I’ve heard this a million times.
Perfection is the enemy of good enough.
But we are doctors. We spend our entire lives striving to be the best.
That is how you get to be a doctor. Your whole life, you are at or near the top of your class, achieving, receiving external rewards, striving for perfection. At each step we are rewarded for this behavior. Gold stars, awards, admissions, scholarships. My medical school has a 2% admissions rate. That means 98% of the well intentioned 10,000 students who believed they had a chance to get in will be rejected.
You can imagine the culture and mindset this has created for those of us in medicine.
We are immersed in a culture of perfection and self-sacrifice.
We have to pay close attention, we can’t miss anything, lives are at stake.
Yet, this perfection, is at what costs?
When is done better than perfect?
My coach talks a lot about B minus work. Many doctors just can’t even fathom B minus work. We are not B minus people. We are A or A+. Well, if B minus is just too far to go, how about A minus or B plus.
You know, we have found an interesting thing in medical school. Changing preclinical years from a traditional A, B, C graded system or a Honors, Near Honors, High Pass, Pass graded system to a Pass / Fail system actually decreases distress.
It’s true, when you stop grading students, even perfectionistic medical students, their well being improves.
What are the lessons from this for us that are further along in life?
How about we learn we have finally reached the pass / fail portion of our lives? We can start to embrace the pass / fail mentality. We don’t need to get honors anymore. We don’t need the gold stars. It is proven and well documented in academic medicine literature that changing to the mental construct of pass / fail improves well being.
The test scores didn’t change, the pass cut off didn’t change, USMLE Step 1 didn’t go away. Just the perception of the pressure to be perfect or that they were always being ranked or that they had to constantly strive for Honors went away.
Try and think outside the box a little for yourself. Where are you striving for Honors?
Is it your notes? Do they have to be perfect? I’m sure you have a good reason they have to be perfect. Maybe you are the consultant and you want to send a thorough assessment and plan to the primary physician. Maybe your patients are very sick. Maybe you can’t stand those other physicians notes that are terrible.
When my students are in distress, I always tell them P = MD.
You’ve likely heard the old joke asking what do they call the person ranked last in their medical school class? Doctor.
Now, I don’t want you to be a bad doctor. But I know you are not. You are reading this blog. That means you care. That means you are engaged. That means you are curious. Chances are your notes are pretty great. Perhaps you could cut them down just a little bit? Outline format for part of it? Only you know yourself and where you have room to grow or room to cut back.
Where else are you criticizing yourself for not being perfect? Perhaps in your parenting? What if however you are showing up as a mom is totally okay? What if you don’t have to be the perfect Pinetrest mom? I know I’m not. I don’t even pretend to be.
For me, it’s mostly in my work life where I obsess. Long emails, long letters of recommendation, “perfecting” my papers before submitting. The notes sitting way too long in my inbox. But I am learning, growing, practicing, and seeing so much more every single day that “Done is better than perfect.” I swear I need this as a tattoo. A constant reminder.
Because in life, there is no more Honors, Near Honors, High Pass, Pass. That phase of life is so far behind us (thank goodness). P = MD. And uh, our passing or “good enough” is most way more than B minus work for most people. It’s just our personality, we are over-achieving perfectionists, it’s in our nature. We have been selected and rewarded for it our whole lives. So now that you have arrived, as a full-fledged attending, after years and years of sacrificing yourself for others and 80 hour work weeks while others were on vacations, getting married, and having babies, I encourage you to continually remind yourself over and over and over, “Done is better than perfect.” Then find a way to go enjoy this life you worked so hard to create.