Dr James Fish, GP and mindfulness teacher, notes how the traits that make us good doctors can also leave us vulnerable to burnout. Drawing on his own experience and research, he explores how mindfulness offers a way through, both for individual clinicians and for the culture of medicine as a whole.
The personalities we bring into the profession
Although we would generally not admit it, GPs are often described as resilient, committed, and deeply caring. Many of us take pride in showing up day after day, holding complexity, uncertainty, and emotional weight for our patients.
But beneath that commitment lies something we speak about less often: what kind of people are drawn to medicine in the first place?
“Sometimes when you want to go faster, you have to slow down”
I am yet to hear a hopeful medical school applicant declare how quick they are at dealing with problems, or how they never get too bogged down in detail. Medicine attracts a particular kind of person — and many of those traits serve us well.
High conscientiousness makes us diligent and driven to do things well. Elements of neuroticism give us a heightened sensitivity to things going wrong — vigilance, attention to detail, a strong sense of responsibility. Together, these traits help us catch diagnoses, follow up on symptoms, and keep patients safe. Even those who haven’t self-selected for them will have been institutionally selected, and trained, to think this way.
But there is a shadow side that’s less explored: what is the effect on us as individuals?
Conscientiousness can tip into perfectionism and an inability to switch off (Perfectionism as a predictor of physician burnout – PubMed). Neuroticism can manifest as self-doubt, worry, and rumination (Personality and burnout among primary care physicians: an international study – PMC). Together, they can make it hard to rest, to feel “good enough,” or to leave work behind. The same traits that make us safe clinicians can also put us at risk of burnout.
The cost of caring without limits
As psychologist Professor Paul Gilbert OBE put it in a recent conversation on the Still Practising podcast, human beings “were not designed, in our hunter-gatherer past, to sit around day after day talking about misery and suffering.”
Healthcare professionals are particularly vulnerable to burnout, given the high emotional demands and chronic stress exposure of the work (Caring for others without losing yourself – PubMed). Clinicians are rarely celebrated simply for keeping up — from medical school to obituary, we’re praised for going above and beyond: staying late, absorbing pressure without complaint, doing more than is asked. So much of the positive feedback I’ve received in my short career has hinged on the one resource I can’t control: time.
The drive to support patients with limited resources leads to an internal narrative — I must keep going. I can’t let people down. I should be able to cope. And so we override our own needs, again and again, until we’re left with exhaustion, emotional depletion, and a fading sense of the meaning that drew us to medicine.
Mindfulness: seeing more clearly
This is where mindfulness can offer something subtle but radical: noticing what’s happening within us as it happens, rather than operating on autopilot. For clinicians with typically high conscientiousness and neuroticism, this is powerful. It lets us recognise the moment striving becomes strain, the point at which care for others excludes care for self, the inner critic driving us beyond what’s sustainable.
Instead of being driven by these patterns, we begin to see them. And in the seeing, there is choice — a shift backed by a meta-analysis of ten studies in primary care clinicians specifically (Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals).
Compassion: the missing piece
Awareness alone isn’t enough. Many clinicians are highly attuned to their own mistakes and limits, but not necessarily kind to themselves — we tend to motivate with the stick rather than the carrot. This is where compassion becomes essential.
Compassion here isn’t about directing ever more effort at patients or colleagues — it’s the capacity to meet our own difficulty with understanding rather than criticism. It isn’t about lowering standards. It’s recognising that we’re human beings doing demanding work within an overstretched system.
Professor Paul Gilbert, the key figure behind compassion-focused therapy, defines compassion as “a sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it.” As he puts it, “compassion gives us the courage and wisdom to descend into our suffering.” For clinicians used to pushing through difficulty, this is a real shift: from striving endlessly harder, to relating differently to experience.
When mindfulness meets compassion, perfectionism softens into flexible commitment, self-criticism gives way to realism, and exhaustion is met with care rather than suppression. Paradoxically, this often lets us care for others more effectively, not less.
A traditional Tibetan Buddhist image presents mindfulness and compassion as the two wings of a bird — both need to be developed. Seeing a situation clearly but without warmth is as unhelpful as seeing it warmly but unclearly; it’s the two together that let us rise above our difficulties. Recent studies suggest self-compassion may be the single biggest factor in improving resilience and preventing burnout among healthcare clinicians (The role of self-care and self-compassion in networks of resilience and stress among healthcare professionals – Scientific Reports; Self-Compassion Explains Less Burnout Among Healthcare Professionals – PMC).
From individual insight to cultural change
It would be naive to suggest individual clinicians, or even small organisations, can resolve healthcare’s systemic challenges alone. Workload, staffing, and organisational pressures are real and must be addressed.
But there’s also an interpersonal and cultural layer worth attention. If many of us share similar personality profiles, and these are trained into our working practices, then the culture of healthcare is shaped by them: high standards, high responsibility, and often, high self-criticism. Mindfulness and compassion offer a way to begin shifting that culture — from relentless striving to sustainable care, from silent endurance to open acknowledgement of difficulty, from self-sacrifice to shared humanity.
A space to reflect
These themes sit at the heart of the upcoming Sussex Mindfulness Centre conference, Can We Heal Healthcare? — an invitation to step back from clinical work and reflect on our individual and collective psychology. Who are we as clinicians? Can we offer ourselves the same compassion we offer others? How can we change the culture of healthcare?
When I was a foundation doctor, a medical registrar — who, perhaps thanks to my overwhelmed and underslept state at the time, has since blurred in my memory into an almost mystical amalgamation of many role models — said something that has stuck with me for years: sometimes when you want to go faster, you have to slow down.
Taking time to deepen awareness of our own and collective psychology isn’t about stepping away from responsibility. It’s about finding a more sustainable, human way of carrying it.
Dr James Fish is a GP, mindfulness teacher and wellbeing workshop facilitator based in East Sussex. He runs the Still Practising Project, which holds groups and seminars for those interested in the intersection of clinical practice and contemplative approaches. If you would like to attend the Can We Heal Healthcare? conference to explore these topics more please book here.