Off the Chart: A Business of Medicine Podcast · Medical Economics

Attending to patients and ourselves, with Melissa Lucarelli, M.D., FAAFP, and Ronald M. Epstein, M.D., FAAHPM

·49 min·5 clips

The show opens on a basic clinical problem: people want to feel understood. From there, Luccarelli and Epstein frame the visit as a relationship as well as a prescription, shifting the center of gravity from information exchange to human contact. The discussion stays practical. Epstein talks about mindfulness as something that can live inside ordinary routines, not as a separate wellness practice set apart from medicine. Handwashing becomes one example. When surgeons wash their hands, some mentally rehearse the operation, while others use the pause to settle into the present moment. The episode also lingers on small shifts in attention. Epstein recalls how a single moment, whether a face, a smile, a flower, or the snowstorm outside, can change the way a person notices the world. A neurosurgical group in New York supplies the clearest operating-room example. They check the right patient, the right side, the right limb, and the right equipment, then stop for a brief mindful moment before the case begins. That pause is short. Even so, Epstein argues, it can gather the team around a shared purpose and reset everyone toward the person on the table. Luccarelli picks up the idea and applies it to her own practice. She says she now pauses at the patient's door, clears her mind, and enters with the intention to be with that person rather than carry the last room into the next one. She also notes the old habit of greeting patients with a handshake or touch. In her telling, that small physical cue fits the larger discipline of showing up present. The conversation never gets flashy. Instead, it keeps returning to the same operational question: how do clinicians protect attention while moving through a heavy day? The answer here is not a policy memo. It is a set of repeatable pauses that keep the work humane, grounded, and easier to share across a team.

As heard by us

Mindfulness here is treated as a clinical habit, not a slogan.

Off the Chart keeps its focus on a practical clinical problem: how to stay with patients without letting the day pull the room apart. Melissa Luccarelli and Ronald Epstein return to a plain but useful idea, that patients want to feel understood and to understand, and that a…

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For when your day needs a quieter way back into the room.

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