Abstract
What are you thinking about as you read this? It’s a serious question. How often is your mind on what you are doing? You drive a couple of miles on a motorway and can’t remember how you did it. Or you relax at home with family, except you have no idea what anybody said or did since you were mesmerised by your mobile device. What’s really on your mind when you are taking a history or examining a patient? You are present in body, but your concentration is elsewhere.
Imagine the simple pleasures you might derive from paying attention to what’s happening around you. The sights. The sounds. The smells. The conversations. Your life might be much richer for it? Your patients might also experience better care and improved outcomes? Mindfulness is the word of the moment, in definition and fashion, and this month’s editorial explains why. 1
Mindfulness might also make you happy. It’s a straightforward logic that leads from mindfulness to contentment, and then on to better patient care. Heyhoe et al. 2 review the evidence on the role of emotion in patient safety, and find that reality, as ever, is more complex than we might imagine.
First, it is important to recognise that doctors aspire to be rational thinkers but emotion gets in the way. Our emotions influence our decision making, and the consequences may harm patients. By confronting this reality, we might provide better care. But the play of emotions depends on the individual, and being in a good mood doesn’t necessarily make for best practice. Second, doctors are emotionally affected by work, the business of life and death takes its toll, which means better support services are required for professionals. More research would help here.
For research to be free of emotion, it needs to be well conducted and reported. A group of international authors examines the complexities of conducting clinical trials in middle-income countries, where vulnerable populations are at risk of exploitation. 3 Countries like China and India, they argue, also possess affluent middle classes, which opens up the possibility of a dual model of clinical research. Trials on middle-class patients can be conducted on the same basis as they would be in richer countries, while special provisions are introduced when vulnerable populations are involved.
Whatever the study design or population, any research requires adequate reporting. 4 Doug Altman and Iveta Simera tell the history of the most mindful and unemotional revolution in medical research: the evolution of reporting guidelines.