By Julia Close, MD

I started a blog post about the curse of perfectionism 3 months ago. I am methodical on many fronts, and writing is no different. I jotted out an outline (in a notebook I carry with me all the time, indexed). I set aside time here and there to write it. I had no specific deadline, but included it as a recurring part of my long list of to-dos. I dutifully worked on it from time to time, trying to craft the perfect sentences to share with you. Searching for the perfect reference to support some of my thoughts. The blog post languished.

A few days ago, I was asked if I could complete a blog post this week. “Of course I can, it is almost done!” I also knew this was exactly what I needed: a deadline. I have always worked better with deadlines. Regardless of when I start, projects are completed on time. Right on time. Rarely early, rarely late. Early in life, like many of us, I had a fair amount of academic success. More contemporarily, I have had career success. I manage to get a lot done. However, I never really liked the last-minute feeling. I longed to be one of those individuals that turned projects in early and moved on to the next. It just rarely seemed to happen, regardless of how early I started or how much I planned. I needed the pressure of deadline to get that final kick to completion.

A few years ago, I stumbled across a quote: “Procrastination is a symptom of perfectionism.” I reflected. I proceeded down a rabbit hole of references outlining lists of symptoms of perfectionism—goal-driven, fear of letting others down, high expectations, procrastination. Hmmm… this sounded familiar. But perfectionism? How could I be a perfectionist when I am so far from perfect?

Examples come to mind. My desk. It is not clean. It is not a fire hazard but there are piles of paper. My Outlook inbox. Annually I get to “inbox zero” right before New Year’s Eve, then the bulk slowly grows. I manage it, considering the volume, fairly well, but it is not perfect.

Let me tell you about my colleague—let’s call her Dr. M—whom I always viewed as perfect. Her desk is clean. (Occasionally I work from it, due to geographic issues inherent to large academic centers. I like to place a variety of papers askew on it and send her pictures.) Her inbox actually is close to zero, every email carefully filed and dealt with in an orderly, efficient manner. (When mine gets particularly large, I like to send her pictures of the number sitting in the inbox so she can shudder.) She turns in forms and projects early. When I receive mundane forms that I know she needs to complete also, I often ask the administrative assistant collecting the forms if I managed to get it in faster than her. Rarely can I do it. (When I do, I like to send her an email claiming my efficiency victory, which she may place in a clearly labeled Outlook file.) She is amazing. She is my organizational hero.

I have written a few papers with Dr. M. When I send off a draft to her, she usually turns it around within hours or a few days. I think she has even done it in minutes. Contained are great suggestions and wonderful edits. I once talked to her about this:

Me: “How did you send that back to me so fast? You didn’t need to stare at the sentences and try them out many different ways?”

Dr. M: “No, I just read through and made some changes.”

Me: “You found another reference. Did you get caught up reading eight different references trying to choose the right one?”

Dr. M: “No, I found that one and I didn’t think the other ones really needed to be reviewed or included.”

Me: “BUT HOW DO YOU DO IT??!?!?”

Dr. M (looking at me strangely): “I just do it. And it’s done.”

This what I have learned by asking Dr. M questions, reading more, and reflecting: Perfectionists strive so hard to be perfect that the work is never done. The high standard can never be reached. Procrastination is a coping mechanism—many learn that if they work on something at the last minute, the fear of disappointing others by turning it in late will tip the scales and the work will finally be completed.

In order to overcome this, I have had to accept that my work will never be perfect. That does not mean it is not good; it may even be excellent. I recently listened to a podcast by a physician named Dr. Katrina Ubell titled “Ditching Perfectionism” (listen here). She refers to this approach as accepting B- work. Her examples illustrate this well—the surgeon who is such a perfectionist that she does not close in an efficient time frame because she is obsessed with the perfect surgery. Her operative note is not done because she is trying to be sure her notes are perfect, and meanwhile an operative complication has occurred and no one can access the note. Most of us would prefer the surgeon who does a great job, is thorough, but does not second-guess every step. The surgeon who writes complete notes in a timely manner, even if there may be an occasional spelling error.

My senior year in college, I took an inorganic chemistry class. The lab assignments were complex, cumbersome, and heavily detailed. Unlike any other course I had taken to reach my chemistry degree, this lab was complex enough to be classified as its own course. We had a weekly lab, and a large write-up due each week. I spent hours on the assignments—carefully plotting and tracking my data, deliberately perfecting the presentation and form of the data and conclusions. I received an A+ in that class, my only A+ at a very reputable institution. Until recent years, in the recess of my mind I’ve been very proud of this. In retrospect, what a waste of time! Did my A+ work really contain any information that A work would not have contained? I probably should have gone to more basketball games, read a book, or taken up running earlier in life.

For a while now, I have been working on accepting B+ work. I am not ready for B-.

Which brings me back to this blog post. This is not the blog post I planned many months ago. I had outlined one in which I had largely overcome my tendencies and became more effective. In many ways I have—I completed a manuscript last week without a looming deadline. I did not perseverate over the sentences or get caught up reviewing more and more tangential references. I reported the data and sent a draft to my colleagues. I’m pretty proud of it. I complete much of my administrative work ahead of time now. I do not find myself up against deadlines nearly as often as I used to.

As I struggled to complete this post, I realized I was falling back on old habits. I spent an embarrassing amount of time trying to find a quote from a reputable psychologist about the definition of perfectionism and the interplay between perfectionism and procrastination. I decided you, the reader, would need to trust me on these points.

I sat this morning and wrote this post. It is done, and it’s pretty good for B+ work. 

Dr. Close is a clinical associate professor at the University of Florida, where she is the program director of the Hematology/Oncology Fellowship Program. In addition to education, she is focused on performance improvement as the assistant chief of medical service in the Gainesville VA Medical Center.