I was drawn to this book because I'd finally found a physician who is conscious about connecting with her patients, and spends enough quality time to get to the root of a problem. I came across this book and was intrigued to find out the reality for most doctors. This is a thought-provoking, fact-filled look at the current state of the medical profession. It carefully lays out the issues that doctors face, along with effective ways to move toward a more fulfilling practice, both for the physicians and their patients.

I got about 30% of the way through this lengthy book and then stopped reading. It was very interesting as someone who is passionate about healthcare and improving the lives of both patients and doctors, but it really could have used additional editing to streamline the narrative. I felt like I got what I needed out of the book by 25% of the way through it. It is well written and provides an important perspective on mindfulness' role in healthcare and patient care, but it really needed to be streamlined.

Scribner and NetGalley provided me with an electronic copy of Attending: Medicine, Mindfulness, and Humanity. I was under no obligation to review this book and my opinion is freely given.

Attending is a book about mindfulness and medicine, changing the way that physicians think in order to provide more compassion to their patients. As health care has been more about the groundbreaking technologies than humanity, Dr. Epstein offers a way to improve the quality of care.

As a professor of Family Medicine, Psychiatry, and Oncology at the University of Rochester School of Medicine and Dentistry, Dr. Epstein directs mindful practice programs. He emphasizes the importance of attending - showing up, being present, and listening to patients. Self awareness on the part of the doctor is the key. Being able to listen to a diverse set of clues, in order to help the patient, is another. Curiosity is a skill that allows doctors an avenue through which they can engage with their patients. Applying Zen principles is an alternative, not only for physicians, but for patients as well, because achieving the emptiness of mind can provide the focus for the issue at hand.

Overall, Attending is a book that can provide useful information to medical professionals, patients, and their loved ones. Dr. Epstein gets to the heart of the matter clearly and concisely, with an honesty that is refreshing. I would recommend this book to both physicians and their patients, as I feel that all can learn valuable lessons from Dr. Ronald Epstein.

Thanks to Net Galley and to Scribner for providing me with an ARC copy of this book that I freely chose to review.
If they asked me to provide a single word review of this book, I would write AMEN.
Ronald Epstein, the author and practising doctor with his own clinic, after years of studying a variety of disciplines (including music, meditation, Philosophy, Zen, Medicine…) and of trying to find the best way to maintain a practice sensitive to the needs of patients, compassionate, focused on well-being and avoiding suffering, rather than on billing, money and the business-side of things, published an article called ‘Mindful Practice’ in 1999. The article was very well received and resulted in the author becoming a speaker and offering training to other health professionals, emphasising the important of being mindful of one’s practice. In this book, the author shares his insight and knowledge to help other physicians avoid errors, burnout, and remember what Medicine should really be about. He offers plenty of background research and information (with abundant notes that take up more than a third of the book and a useful bibliography for those who want to check the original sources) interspersed with case stories that illustrate the topics. These include cases Dr Epstein had personal experience of (both as a physician and as a patient) and others that he’s accumulated over years of educating other professionals and talking to friends and colleagues. These cases not only reinforce the theoretical points but also add a practical and personal touch that can be lost in purely theoretical texts.
The book is written in a fluid and clear style, accessible and interesting also to those who might not work in healthcare, although it is particularly geared towards health professionals. Due to the themes and subjects touched upon, this book would be useful to individuals and institutions heavily invested in helping people and dealing with the public, in particular, those offering care. Although many of the reflections are particularly pertinent to individuals, the emphasis on education and the fact that many of the qualities discussed, like compassion and resilience can be taught, are particularly important for organisations and institutions that manage human resources. As Dr Epstein explains, they would go a long way to help avoid professional burnout.
Although Attending mentions Zen, neurocognitive studies, philosophers’ books, mindfulness and meditation, the overall message does not require an in-depth knowledge of any of those subjects and I cannot imagine anybody who would not find something useful in this volume.
As a doctor and one who left the job a few years back less than enamoured with the way health care is organised, I kept nodding all the way through. I highlighted so many sentences and quotes that I cannot share them all, but I will choose a few ones that I felt were particularly pertinent:
Medicine is in crisis. Physicians and patients are disillusioned, frustrated by the fragmentation of the health care system. Patients cannot help but notice that I spend more and more time looking at computer screens and less time face-to-face. They experience the consequences of the commodification of medicine that has forced clinicians’ focus from the healing of patients to the mechanics of health care —productivity pressures, insurance regulations, actuarial tasks, and demoralizing metrics that measure what can be counted and not what really counts, sometimes ironically in the name of evidence-based and patient-centered care.
Maslach found that burnout consisted of three factors: emotional exhaustion, depersonalisation (treating people as objects), and a feeling of low personal accomplishment.
But now, in the age of the corporatization and widgetization of medicine, there is a new kind of burnout, a slow, relentless “deterioration of values, dignity, spirit and will” that comes from the structure of health care itself.
The problem is not only overwork; it’s a crisis of meaning, resilience, and community.
As I said, I think this book should be required reading for medical students, qualified doctors and also for other professionals working in healthcare and those who manage staff and organise the educational programmes of institutions, not only those providing healthcare but also any that deal with the public and its problems on a regular basis.
If I were to make a suggestion, it would be that the book could easily be made even more relevant to other disciplines by adding examples pertaining to other professions (not only nurses or paramedics but also social workers, counsellors, teachers…). It is clear from the content that although the principles can be applied individually, organisations would also do well adopting the ideals and attitudes highlighted by the research. Becoming attentive, compassionate, curious and mindful would help patients and staff increase their wellbeing and avoid burnout and complaints.
I recommend this book to all healthcare professionals, and those interested in how to improve healthcare and increase the resilience and wellbeing of staff. I think that anybody could potentially benefit from this book, and I’d recommend checking the sample if you think it might help you. I will definitely recommend it to some of my previous work colleagues.

