HealthMay 06, 2020

The illusion of the perfect physician: The problems of perfectionism in medicine

By: Melissa Welby, MD

 "That doctor is such a perfectionist; she doesn't miss a thing. She's amazing! Even the sutures were perfect!"

Often wielded as a compliment and viewed as a valuable trait for a physician, perfectionism is a double-edged sword. Many physicians walk a fine line between high standards and unrealistic expectations. On one side of that line, driven doctors are motivated and energized to deliver their best. On the other, physicians are providing the same quality care yet feel they're failing.

The problems of perfectionism are caused by the belief that your best is never good enough. The resulting challenges can hinder a physician's performance and hurt their mental health. Being a perfectionist doesn't make someone a better physician.

The problems of perfectionism in medicine

Perfectionism shouldn't be confused with the pursuit of excellence. The negative consequences of this unreachable drive may not be immediately apparent to those around the person, but to the individual they're clear. Here are a few of the problems with perfectionism:

  1. Humans make mistakes. Making mistakes is a necessary part of growing and learning, a fundamental part of being human. Sometimes, perfectionists are so driven to avoid "failure" that they're unable to accept their limits and end up sacrificing what they need to do to take care of themselves.
  2. Shame becomes inevitable. Since performance is tied to a perfectionist's sense of self, if they can't complete something or view their work as unsuccessful, shame kicks in, and self-worth takes a hit. Impossibly high standards mean perfectionists aren't happy even when they achieve what others may think of as "success."
  3. Perfectionism slows us down. Perfectionists can get stuck in the minutia and end up inefficient and behind. If each dictation needs to have all spelling and grammar errors corrected, charts are going to pile up and be one more source for self-criticism.
  4. We have a finite amount of energy and time. If we strive for perfection at work, how do we perform at home? We don't have enough time in our day to do everything perfectly. Superhuman expectations can make doctors feel they're failing everywhere.
  5. Physician well-being suffers. Perfectionism can harm mental health, and the high levels of stress that result from it certainly don't reduce the risk of burnout. Perfectionism is associated with increased anxiety, depression and suicide, according to studies in BMC Medical Education and in the Journal of Personality.

3 Tips for letting "Good" be good enough

Of course, physicians need to have high standards. The goal isn't "mediocracy" but the ability to recognize when expectations are unrealistic and unnecessarily high.

The belief that your best is never good enough is incompatible with a harmonious work-life balance. Here's how to protect your well-being from the problems of perfectionism.

1. Put things in perspective

Physician mistakes can have grave consequences, so it's no surprise that many doctors feel they need to be perfect. But perfectionists forget that every action isn't life-threatening and doesn't need to be treated that way. When feeling stressed, periodically stop and ask yourself if the decision or task could potentially have fatal consequences. This can help you put things in perspective and determine if the anxiety is worth it.

2. Find the middle ground

Watch out for black-and-white thinking, a trap for many perfectionists. Everything isn't all or nothing, and it's important to look for options that exist in the middle. Lack of perfection doesn't equal failure, and not being the "best" doesn't mean you're the "worst." Take time to identify your beliefs around failure and perfection and determine if they're causing you unnecessary stress. Work to discover the middle ground!

3. Set realistic expectations

Recognize that altruism often celebrated when physicians go the "extra mile" comes at a cost. When standards in medicine are set at unrealistic performance levels, they can't be met without self-sacrifice and self-neglect. It's hard enough to keep up with the daily demands of physician practice and have a balanced life outside work. Take a step back and look at what you expect of yourself. Practice self-compassion to help change the harsh inner dialogue that takes a mental toll. Allow yourself and others to be human.

Dispelling the illusion of the perfect physician

Striving for excellence, hard work and diligence are desirable traits for a physician, but perfectionism isn't a badge of honor. Physicians can work toward greatness, but the pursuit of perfection is a dead end that isn't worth the sacrifice. Perfect physicians don't exist because humans make mistakes.

Most doctors are intrinsically compassionate people, but too often, it all gets directed toward their patients. This can be the biggest mistake of all. And yes, it can have life-threatening consequences.

Melissa Welby, MD
Lippincott® Medicine
Lippincott is a leading international medical publisher of professional health information for practitioners, faculty, residents, students, and healthcare institutions with a full suite of essential medical products, from books and journals to digital solutions.
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