How to Begin a Meditation Practice: A Guide for Physicians

An earlier version of this article appeared on this website in July, 2024

As a cardiologist, a certified mindfulness meditation teacher, and a yoga teacher, I’ve been fortunate to learn from a diverse group of mentors, ranging from world leaders in cardiology to a former Buddhist monk.

I learned about the power of meditation early on in my professional life and found that the presence and equanimity it cultivated inspired both my medical practice and my life outside of medicine.

More recently I have had the privilege of participating in the Enhanced Stress Resilience Training (ESRT) program, originally developed for surgeons. This evidence-based and academically rigorous program was developed through the Department of Surgery at University of California San Francisco and continues to expand.

ESRT integrates mindfulness-based skills such as metacognition, emotional regulation and interoception for surgeons and other clinicians working in environments defined by high stakes, intense pressure, and constant expectations. Meditation is a key aspect of this program.

If meditation sounds a little too nebulous, out-there, or maybe even intimidating, it can help to remember that meditation is something that many of our key thought leaders practice on a daily basis. It’s not a passing trend or a fad. Mindfulness meditation has been part of modern healthcare since the 1970s, when molecular biologist Jon Kabat-Zinn, Ph.D.  founded the Mindfulness-Based Stress Reduction Clinic at the University of Massachusetts Medical School.

Meditation is not just about feeling calm. It can strengthen core clinical skills, improving your ability to focus on details and regulate emotions under stress. It may also improve your sleep quality and even contribute to better cardiovascular health.

Meditation is for all of us. You don’t need a guru or even a class. In this article, I’m sharing some simple ways that you can get started with meditation.

Start Small

Begin with just 3-5 minutes of meditation each day. Even brief practices can be surprisingly beneficial when practiced regularly. If a few minutes feels manageable, you can experiment with a 10-minute session and see how that feels.

Some people prefer longer meditations, but it’s good to know that when scientists compared 10-minute to 20-minute sessions, there was very little difference in overall mindfulness measures. Consistency matters far more than duration.

Use Guided Meditations

If you're new to meditation, guided practices can be very helpful. They provide structure, direction, and reassurance—particularly when your mind feels busy or skeptical.

Many excellent apps and online platforms offer free or low-cost sessions tailored to different needs and preferences. Some good options are Head Space, Waking Up, Insight Timer, and Calm.

Find a Quiet Space

It’s hard to meditate when there are too many external stimuli, especially when you are just starting. Although you can learn to meditate anywhere, begin by choosing a quiet, comfortable place where you are unlikely to be disturbed. If you can close a door and put your phone in do-not-disturb mode, so much the better.

Eventually you’ll be able to incorporate this sense of focus and ease into your daily life wherever you happen to find yourself.

Focus on Your Breath

One of the simplest ways to begin meditating is by focusing on the breath. Close your eyes and take slow, steady breaths in through your nose and out through your mouth.

There are many ways to work with the breath, but there’s no need to overthink it. Settle into a rhythm that feels natural. By gently returning your attention to the physical sensation of breathing, you give your mind a stable anchor.

Go for a Walk

Walking meditation is an ancient and well-established mindfulness practice.  Rather than using the breath as your anchor, you bring purposeful attention to the sensation of your feet meeting the ground.

Traditionally, walking meditation is slow and contemplative, often practiced back and forth along a short path. It’s not about getting somewhere. It can be done in the space of your living room, but there’s no reason you couldn’t use your walk from the parking lot to the hospital or office as a walking meditation.

Many meditation apps include guided walking practices. And while traditional walking meditation isn’t fast, some runners find that rhythmic, attentive running becomes meditative when they focus fully on each stride.

Be Consistent

Like anything else, getting started with meditation is a habit to be cultivated. Since briefer meditations of 5-10 minutes can be highly effective, let go of the idea that longer is better.  

You might start with a goal of three or four five-minute sessions per week and see how that feels. If you don’t notice an immediate shift, don’t be discouraged. Research suggests that eight weeks, but not four, of daily meditation can lead to measurable improvements in mood, attention, and fatigue.

Listen to Your Inner Wisdom

It’s important to know that meditation isn’t right for everyone. For instance, although many people with anxiety find meditation helpful, others may notice increased anxiety or a sense of disconnection, particularly with practices that last for more than 30 minutes.

If meditation is not right for you right now, you may find that simply taking a mindful pause can create a meaningful difference in a hectic day.

---

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.

Three Things Physicians Should Know About Meditation

An earlier version of this article appeared on the KevinMD website in November, 2o23.

Meditation is a hot topic with deep roots, but sometimes it feels like it’s being pushed as a modern-day version of snake oil for what ails the spirit.

The practice is often touted as an antidote to burnout, when in truth most of us know that a meditation app won’t solve the systemic issues that plague healthcare today. It’s no wonder that some physicians might be skeptical.

