Paradox of perfection: modern general practice and the impossibility of ‘Good Enough’ in neoliberal healthcare

The changing nature of medicine in primary care from an individualised patient-centred practice to industrialised, protocol driven care is fuelling a rise in perfectionism in general practitioners (GPs). Systemic surveillance and loss of individual autonomy leave individual practitioners in fear of stepping outside guidelines and engaging in the craftsmanship of their healing role. Their training leaves them ill-equipped for the inherent uncertainties of human suffering and the systemic rise of socially prescribed perfectionism and fear of failure, with its resultant blame and shame. It leaves individual GPs exposed to burnout and mental illness. Working towards excellent patient care, while accepting medicine is still an art of understanding human need rather than a pure science of molecular manipulation, may bring the much-needed acceptance of doctors to be 'good enough'.

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Publication Details

Journal
Medical Humanities
Published
2026-02-25
DOI
https://doi.org/10.1136/medhum-2025-013533
Primary Topic
Healthcare Systems and Challenges
Type
article
Field-Weighted Citation Impact
0.00
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article

Paradox of perfection: modern general practice and the impossibility of ‘Good Enough’ in neoliberal healthcare

Sandy Miles
Medical Humanities
Healthcare Systems and Challenges
article

Paradox of perfection: modern general practice and the impossibility of ‘Good Enough’ in neoliberal healthcare

Sandy Miles
article en

Abstract

The changing nature of medicine in primary care from an individualised patient-centred practice to industrialised, protocol driven care is fuelling a rise in perfectionism in general practitioners (GPs). Systemic surveillance and loss of individual autonomy leave individual practitioners in fear of stepping outside guidelines and engaging in the craftsmanship of their healing role. Their training leaves them ill-equipped for the inherent uncertainties of human suffering and the systemic rise of socially prescribed perfectionism and fear of failure, with its resultant blame and shame. It leaves individual GPs exposed to burnout and mental illness. Working towards excellent patient care, while accepting medicine is still an art of understanding human need rather than a pure science of molecular manipulation, may bring the much-needed acceptance of doctors to be 'good enough'.

Medical Humanities
Brixham Community Hospital (GB)
Openalex Percentile: Top 46%
Healthcare Systems and Challenges
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