Judgment pervades medicine—of patients, colleagues, and ourselves.

We’re trained to judge, disguised as caring, standards, and competence. It’s seen as essential to being a “good physician.” We do it so instinctively, we rarely question it.

But we should.

The culture of judgment in medicine

Judgment is baked into our training: The scrutiny of rounds, the competition of grades, the pressure of evaluations. It’s in our language: “noncompliant,” “failure to thrive,” “incompetent cervix.” Even our metrics—HEDIS scores, peer reviews, and performance plans. All of this is steeped in judgment.

The intense judgment and comparison culture creates hypervigilance. We push ourselves harder, assuming judgment leads to excellence.

But does it?

In my experience, judgment doesn’t drive excellence. It drives shame, blame, and guilt. It triggers stress hormones like cortisol and norepinephrine. These narrow our perspective, crush creativity, and lock us into loops of imposter syndrome and exhaustion.

What judgment costs us

We are taught that judgment is necessary to maintain high standards. But we rarely examine the cost.

When we judge ourselves for not meeting impossible expectations, we suffer. When we judge patients as “noncompliant” or “difficult,” we dehumanize. When we judge learners or colleagues for their pace or style, we miss the chance to foster growth.

Judgment consumes energy. No physicians I know have energy to waste. Judgment creates disconnection—from our patients, our purpose, and one another. It’s no wonder so many physicians struggle to connect to purpose and find alignment.

A different path: mindfulness and Maitri

Mindfulness offers a radical alternative: Non-judgment. Or, as one of my physician clients reframed it—Maitri: Unconditional friendliness. Kindness. Toward others. And toward ourselves.

Letting go of judgment doesn’t mean lowering standards. It means showing up with curiosity, clarity, and compassion. It means noticing the reflexive judgment habit—and choosing to opt out.

It looks like:

• Noticing judgment: Where does it show up in your thoughts, language, evaluations?
• Pausing and being intentional: Is this thought helpful? Is this reaction or approach helpful? Are these words kind or judgmental?
• Shifting to curiosity: What’s happening here? What else might be true? What am I trying to accomplish? What can I/we learn from this?
• Practicing self-compassion: You are not alone in your struggles. You are not broken or inadequate. You can
• Protecting your energy: Judgment is draining. Kindness and acceptance restore and lead to learning and growth.
• Practicing generosity: Assuming others are working hard, have good intentions and are doing their best. No one in medicine doesn’t care. If they didn’t care, they would have chosen an easier path.

Reimagining growth and feedback

Much of our teaching culture reinforces judgment. Learners are labeled “problems.” Feedback focuses on “areas for improvement.” Performance improvement plans feel, and often are, punitive.

What if we reframed feedback as an opportunity to invest in our colleagues—not correct them? What if evaluations were strength-based, energizing, and designed for true growth?

Imagine if M&Ms and peer reviews prioritized learning over blame. Imagine how medicine could be different if every physician was seen for their efforts, believed in for their potential, and supported in their evolution.

What medicine without judgment could look like

What could happen if we stopped judging?

We could reclaim time, energy, and emotional capacity. We could build healthier, more connected teams. We could create cultures where learning and healing thrive.

We could finally begin to heal medicine—from the inside out.

We may not be able to opt out of the entire system—but we can choose how we engage with it. We can choose our language, our energy, and our mindset.

As a pediatrician, mindfulness teacher, and physician coach, I see firsthand the toll judgment takes on our nervous systems, our performance, and our well-being.

Awhile back I devoted an entire 45-minute Healing Medicine podcast to this topic. And I could have gone on even longer.

The cliff notes: The judgment culture is crippling to physicians and the system.

Could you practice Maitri—benevolent kindness to yourself and others?

Could you start by choosing healing words rather than judgmental words—with patients, trainees, colleagues, and even yourself?

Could you frame improvement as investing in growth, learning, and the future of medicine rather than remediation or a problem to be fixed?

One at a time, we can choose to opt out of judgment.

When physicians are willing to do this, we, and medicine, will begin to heal.

Jessie Mahoney is a board-certified pediatrician, certified coach, mindfulness and yoga teacher, and the founder of Pause & Presence Coaching & Retreats. After nearly two decades as a physician leader at the Permanente Medical Group/Kaiser, she stepped outside the traditional medical model to reimagine what sustainable well-being in health care could look like. She can also be reached on Facebook and Instagram.

Dr. Mahoney’s work challenges the culture of overwork and self-sacrifice in medicine. She helps physicians and leaders cultivate clarity, intention, and balance—leveraging mindfulness, coaching, yoga, and lifestyle medicine to create deep and lasting change. Her CME retreats offer a transformative space for healing, self-discovery, and renewal.

As co-host of the podcast, Healing Medicine, she brings self-compassion and presence into the conversation around modern medical practice. A sought-after speaker and consultant, she partners with organizations to build more human-centered, sustainable, and inspired medical cultures.

Dr. Mahoney is a graduate of Dartmouth College and the University of California, San Francisco, School of Medicine.