That’s why it’s exciting that academic researchers have been taking this ancient practice seriously. And they are discovering that meditation can have powerful and measurable benefits for your mental well-being, your memory, and even your physical health.

A quick search on PubMed.gov retrieves thousands of reports and peer-reviewed studies on meditation, the majority of which were published in the past 10 years. Getting a handle on the health benefits of meditation could take you down a fascinating, twisty-turny rabbit hole worthy of Alice in Wonderland.

There are many forms of meditation, but this article will focus on mindfulness meditation. This is sometimes known as Vipassana or insight meditation, although Vipassana is a more specific form of meditation that comes from the Buddhist tradition.

Mindfulness meditation is a form of meditation that focuses on being present in the current moment, slowing down your thoughts, and observing without judgement. These features make mindfulness meditation especially valuable for physicians.

Here are three things that you should know about mindfulness meditation.

Meditation may enhance your skills as a physician.

There is a broad range of research looking at the impact of meditation on neuroanatomy and neurophysiology. For physicians, the ability to focus on the details, remain present for our patients, and maintain equanimity when faced with stressful situations are especially important.

Meditation can help by

• Improving the ability of the brain to pay attention to a task

• Enhancing body awareness

• Helping you to regulate your emotions

• Increasing capacity for memory

• Boosting your sleep quality

• Improving your cardiovascular health

It may be best to meditate in the morning.

Although meditation may improve your sleep quality, there is good evidence that in the short term, mindfulness meditation can actually increase brain arousal. Why does this happen? The theory is that since meditation may help to focus the mind, this can result in heightened awareness and attention. That’s why it may be better for most people to meditate at the beginning of the day.

On the other hand, you may find that less focused forms of meditation can help you drift off to sleep. Apps like Calm and Headspace are good places to find these types of practices.

 A five-minute daily meditation can have lasting benefits

Morning might be the best time to meditate, but few of us are willing to wake up 30 minutes early just to sit quietly in a comfortable position. The good news is that a study of stressed-out mental health professionals found that a mere 5 minutes of mindfulness meditation can have important benefits.

How to get started with meditation

Getting started with meditation is easy. Counter to what you might have heard, you don’t have to escape to an ashram or travel to a tropical island to learn how to do it. I’ve written a quick-start guide to meditation for physicians that you can access here.

As a certified Mindfulness Coach, I share meditations online, along with many other excellent meditation teachers, but there are even simpler options. The Waking Up app is a fantastic resource, and includes a 30 day starter course. Insight Timer is another good choice.

As with many things, meditation isn’t for everyone. For some, it can even create mental distress. If you find that meditation provokes anxiety or agitation, it may be best to avoid it. And if you’re under the care of a mental health professional, check in with them first before beginning a meditation practice.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.

---

References:

Britton WB et al. Awakening is not a metaphor: the effects of Buddhist meditation practices on basic wakefulness. Ann N Y Acad Sci. 2014 Jan;1307:64-81.

Fox KC et al. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev. 2014 Jun;43:48-73.

Hölzel BK et al. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res. 2011 Jan 30;191(1):36-43.

Kozasa, EH et al. Meditation training increases brain efficiency in an attention task. NeuroImage, 2012 Jan; 59: 745-749,

Krittanawong C et al. Meditation and Cardiovascular Health in the US. Am J Cardiol. 2020 Sep 15;131:23-26.

Lam AG et al. Effects of Five-Minute Mindfulness Meditation on Mental Health Care Professionals. J Psychol Clin Psychiatry 2015 March; 2(3): 00076.

Levine, G. N., Lange, R. A., Bairey‐Merz, C. N., Davidson, R. J., Jamerson, K., Mehta, P. K., Michos, E. D., Norris, K., Ray, I. B., Saban, K. L., Shah, T., Stein, R., & Smith, S. C. (2017). Meditation and cardiovascular risk reduction. Journal of the American Heart Association, 6(10). https://doi.org/10.1161/jaha.117.002218

Pérez-Peña M et al. Mindfulness-Based Interventions and Body Awareness. Brain Sci. 2022 Feb 18;12(2):285.

Rusch HL et al. The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Ann N Y Acad Sci. 2019 Jun;1445(1):5-16.

Taylor, G. B., Vasquez, T. S., Kastrinos, A., Fisher, C. L., Puig, A., & Bylund, C. L. (2022). The Adverse Effects of Meditation-Interventions and Mind–Body Practices: a Systematic Review. Mindfulness, 13(8), 1839–1856. https://doi.org/10.1007/s12671-022-01915-6

Youngs MA, Lee SE, Mireku MO, Sharma D, Kramer RSS. Mindfulness Meditation Improves Visual Short-Term Memory. Psychol Rep. 2021 Aug;124(4):1673-1686. doi: 10.1177/0033294120926670. Epub 2020 May 25. PMID: 32448056; PMCID: PMC8242403.

