of hope: that healing is possible not only for patients, but for those who care for them.
Acknowledgements: This article is an AI-generated summary of a presentation delivered on August 27, 2025, as part of the MBMRC Guest Lecture series. The presentation was conducted in a hybrid format and recorded; the AI generated this summary based on the audiovisual recording.