Experts say it’s important for physician leaders to remember they’re only human.
Within the culture of medicine, perfectionism may come at a hefty price: the expense of physician well-being.
“It’s something that most physicians struggle with on a regular basis,” says Kathy Stepien, MD, a pediatrician in Seattle, Washington. But, she adds, “Medicine is starting to realize that absolutes aren’t realistic.”
In 2016, Stepien’s interest in physician wellness blossomed into a desire to help colleagues balance high expectations of themselves with acceptance of fallibility as an inherently human quality. She began offering continuing medical education, physician retreats and speaking engagements across the country.
Physician leaders can help keep perfectionism in check by advocating for work-life balance. They could offer treatment programs that address this issue, says Martin M. Antony, PhD, FRSC, ABPP, professor and graduate program director in the department of psychology at Ryerson University in Toronto, Ontario.
Common conditions associated with perfectionism include anxiety, obsessive-compulsive disorder and depression, says Antony, whose research has examined this connection closely.
While “there’s nothing wrong with having high standards,” he explains that “the problem in perfectionism is when people set their standards impossibly high and judge their self-worth entirely based on whether they meet these impossibly high standards.”
Individuals with a bent toward perfectionism may consider asking themselves, “Am I able to be flexible and forgive myself and move on?” Recognition of a good effort serves as a learning experience and as a launching pad for a different approach in the future, Antony says.
To help physicians deal with perfectionism, cognitive behavioral therapy can be done in groups or on an individual basis. “It would be worth the investment of hospitals,” says Michael Myers, MD, professor of clinical psychiatry at State University of New York Downstate Medical Center in Brooklyn and author of the book Why Physicians Die by Suicide: Lessons Learned from Their Families and Others Who Cared, which includes a section on perfectionism. “It’s important to just make this part of a menu of options that are available there for doctors.”
Continuing medical education credits would be a good incentive, as well as instilling the idea that “this is normal, and you guys are working hard. And we have psychologists coming to kind of help and to train you to be able to face these things in yourself and overall stay well,” says Myers, a specialist in physician health. He acknowledged that physicians are often reluctant to seek mental health counseling out of fear that personal disclosure could affect their medical license.
The field of medicine, even the medical school application process, tends to draw people who are meticulous and perhaps even compulsive to some degree, extensive research suggests. Desirable traits include “rigorous attention to detail, integration of complex and voluminous information, as well as dedication and follow through,” says Tait Shanafelt, MD, director of the Stanford WellMD Center and chief wellness officer at Stanford Medicine.
However, “the challenge is that they often lead physicians to feel responsible for things outside their control, to conflate self-care with selfishness, and to make it difficult for them to set health limits and disconnect from work,” says Shanafelt, an expert in burnout.
Reining in these tendencies requires developing a growth mindset that eschews perfectionism in favor of a commitment to excellence and continuous improvement. “It also involves learning to treat yourself with the same compassion you would show a colleague in a similar circumstance,” he says, “rather than harsh and unconstructive self-criticism.”
Susan Kreimer is a freelance health care journalist based in New York.
Editor’s note: This article is related to the cover story, “In Pursuit of Perfection,” in the July/August 2019 issue of the Physician Leadership Journal.