Judgment is pervasive in medicine—of patients, colleagues, and ourselves. We are conditioned to evaluate, masked as compassion, standards, and a sense of competence. It is regarded as a prerequisite for being a “good physician.” We engage in it so automatically that we seldom question it. Yet, we should.

**The culture of judgment in medicine**

Judgment is ingrained in our education: The scrutiny during rounds, the rivalry over grades, the stress of evaluations. It’s embedded in our terminology: “noncompliant,” “failure to thrive,” “incompetent cervix.” Our metrics—HEDIS scores, peer reviews, and performance plans—are all saturated with judgment. The intense culture of judgment and comparison incites hypervigilance. We push ourselves harder, believing that judgment begets excellence. But does it?

From my perspective, judgment does not foster excellence. It breeds shame, blame, and guilt. It activates stress hormones like cortisol and norepinephrine. These narrow our focus, stifle creativity, and trap us in cycles of imposter syndrome and exhaustion.

**What judgment costs us**

We are instructed that judgment is vital to uphold high standards. However, we seldom scrutinize the consequences. When we criticize ourselves for failing to meet unrealistic expectations, we suffer. When we label patients as “noncompliant” or “difficult,” we strip away their humanity. When we judge learners or colleagues based on their pace or style, we overlook opportunities to nurture growth. Judgment drains energy. No physicians I know have energy to squander. Judgment creates disconnection—from our patients, our purpose, and each other. It’s not surprising that many physicians struggle to connect with their purpose and find alignment.

**A different path: mindfulness and Maitri**

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

Releasing judgment doesn’t entail lowering standards. It involves arriving with curiosity, clarity, and compassion. It involves recognizing the habitual judgment reflex—and opting out. It manifests as:

– **Noticing judgment:** Where does it appear in your thoughts, language, evaluations?
– **Pausing and being intentional:** Is this thought beneficial? Is this reaction or method constructive? Are these words kind or judgmental?
– **Shifting to curiosity:** What’s unfolding here? What else might be true? What am I trying to achieve? What can I/we derive from this?
– **Practicing self-compassion:** You are not alone in your challenges. You are not broken or unworthy.
– **Protecting your energy:** Judgment is draining. Kindness and acceptance rejuvenate and lead to learning and growth.
– **Practicing generosity:** Assuming others are making an effort, have good intentions, and are doing their best. No one in medicine lacks care. If they didn’t care, they would have chosen an easier path.

**Reimagining growth and feedback**

Much of our educational culture reinforces judgment. Learners are branded as “problems.” Feedback emphasizes “areas for improvement.” Performance improvement plans often feel punitive.

What if we redefined feedback as an opportunity to invest in our colleagues—not to correct them? What if evaluations centered on strengths, invigorating, and designed for genuine growth? Imagine if M&Ms and peer reviews focused on learning rather than blame. Envision how medicine could transform if every physician was acknowledged for their efforts, believed in for their potential, and supported in their development.

**What medicine without judgment could look like**

What could occur if we ceased judging? We could reclaim time, energy, and emotional capacity. We could foster healthier, more interconnected teams. We could cultivate environments where learning and healing flourish. We could finally start to heal medicine—from within.

We may not have the option to disengage from the entire system—but we can decide how we interact with it. We can select our language, our energy, and our mindset. As a pediatrician, mindfulness teacher, and physician coach, I witness firsthand the impact of judgment on our nervous systems, our performance, and our overall well-being. Some time ago, I dedicated an entire 45-minute Healing Medicine podcast to this subject. I could have continued even longer.

The summary: The culture of judgment is debilitating to physicians and the system.

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

Could you begin by using healing words instead of judgmental ones—with patients, trainees, colleagues, and even yourself? Could you view improvement as an investment in growth, learning, and the future of medicine rather than as remediation or a problem to be solved? One at a time, we can choose to opt out of judgment. When physicians are ready to do this, we, and medicine, will start to heal.

*Jessie Mahoney is a board-certified pediatrician, certified coach, mindfulness and yoga teacher.*