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NEWPORT, Wales — Compassion has its limits and doctors need care too, experts warned at a well-being session at the Royal College of General Practitioners (RCGP) Annual Conference 2025.

Presenters Dr Roopinder Brar, medical adviser and GP in Woking, Surrey, and Kay Louise Grant, risk adviser at the Medical and Dental Defence Union of Scotland (MDDUS), shared alarming survey data. The figures showed that 60% of healthcare professionals have experienced compassion fatigue, 66% reported burnout, and 74% have considered leaving or retiring early.

Alarmingly, 1 in 5 (19%) admitted to having thoughts of self-harm or suicide during their career.

Michael Blackmore, a GP partner at NHS Forth Valley, Grangemouth, Scotland, and chair of the RCGP West Scotland Faculty, moderated the session.

“Compassion fatigue does not mean burnout; it means emotional depletion, which is an empty cup when, in fact, you need a full one to care for others,” he told Medscape News UK afterward.

Warning Signs and Risk Factors

Coined by Carla Joinson in 1992, compassion fatigue describes “a loss of the ability to nurture.”

Warning signs include detachment, irritability, self-criticism, and cynicism. Risk factors include high work-stress, low support, and negative coping mechanisms.

Brar provided context through two anonymised GP vignettes — “Dr M” and “Dr P” — illustrating emotional depletion in practice.

Dr M is an eight-session GP partner. He works 8.00 AM to 6.30 AM most days, and often later on call days. He frequently skips lunch, checks emails on days off, and feels guilty saying no. Every task feels urgent to Dr M, and with GPs constantly told how resilient they are, Dr M feels unable to share that the workload is unmanageable and does not want to let anyone down.

Turning to the second case study, Dr P is a salaried GP with two small children. She describes being perpetually late, feels guilty about limited sessions, and never has downtime. She is known to be a perfectionist, so she often stays late, checks emails on days off, and logs in to get ahead of her next day. Dr P feels there is pressure to get everything done and no one wants to wait anymore. She is also annoyed and irritated all the time. Dr P says she feels like a pressure cooker about to explode.

Unrealistic Expectations

Blackmore, who oversees GP recruitment and retention in Scotland, told Medscape News UK that compassion fatigue is compounded by “unrealistic” public and media expectations.

“There’s a sense of entitlement among patients with people believing this is how the NHS should work, and if it doesn’t, they get upset,” he said. “We’re the front-facing part of the NHS, so we get the complaints about secondary care, about things that aren’t even within our control.”

He argued that continuity of care could ease some of the strain.

“If patients saw the same doctor more consistently, you could communicate better and build trust. You’d spend less time going over the same history and more on a meaningful management plan.”

Blackmore asserted that investment was the root solution.

“In Scotland, we have around 1700 patients per doctor — ideally that should be closer to 1000. For every pound spent on general practice, £14 is saved in the wider system.”

Despite government pledges, hospital consultant numbers have risen far more than GPs, he noted. In England, the NHS Long Term Workforce Plan projects a 49% increase in hospital consultants over a decade compared with only 4% for GPs.

He pointed out that since 90% of NHS consultations happen in general practice, “that imbalance is unsustainable.”

Communication Challenges

Communication breakdown often escalates compassion fatigue, added Blackmore.

“We all learn communication skills at medical school, but there’s little training after this or in mid-career, when pressures are greatest.”

Patients often hear only fragments of what doctors say, especially when emotions run high.

“Different patients prefer different communication styles. Some want directness; others need more sensitivity. But when you’re exhausted, it’s harder to get that balance right.”

Short appointment times magnify the challenge.

“We have 10 minutes to review notes, take a history, discuss management, and safety-net. It’s impossible,” said Blackmore. “When we overrun, we feel pressured to say the right thing quickly, and sometimes it comes out wrong. But we’re human, and when that happens, we apologise.”

Blackmore, who also works in addiction medicine, said funding for specialist GP training is crucial. “If we could upskill GPs to manage more specialisms in the community, patients wouldn’t need to travel miles to hospital clinics. It would save time, money, and improve outcomes.”

Brar and Grant closed with evidence-based tools to help clinicians “protect the cup.”

These included recognising the difference between compassion and empathy — the former being active and having boundaries, the latter potentially depleting.

They also suggested using cognitive-behavioural therapy to challenge unhelpful thoughts, and acceptance and commitment therapy to stay aligned with values during discomfort.

Mindfulness, breathing techniques, and peer-to-peer reflection were also encouraged.

Blackmore declared no relevant financial disclosures. Brar and Grant declared no relevant financial disclosures other than representing MDDUS. The session was sponsored by MDDUS.