The Cost Of Perfectionism

A physician was sharing with me in our coaching session that he was doing patient documentation way after hours and frequently had to do work in the weekends just to finish his charts. Let us call him John. He was miserable and wanted change. He wanted to go home with all the work done at a normal hour like most other professions.

As we were exploring further into his work situation, John revealed to me that he needed to make sure each patient’s note included all the details and that it should be perfect. He always felt that the note was not good enough and would think about it, edit it and edit some more.

I asked him what a perfect note would look like and if he had written a perfect note.

He told me that a perfect note would have all the details about a patient’s clinical history and plan of treatment. It would be in perfect flow, without any misspelled words or grammar mistakes. He wanted to write every note that way, and thought that he was close to writing almost perfect notes.

“What did it cost you to write patient charts this way?” I asked.

His reply was that he was spending too much time to write a single note. The fact that he could rarely get to the “perfect” standard he set for himself was crippling to him. He made it mean that he was not good enough to be a doctor. Then he pushed himself harder, to the point that he did not want to even write the more complicated patient notes, procrastinated some more, and ended up working all those unrecognized hours to finish writing the patient charts.

Does that sound familiar to you?

That was similar to my story not too long ago.

When you focus on being perfect, you spend excessive time to achieve that goal. You want everything to be perfect, to the point that may hinder your progress in doing a task. There is fear, fear of making mistakes, fear of being looked at as not good enough.  There is the constant pressure and urgency to achieve the highest of the highest standard, yet that seems to be impossible at the same time. There is also the need for others’ approval, for other people to tell you that whatever you are doing is perfect. During this process, you become more rigid because you are set on the whatever standard you are supposed to achieve.

The result is that you do not get things done efficiently. You waste the excess time on trying to make things flawless. You overthink things and it is hard to make a decision, because you want that to be perfect too. Besides having poor time management, there is undoubtedly decreased productivity. As you think that you are the one responsible to do it perfectly, it is also difficult for you delegate.

All these may have an effect on your self-esteem. You are not easily satisfied. You do not give yourself credit for your achievement. There is increased risk of anxiety and depression. You start to ignore and forget to take care of yourself.

I asked John what the goal of doing patient documentation was. He said it was to record what happened during the appointment and what the management plan was.

Was the goal to be perfect in documentation? No.

Is there a need for the patient documentation to be perfect and flawless? Or is it enough to document the necessary items to communicate with other members of the patient’s healthcare team?

During our coaching session, I discussed with John that it was alright to keep the patient notes simple yet comprehensive. That does not mean to include all the details, but to include the pertinent data. Certain things can be summarized rather than recording word for word. Keeping it simple is also beneficial for whoever is reading the document.

It is important to realize and acknowledge what perfectionism is and how it is affecting you. Realize that we as human beings are not perfect. That does not mean that we are reckless or careless.

Take a step back and reflect on why you are doing something, and remind yourself the ultimate goal is not to do something flawlessly, but to get that thing done.

As to what attitude to take, I would suggest to do things seriously and light-heartedly at the same time. When you are light-hearted, you allow yourself to make mistakes.

Just do it – even when you do not have a “perfect” solution, even when you do not have a “perfect” decision. You are doing the best that you can given the circumstances. You are using your best effort. You are being as careful as you can be.

Set a time limit – just as you would mind your time when you are taking a test with multiple choice questions, mind your time when you are seeing patients and doing their charts. Decide how much time, how much detail you want to include in your writing.

Practice mindfulness. Be in the present. Enjoy the process, even when it is a challenging task.

If you are a physician who wants to go home on time with all your charting and clinical tasks done, so that you can enjoy life and medicine again, message me to find out how to work with me to achieve your goals.