Wu R et al. Brief Mindfulness Meditation Improves Emotion Processing. Front Neurosci. 2019 Oct 10;13:1074.

The Hidden Downsides of Meditation: A Guide for Physicians

As a physician coach and certified mindfulness meditation teacher, I find meditation to be a powerful and sustaining practice.

Meditation, especially a mindfulness practice, has been shown to improve focus and to mitigate stress and burnout. It can even improve sleep quality.

But while meditation has numerous benefits, there are also a few drawbacks that are not often discussed. With widespread recommendations for meditation and meditation apps, it’s important to keep in mind that meditation is not for everyone.

For some people, meditation may have unintended, and unexpected consequences. In some cases, simply changing the time of day or duration of practice can make all the difference. In this article, we’ll explore the potential downsides, along strategies for getting the most benefit from meditation and mindfulness practices.

Mental Health Impact

Because of its inward focus, meditation can sometimes bring up uncomfortable emotions or past traumas. People with diagnosed anxiety often benefit from meditation, but they may be especially vulnerable to this negative effect.

Of course, it’s normal to feel a little anxious when you are not accustomed to sitting quietly. Cultivating stillness can take time. But if the anxiety does not lessen, or if you are not able to let go of uncomfortably intrusive thoughts, then meditation may not be right for you.

And while detachment is often a goal of mindfulness meditation, some people may develop a distressing sense of detachment from reality.

Longer meditation sessions, including meditation retreats, are more likely to cause this type of trouble. If you are prone to anxiety or depression, it makes sense to keep your sessions to 20 minutes or less and to approach meditation gently.

Seek professional guidance if intense emotions or memories arise that are difficult to manage on your own.

Insomnia

Mindfulness meditation can improve your sleep quality. But a focused meditation at bedtime might actually cause the mind to become more alert, making it harder to fall asleep.

Consider meditating in the morning, mid-day, or before you head home from work. That way you’ll refresh your mind and gently reset your focus for the rest of the day ahead.

Decision Making

For many people, mindfulness meditation can improve decision-making speed and help with goal setting for positive outcomes.

But if you are someone who consistently tries to find the “best” possible choice when making decisions, you may find that mindfulness practices actually make it harder for you to make decisions. Instead of taking action, you might find yourself ruminating on all the possible outcomes.

Physical Discomfort

Sitting for extended periods, especially without proper support or in an uncomfortable posture, can lead to physical discomfort, including back pain, stiffness, or joint pain.

When meditating, ensure you are sitting in a comfortable position, perhaps using cushions or a chair for support. You might even find it more comfortable to meditate lying down.

Another option to consider is walking meditation. You can find these types of meditations on most meditation apps.

Many people are not aware that the physical practice of yoga developed as a way to prepare the mind and body for meditation. Yoga works by releasing stress and strain in the muscles and guiding you to consciously slow down your breathing pattern.  When time permits, consider incorporating gentle stretching or yoga before meditation.

Conclusion

While meditation can be a powerful tool for improving focus, reducing stress, and enhancing sleep, it’s important to be aware of its potential downsides.

By starting with shorter sessions, being mindful of any arising emotions or negative feelings, and ensuring a comfortable posture, you can minimize risks.

Reach out to your mental health professional if you feel that meditation has aggravated or brought on uncomfortable feelings or persistent symptoms.

For many people, setting the stage for meditation with gentle stretching or yoga may offer a more sustainable and beneficial experience.  

If meditation isn’t for you, don’t force it. Instead, you can find a similar mental reset by simply taking a brief walk or finding a minute between patients to take a few slow, deep, purposeful breaths.

---

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

If you’d like to learn more about my coaching practice, you can schedule a complimentary introductory meeting by clicking the link below.

My Podcast Appearance with Kevin MD on Meditation and Mindfulness

I enjoyed my recent conversation with Kevin Pho, M.D. We discussed how mindfulness can have far-reaching effects not only for yourself, but for those you care for. We also discussed the best times for meditation, when you might want to avoid it, and how a brief meditation can impact your sense of well-being.

As a physician coach, I love sharing this story, because it encapsulates how such a simple and brief practice can have a meaningful impact.

Despite often heavy-handed corporate efforts to the contrary, mindfulness is not a bandaid to fix all that is wrong with healthcare. And it’s not a substitute for the meaningful change that is so desperately needed. Instead, it’s a reminder to be present and engage with what is happening right now, without judgement or reactivity.

Through mindfulness, you are can find a way to take a moment in the middle of the daily storm to re-center and reset. And for physicians, that can go a long way towards building stronger relationships with patients and staff based on trust and respect.