Doctors working for a just cause, playing an infinite game have a more sustainable mindset

February 27, 2026 Published by Sharee Johnson

Philosopher James P. Carse first wrote about the concept of infinite and finite games in 1986.  He distinguished the two by saying that the intention of the first is to keep the game going, the second is to win the game.  

I learnt a lot about this model from @Simon Sinek’s excellent book The Infinite Game and have been recommending it to those I work with since it was published in 2019. 

Its relevance to the working life of healthcare professionals is profound in my opinion.

At the core of an infinite game is a just cause. For many healthcare workers the just cause seems obvious; to keep people well, to care for the sick, to help people.  In healthcare we must be playing an infinite game, right? 

Except that when leadership and policy is focused on patient throughput, rationing of resources, maximising bed use, valuing quantity, over things that are harder to measure, like healthcare experience for patients, meaningful work and team trust for healthcare workers, we are not playing an infinite game.

We are stuck in a finite game where there is a scarcity mindset, much less discretionary effort and winners, and therefore losers. Some patients and healthcare workers win, some loose.

Leaders can make all the difference setting the tone for playing a finite or infinite game. 

Leaders who have a vision outward to the horizon, who promote the just cause and invite people to join this irresistible movement, who can look beyond the day to day resourcing to inspire and uplift teams of people and who create environments of psychological safety for those doing the work of caring for patients, are playing an infinite game. 

They know that outcomes and processes go on after their tenure and they seek to create environments and teams that can’t help but carry on the cause, because it is so just, if you will. Motivation is implicit and meaningful for the workers, the other players matter to them, as they are all in service of the same just cause, the games’ continuation matters to all. 

Can you tell if you are playing an infinite or finite game? 

Just because you work in healthcare does not automatically mean anything about your mindset.  It’s not the game but how you play that is important. If you play with a fixed rules mindset, with a need to win and a desire for certainty, then you are playing a finite game. That may be where some of your frustration with the healthcare system comes from. 

If you bring a psychologically flexible mindset to work, if you are focusing on how the game can be perpetuated and improved over time, with trusted team members who are also focused on the greater good, the just cause, then you will want to leave the place you work in improved and you will know there are lots of ways to succeed. You will be playing for the good of the game, and you will want to keep playing. That is a sustaining, hopeful mindset, designed for longevity, impact and joy.

When it comes to coaching in medicine the infinite game mindset celebrates the progress we are making. 

While I wish more doctors, especially leading doctors were embracing coaching faster for systemic impact, coaching is becoming normalised in medicine. We have come a long way. More doctors seek coaching and trust the process. Some doctors are openly public about having coaching and the positive value it has for them in creating change in their lives and in the systems they work in. 

Coaching is a powerful vehicle for improving performance, creating change, raising personal awareness and wellbeing.  When doctors are engaged in this kind of developmental work, leading themselves well, the ripples are significant in all their relationships. Working with a coach raises your awareness to your own mindset, how you are limiting or opening up your potential and that of those who you interact with. 

The infinite game is not about being the best, it is about bettering one’s self, the team one is working with and the game itself.  The infinite game I am playing in is about patients receiving better care and having better healthcare experiences. The doctors I work with want that too. It is a joy and a privilege to be on the pitch with them. 

==

Sharee Johnson is the Founder, Managing Director, Principal Coach at Coaching for Doctors. She is the bestselling author of The Thriving Doctor: How to be more balanced and fulfilled, working in medicine and a Registered Psychologist. She has written extensively about doctor wellbeing, performance and coaching, delivers workshops to doctors and speaks at medical conferences. You can connect with her on Linkedin and Instagram.

For more like this.

The Thriving Doctor

---

Sharee Johnson’s book The Thriving Doctor is available in all good bookstores or online.

Sharee has been coaching doctors since 2014, find out more about her work