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Introduction to Mindfulness for Physicians

Teaser: 

D'Arcy Little MD CCFP FCFP FRCPC,

D’Arcy Little, MD, CCFP, FCFP, FRCPC, Medical Director, Journal of Current Clinical Care and www.healthplexus.net Radiologist, Orillia Soldiers’ Memorial Hospital, Assistant Professor, Department of Medical Imaging cross-appointed to Department of Family and Community Medicine, University of Toronto, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract:
This article was modelled after the Mindfulness Research Symposium and Retreat at the University of Toronto* in partnership with monastics from Plum Village, France, January 2026, the monastery of the famous Vietnamese Buddhist monk, Thich Nhat Hanh. (See Figure 1)
Mindfulness, the practice of bringing non-judgmental awareness to the present moment, has emerged as a significant intervention for addressing physician burnout, enhancing clinical decision-making, and improving patient-provider relationships. This article synthesizes teachings from contemplative traditions with contemporary neuroscience to provide physicians with practical, evidence-informed techniques for cultivating present-moment awareness. Drawing on symposium presentations by experienced practitioners, we explore the foundational elements of mindfulness practice, including breath awareness, body scanning, emotional regulation, and the integration of mindful awareness into daily clinical activities. The article emphasizes that mindfulness is not an additional task to be accomplished but rather a quality of attention that can transform routine activities into opportunities for restoration and insight. *https://www.newcollege.utoronto.ca/events/mindfulness-research-symposium/



Key Words: mindfulness, present-moment awareness, physician burnout, decision-making.
1. Mindfulness is non-judgmental awareness of present-moment experience, distinct from relaxation or concentration techniques.
2. The breath serves as an ideal anchor for practice because it is always available, reflects emotional state, and can be attended to discretely.
3. Difficult emotions, when met with acceptance rather than resistance, tend to resolve within 90 seconds; rumination extends suffering.
4. Integration into clinical workflow requires no additional time; it transforms the quality of attention brought to existing activities.
5. Self-compassion is not self-indulgence; it is a prerequisite for sustainable compassionate care of others.
The 90-Second Emotion Rule: Difficult emotions like anger naturally resolve within 90 seconds if you don’t resist them. Suffering extends beyond this only through rumination. Allow the emotion, then consciously choose whether to continue engaging with it.
Transform Transitions into Micro-Resets: Use existing clinical moments—handwashing, walking between rooms, waiting for the EMR—for brief breath awareness. Even a single conscious breath during these transitions helps reset your presence.
Self-Compassion as Professional Responsibility: Self-care isn’t optional; it’s essential for sustainable patient care. When your inner critic says “I’m not good enough,” recognize this as a passing thought, not truth—it’s one aspect of your experience, not your totality.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Radiology, mindfulness, present-moment awareness, Physician burnout, decision-making
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Adverse Childhood Experiences and Chronic Low Back Pain

Teaser: 

Kelachi Nsitem, MSc (Clin Epi), MD Candidate,1 Sean D Christie, MD, FRCSC,2

1McMaster University, Class of 2028
2Head, Division of Neurosurgery and Sustainability Leader, Dalhousie University and Nova Scotia Health.


CLINICAL TOOLS

Abstract: While adverse childhood experiences (ACE) is a risk for chronic pain broadly, their specific association with chronic low back pain (cLBP) and recommended management remains unclear. We conducted a systematic review and demonstrated substantial heterogeneity reflecting methodological variability and inconsistent results. However, there was moderate evidence that increasing number of ACE and emotional abuse was associated with cLBP. This suggests a need for an individualized biopsychosocial approach to management with best practice of a trauma informed approach.
Key Words: low back pain, chronic pain, adverse childhood experiences, childhood adversity, systematic review, meta-analysis.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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Pre-test CME Quiz Post-test CME Quiz
Adverse childhood experiences (ACE) are any preventable act that results in harm, or potential for harm to a child. ACE include but are not limited to, direct acts or witnessing of various forms of abuse, including physical, mental, emotional and sexual
ACE is a risk factor for chronic pain and our systematic review demonstrate moderate evidence that increasing ACE and emotional abuse specifically
A holistic biopsychosocial approach is critical in the management of chronic low back pain CLBP in the setting of ACE
Consider assessing for ACEs in the management of CLBP, especially if there is failure of a biomedical focused approach.
Patients with ACE are at risk for further harm and it is recommended that a trauma informed care approach should be used.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, low back pain, chronic pain, adverse childhood experiences, childhood adversity, systematic review, meta-analysis

Founier’s Gangrene: A Rare Life Threatening Story

Teaser: 

1William J. Watson, MSc, MD, CCFP, FCFP, 2D'Arcy Little MD CCFP FCFP FRCPC,

1Staff Physician (Retired), Honorary Consultant, Family Medicine, St. Michael’s Hospital, Associate Professor Emeritus, Department of Family and Community Medicine and the Dalla Lana School of Public Health, University of Toronto. 2Medical Director, Journal of Current Clinical Care and www.healthplexus.net Radiologist, Orillia Soldiers’ Memorial Hospital, Assistant Professor, Department of Medical Imaging cross-appointed to Department of Family and Community Medicine, University of Toronto, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract:
A 45-year-old diabetic male developed Fournier’s gangrene requiring emergency surgery. His infectious disease specialist noted his rapid recovery was partly attributable to preserved antibiotic susceptibility from years of judicious prescribing by his family physician who avoided unnecessary antibiotics. This case highlights antibiotic stewardship’s critical role in maintaining treatment effectiveness for life-threatening infections.

Key Words: Fournier’s gangrene, antibiotic stewardship, necrotizing fasciitis, antibiotic resistance.
Fournier’s gangrene is a rapidly progressive necrotizing infection of the genitals and perineum with 40-50% mortality requiring emergency surgical debridement and broad-spectrum antibiotics.
The patient’s preserved antibiotic susceptibility, resulting from years of avoided unnecessary antibiotic use, contributed to his rapid recovery from this life-threatening infection.
CT imaging is the preferred diagnostic modality, detecting subcutaneous emphysema in soft tissues, though clinical diagnosis should never delay urgent surgical intervention.
Risk factors include diabetes mellitus, immunocompromise, alcohol misuse, and SGLT-2 inhibitor use, with early recognition being crucial to reducing mortality.
Time is tissue: Fournier’s gangrene progresses at 2-3 cm per hour—immediate surgical debridement is lifesaving and should never be delayed for imaging when clinical diagnosis is evident.
Antibiotic stewardship saves lives: Preserving antibiotic effectiveness through judicious prescribing for minor viral infections maintains therapeutic options for critical infections requiring immediate broad-spectrum coverage.
High index of suspicion: Scrotal or perineal pain with systemic toxicity (fever, tachycardia, hypotension) in diabetic or immunocompromised patients warrants urgent evaluation—systemic signs may be disproportionate to local findings.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Radiology, Fournier’s gangrene, antibiotic stewardship, necrotizing fasciitis, antibiotic resistance
Disclaimer: 
Disclaimer at the end of each page