Attending isn't necessarily a book for everyone, but I appreciated many of the ideas Dr. Epstein puts forth. I think the primary audience is anyone in a health care provider, student, or administration role. However, as a massage therapist and patient I still found the ideas relevant and eye-opening.

First, I'll say that Attending rotates between being interesting and being a bit dull. It's certainly well researched, with about 35% of the book as footnotes and references.

Dr. Epstein clearly describes the components of being a mindful physician, as well as having a mindful medical practice. Those components are qualities that anyone in the health care field can incorporate into their interactions with both patients and colleagues.

This was the point in the book where I wished I knew doctors who practiced this way. And then I considered buying copies of the book for all of the physicians I see regularly. And reading it out loud to them!

After describing the ideals of Attending, Dr. Epstein explains the reality physicians face every day. With electronic health records and productivity quotas, the structure of health care today doesn't automatically encourage a mindful approach. But that's why mindful, compassionate, and curious practices matter more than ever. Epstein makes a strong case for this approach as a method to help prevent and / or fix physician burnout.

After reading about the realities of a doctor's life, I expect to be a more compassionate and understanding patient as well. Plus, I think the Attending approach should be taught at all medical schools and conferences. It sounds like it can save the lives of patients and physicians!

Thanks to NetGalley, Scribner, and the author for a digital review copy in exchange for this honest review.

Amongst medical practitioners, Ronald Epstein, Professor of Family Medicine, Psychiatry, and Oncology at the University of Rochester, is known for contributing what is now a classic article, "Mindful Practice," to the Journal of the American Medical Association in 1999. In his new book, ATTENDING, Epstein uses anecdotes and disguised personal experiences to further discuss the habit of mindfulness in a medical setting. As I read this book, though, I was picturing the classroom and became increasingly excited about applying some of his concepts to a school environment. Consider this quote, for example:

"Falling short had little to do with knowledge and technique, but rather it had to do with my state of mind, what I noticed and attended to. Sometimes I practiced with clarity and compassion, and other times impatience, distraction, unexamined emotions, and defensiveness got in the way." OR "Attending means showing up, being present, listening ...."

I will be recommending ATTENDING to members of our learning cohort on mindfulness. I am curious to hear their reactions and to perhaps propose this as an all school read. Epstein's comments on defining and developing expertise and attention training, as well as on compassionate caring, increasing effective communication, and reducing burnout seem particularly applicable.

Related postings on mindfulness:
http://treviansbookit.blogspot.com/2016/12/stress-management.html
http://treviansbookit.blogspot.com/2017/01/look-for-these-new-non-fiction-titles.html