_ RCGP Learning

Written by Dr Dirk Pilat

There is no question that general practice is an increasingly stressful profession, with ever growing demands placed on GPs while battling with diminishing financial and staffing resources. Days at work that just won’t end, never-ending workload and little control over our working lives can affect even the most resilient of practitioners. Throw in the constant battle with complaints and medicolegal issues and it’s no wonder that the prevalence of burnout, depression, low self-esteem and anxiety are significantly higher in the medical profession compared with the general population¹. The numbers are startling: An MDDUS survey from 2024 reported 71% of general practitioners suffering from compassion fatigue and 65% suffering from burnout². A PULSE survey from 2025 found that more than 54% of primary care doctors had to reduce sessions due to stress³. Unfortunately doctors aren’t great patients: we tend to downplay the severity of our symptoms and under-diagnose conditions in ourselves and often ignore the fact that we should seek help⁴.

For some time now, but particularly during and after the COVID-19 pandemic, attempts have been made to prevent burnout syndrome through individual and systemic approaches within the primary care workforce. Various psychological interventions were developed to empower professionals coping with increasing stress and burnout. Mindfulness-based interventions (MBI) are effective in reducing stress and promoting self-care and wellbeing: there is a growing body of research evidence that these can increase job satisfaction and even improve patient outcomes. Mindfulness has a well-established evidence base showing efficacy in improving the psychological wellbeing in both clinical and non-clinical populations. Various MBIs exist, though mindfulness-based stress reduction (MBSR) is the most extensively reviewed. Originally designed for patients with chronic medical and psychological conditions, it improves quality of life via focussed attention exercises, cognitive restructuring and adaptive learning techniques⁵. A 2020 systematic review of mindfulness – based stress reduction interventions on the psychological functioning of healthcare professionals showed that this particular method reduced anxiety, depression and stress and increased self-compassion⁶.

A 2021 systematic review on the impact of psychological Interventions with elements of mindfulness for physicians came to a similar conclusion: the vast majority of studies showed a positive impact on empathy, well-being, and reduction of burnout⁷. Similarly, a 2016 mixed method study showed that general practitioners who learned mindfulness based stress reduction (MBSR) techniques as a part of their regular CPD programme showed a significant decrease in depersonalisation and an increase in dedication and mindfulness skills compared with the control group⁸.

Interestingly, a decline in empathy and an increase in stress levels is not only experienced by established general practitioners but also by medical students and young doctors during their training. At the Charité – the medical faculty of the Freie Universität Berlin and Humboldt-Universität zu Berlin - medical students can choose to take part in a voluntary course on stress reduction. Delivered over one semester, students are being taught methods of mindfulness and meditation with quantitative results showing a reduction in perceived stress and an increase in self-efficacy, mindfulness, self-reflection and empathy⁹, confirming previous results of similar interventions, including previously obtained long-term results of this course format showing effects on stress biomarkers¹⁰.

For those struggling to find the time to engage in MBI, the ubiquitousness of wearable technological devices such as smart watches and mobile phones can – rather counter-intuitively – help to take part in short activities helping to achieve emotional control in the middle of a busy day. An example for this is the ‘Mindfulness app’ on the Apple Watch (similar apps exist on Android-based devices). A small 2024 mixed method study invited participants to engage for 5 minutes daily with the application, trying to achieve 6 breaths per minute during usage. After two weeks the data showed this to result in a significant increase in participants’ coping skills and slight reduction in symptoms of depression and anxiety¹¹.

In these stressful days it feels important to identify strategies to the improve quality of life for the primary care workforce. For some, mindfulness-based interventions might be just the ticket, even when it’s only for 5 minutes a day.

References:

1. Society of Occupational Medicine. What could make a difference to the mental health of UK doctors? A review of the research evidence. 2018.
   
2. MDDUS. Compassion fatigue in healthcare professionals 2024.
   
3. Colivicchi A. More than half of GPs reduced their sessions due to work-related stress. Pulse Today. 2025. 
   
4. Best, Ho. What’s it like to be a patient as a doctor. British Medical Journal 2024 Oct 11; q1486–6.
   
5. Kabat-Zinn, Jon. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam Books, 2013
   
6. Kriakous SA, Elliott KA, Lamers C, et al. The Effectiveness of mindfulness-based Stress Reduction on the Psychological Functioning of Healthcare professionals: a Systematic Review. Mindfulness. 2021 Sep 24; 12 (1): 1–28.
   
7. Tement S, Ketiš ZK, Miroševič Š, et al. The Impact of Psychological Interventions with Elements of Mindfulness (PIM) on Empathy, Well-Being, and Reduction of Burnout in Physicians: A Systematic Review. International Journal of Environmental Research and Public Health. 2021 Oct 25; 18 (21): 11181.
   
8. Verweij H, Waumans RC, Smeijers D, et al. Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care. British Journal of General Practice. 2016 Jan 28; 66 (643): e99–105. 
   
9. Brinkhaus B, Stöckigt B, Witt CM, et al. Reducing stress, strengthening resilience and self-care in medical students through Mind-Body Medicine (MBM). 2025 Jan 1; 42 (1): Doc7–7.
   
10. MacLaughlin BW, Wang D, Noone AM, et al. Stress Biomarkers in Medical Students Participating in a Mind Body Medicine Skills Program. Evidence-Based Complementary and Alternative Medicine. 2011; 2011: 1–8.
    
11. Wright SL, Bach E, Bryson SP, et al. Using an App-Based Mindfulness Intervention: A Mixed Methods Approach. Cognitive and behavioral practice. 2024 Apr 1.