Modern Medical Musings: Perfect is a false idol

Is perfect actually what's best for the patient and perfectionism for a physician?

It seems fitting that perfectionism is pervasive in the medical field. If there is any time to demand perfection, it should be when lives are at stake. Perfectionism is bred into medical professionals at a young age. From our early school days, we discovered that perfect grades yield accolades and a feeling of accomplishment. A >4.0 GPA and a perfect résumé are likely what gained us entry into the medical field in the first place. Perfectionism has served a very real purpose in our lives.

Now as practicing physicians, we employ perfectionism in hopes of ensuring excellent patient care. There are quite a few areas of medicine where perfection seems fitting, such as careful synthesis of a patient’s history, curation of diagnostics, and ultimately diagnosis and choice of appropriate therapy. A physician with attention to detail in key diagnostic and therapeutic areas can, in the most extreme cases, mean the difference between life and death. But attention to detail is possible, and maybe even better off, unencumbered by the shackles of perfection.

Since starting what I consider to be my dream job in integrative cardiology, I have been striving for perfection because I care deeply. What could be wrong with that? The problem with perfectionism is perpetual dissatisfaction. It causes us to examine our own performance under a microscope, question every detail, internalize every mistake. While it may masquerade as a valiant impetus for constant improvement, it actually drags us down. The constant negative self-talk associated with perfectionism is draining far beyond long hours. The running list of self-criticisms and nit-picks is a heavy load to bear. To finish each already physically and mentally demanding shift feeling inadequate is not only exhausting, but anxiety-provoking and depressing. When doing your best is not enough, what then?

Ultimately, having passed our boards and completed many years of necessary training, doing our best as physicians is enough. But of course, most of us won’t stop there. On a personal level, we get to define what being a good doctor means to us—and we should strive for that, not perfection. For me, it means working on a foundation of good intention: to serve others through medicine; treating people with empathy and kindness; remaining methodical and meticulous in my work; and showing up each day with curiosity and humility, with a commitment to lifelong learning and a growth mindset. To me, that actually sounds better than the nebulous idea of perfection: it’s personal, it’s specific, it’s real, and it’s rooted in love. A robot could never do it. The irony is that in order to achieve these goals, I can’t be running myself ragged chasing the pipe dream of perfection. While perfectionism may have served me well in the past, now it is only a distractor from my greater purpose.

From now on, I choose to replace perfectionism with a better ideal that only I define. I choose to intentionally glean helpful knowledge and experience from both positive and negative feedback, but remain detached from it, letting it go at the end of the day. I choose to treat myself with compassion. I allow myself to feel proud of the work I do each day so that I can get up and do it again the next.