The Problem With Perfect: Addressing Perfectionism in Healthcare
Key takeaways:
The personality characteristic of perfectionism is common among healthcare providers (HCPs).
Perfectionism that leads to maladaptive or negative behaviors is associated with health problems.
HCPs can learn to reframe their perspective and embrace imperfection as a strategy to protect their own mental health.
Perfectionism is a personality characteristic that is common in the healthcare profession. On the surface, it seems that the attainment of perfection should be a desirable trait that anyone, including healthcare providers (HCPs), would want to aspire to. But there is a difference between striving for excellence and unrealistic expectations of perfection.
The desire for perfection can become detrimental and even cause negative mental and physical health effects and strongly influence the incidence of burnout.
What is perfectionism?
Perfectionism is an inherent personality characteristic and trait that is often rewarded in the medical profession. Early in their education, students begin to emulate perceived demonstration of perfection from educators and preceptors. Perfectionists exhibit the following behaviors:
An all-or-nothing mentality classifying outcomes as either a complete success or a complete failure
A focus on and overgeneralization of failure
Rigorous self-evaluation
Setting unrealistic goals and standards
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Perfectionists not only set these standards for themselves but extend them to others. They believe that every task or project has a perfect outcome and expect the standard of perfection to be reached at all costs.
Perfectionism can be adaptive or maladaptive. Adaptive perfectionism is associated with positive traits such as a desire to be successful and attain goals. Individuals are highly organized, set high personal standards, and are conscientious and self-oriented in their perfectionism.
When perfectionism becomes maladaptive, it becomes negative. Fear of failure and the need to conceal imperfections become the drivers of behavior, and the individual has frequent doubts about their actions. Maladaptive perfectionism is associated with the following health effects:
Anxiety
Anorexia nervosa
Bulimia nervosa
Burnout
Chronic fatigue syndrome
Cynicism
Depression
Lower levels of engagement with preventative health measures
Low levels of self-confidence
Psychological distress
Adaptive perfectionism can be useful and results in satisfaction when efforts go well, but you must remain flexible enough to allow for occasional mistakes. The maladaptive perfectionist can’t do this and becomes negatively impacted by their perfectionist tendencies.
How perfectionism impacts HCPs
The healthcare profession seems to draw perfectionists and even values the personality trait. Society and educators expect HCPs to provide flawless care, make no errors, and carry out tasks with precision. Prevailing medical culture attempts to avoid displays of personal vulnerability and delays gratification.
Perfectionism can negatively impact HCP wellbeing, resulting in suboptimal care and an increased risk of medical errors. When HCPs are unable to meet their self-imposed expectations of perfection, they experience shame and self-doubt. Insecurities cause the HCP to question decisions and second-guess themselves. Ruminating thoughts and worry over the perfect actions can lead to delayed action or inaction.
In a culture that reveres perfection, the development of maladaptive perfectionism is the strongest predictor for experiencing depression and anxiety. At the same time, HCPs who seek help for mental health are often stigmatized.
What HCPs find over time is that perfection is unrealistic and unattainable. The strain of reaching for perfection results in detrimental effects, such as:
Mental and physical exhaustion: HCPs only have so much energy and time. Trying to create perfect outcomes is exhausting, and HCPs don’t have enough time each day to do it. Something will suffer, and, often, it’s life outside of work.
Mental health declines: HCP wellbeing suffers. Expectations of perfection lead to mental health problems and high stress levels.
Self-care is lacking: Humans make mistakes. When HCPs are so driven to avoid failure that they can’t accept their limits, they ignore their self-care needs.
Feelings of being overwhelmed: Perfectionism slows HCPs down. Getting bogged down in micromanaging causes HCPs to become inefficient and get behind.
Decreased self-worth: Shame becomes inevitable. If performance becomes tied to feelings of self-worth and work is viewed as unsuccessful, shame is experienced.
Eight tips to overcome perfectionism
Continual expectations for perfectionism are unrealistic, but HCPs want to achieve perfect patient outcomes. HCPs must learn how to balance their perfectionist tendencies in order to prevent burnout.
Using the following eight tips, HCPs can begin to alter their need for perfection and avoid maladaptive perfectionism.
Connect with colleagues. The support of colleagues can bolster you when you feel like you aren’t performing according to perfection.
Find the middle ground. Avoid all-or-nothing thinking and look for options in the middle.
Learn to embrace imperfection. Learn to reframe challenges as opportunities while focusing on processes rather than outcomes. Instead of feeling like you’ve failed, try self-acceptance.
Let some things go. Learn to be flexible. Developing resilience allows HCPs to process change and know when perfection isn’t required.
Put things in perspective. Not every task or action is life-threatening. When feeling stressed, ask yourself if the decision or task could have fatal consequences. If the answer is no, it doesn’t need to be perfect.
Recognize when you set unrealistic and unnecessarily high expectations.
Reframe what is important. Not every task requires perfection. Some things just need to get done. Analyzing your to-do list will help prioritize where to put your efforts while avoiding the belief that everything must be perfect.
Set realistic expectations. Recognize when performance levels can’t be met without self-neglect or sacrifice and learn to care for yourself.
The bottom line
Inherent personality traits in HCPs and societal expectations perpetuate the concept that HCPs should be infallible. HCPs who learn to recognize the difference between high standards and unrealistic expectations can learn to avoid the pitfalls of maladaptive perfectionism.
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