Barriers to the integration of mind-body medicine: Perceptions of physicians, residents, and medical students

Objective: This study of medical students, residents, and physicians examined their responses to focus group questions in an effort to understand barriers to discussing psychosocial issues and using mind-body interventions to address health issues. Methods: Four focus groups were conducted: two with medical students and residents, one with primary care doctors, and one with physicians representing different specialties. Responses were audio recorded and transcribed verbatim. Results: Factors identified as possible barriers to recognizing the importance of psychosocial/mind-body factors included lack of knowledge of evidence base, inadequate attention paid to the mind-body area in training, perceived lack of competence to use mind-body methods, inadequate time, lack of economic incentive, perception that psychosocial factors are beyond their capacity to control, tendency to perceive conditions as either biological or psychosocial in nature, perception that patients do not want to address psychosocial/lifestyle issues, and cultural beliefs that addressing the psychosocial domain is not within the purview of physicians. Conclusions: Despite evidence that psychosocial issues play an important role in health outcomes, students, residents, and practicing physicians reported that methods to deal with these issues are frequently given inadequate attention in medical training, and many physicians feel ill equipped to deal with these issues. In addition, environmental factors, including lack of time, insufficient monetary incentives, and a larger cultural ethos that favors the "quick-fix" over the more difficult task of examining the role of psychosocial factors, appear to serve as significant barriers to medicine's more fully embracing the biopsychosocial model.