While burnout in the medical field is well documented, affecting about half of healthcare workers, far fewer studies have explored ways to address it. Now, a Northwestern Medicine study has found one simple intervention may help.
Building on earlier Northwestern University research that found improvisatory music can lower blood pressure, slow breathing and induce a meditative brain state, Northwestern scientists tested whether the same approach could improve clinician wellbeing.
In the new study, 724 Northwestern Medicine physicians and neurology staff and Chicago-area social workers laid in a quiet, dimly lit room and listened to 20 minutes of live or pre-recorded restorative improvisatory music consisting of slow, meandering melodies interspersed with periods of silence. (Listen to recordings used in the study.)
After the intervention, the clinicians reported improvements in mood and energy levels, with average self-reported energy increasing from 56% before the intervention to 83% after it.
The study was published Sept. 20 in Frontiers in Psychology.
"This is not like guided meditation," said corresponding author Dr. Borna Bonakdarpour, associate professor of behavioral neurology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. "They just lay down and listen; that's the beauty of it. Music will do its magic."
Bonakdarpour and Clara Takarabe, music practitioner and study co-author, originally developed the intervention as a wellness initiative during the COVID-19 pandemic when stress was high.
Through a partnership with Northwestern Medicine chief wellness executive and study co-author Dr. Gaurava Agarwal, study participants accessed Northwestern Medicine's Recuperation Room nestled within the physician's lounge and listened to pre-recorded music by Takarabe, a professional violist. When the scientists saw how many physicians were using the room, they began to conduct surveys to gather data on the intervention.
Among the participants who completed post-session surveys, clinicians reported improved emotional state, increased energy level and a high likelihood of recommending the intervention. Once the pandemic was over, Takarabe began playing live music for social workers in the community.
"Health workers face unrelenting stress, grief and trauma that compound daily, and although training can prepare them to manage some of this, novel and integrative approaches are needed to alleviate it without adding to their existing workload," Takarabe said.
While this early study was designed to provide an initial look at the Recuperation Room wellness initiative, the findings suggest that restorative music could be an easy and practical way to support clinicians' wellbeing, the authors said. The next step is to conduct larger controlled studies using standard measures of wellbeing and burnout to confirm whether the improvements observed were caused by the music program, Bonakdarpour said. He and his team are also currently studying if the intervention helps patients with Alzheimer's disease.
Why music is more effective than silence
Sometimes when faced with overstimulation, we crave total silence. But Bonakdarpour and his team found in their earlier work that music can shift brain activity from faster beta waves toward slower alpha waves, which are associated with relaxation and meditation. (This video illustrates the music-induced calmer brain waves.)
"Silence is great, but what happens with music is it clears the dirt of everyday life in the brain," Bonakdarpour said. "When the brain slows down, it gets an opportunity to recuperate, clear metabolites and rebuild energy. That's why we sleep. During sleep, we recuperate because the brain gets rid of the waste. The alpha state is really the first step in sleeping, so with this intervention, people are not yet asleep, but they're getting close."
Bonakdarpour said music influences the nervous system almost immediately - before the person is consciously aware of it - by slowing breathing and heart rate and calming brain activity. While that's true for most musical genres, restorative improvisatory music is specifically designed to be slower and offer periodic pauses to give the brain a break.
"Something special about the restorative music is the brain's ability to get in tune with the music and synchronize to it," said first author Pariya Salehi, a research assistant in Bonakdarpour's lab. "I think there's a beauty in the slowness and the ability to just sit and listen as opposed to other mindfulness techniques that require more active work."
Dr. Ryan Donaghy, who participated in the study when he was a medical resident, said he believes the music is critical in getting people to relax and keep their minds from wandering.
"The music gives the listener an ability to focus on something with their whole being," said Donaghy, now an assistant professor of neurology at Feinberg and a Northwestern Medicine neurologist. "You're able to be fully immersed in the music and identify how subtle changes in it can be something to pay attention to. That piece allows you to build focus, which, in the modern world, is almost an impossibility at times."
Donaghy said he continues to use restorative music and mindfulness practices in his daily life as a clinician because it helps him better care for his patients.
The study is titled "Sound Relief: Restorative Music as a Strategy to Improve Clinician Wellbeing." Other Northwestern study authors include Macy Walesa and Logan Pause.
