I turned and looked at the x-ray image on the screen and adjusted the needle slightly. I was performing a transforaminal epidural steroid injection under the supervision of a community physician who had offered to proctor me so I could obtain hospital privileges. I looked over to my colleague to see what she thought. I wanted to get this procedure absolutely perfect, partly for my own satisfaction and partly to impress my proctor. She gave me a small smile and said, “Ya know, better is the enemy of good.” I didn’t know what she was talking about. I must have looked very confused because she gave a short laugh and said, “It looks fine, I think you’re good.” I proceeded with the procedure and the patient did well.
Later I asked my proctor what she meant by “better is the enemy of good.” She said that sometimes you have to know when to stop. Doctors are known to be perfectionists and she had seen lots of new doctors spend an inordinate amount of time getting the procedure as close to textbook picture “perfect” as possible that we use in our training. The truth is that often medical procedures don’t have to look exactly like the textbook procedure to be effective. And the bottom line is no one really cares how the procedure looks as long as it is effective. If physicians spend too much time trying to improve an already well-done procedure just for aesthetic value, physician ego, or trying to impress their proctor, it prolongs the case unnecessarily and can expose the patient to increased risk of injury, infection, or something going wrong.
Recent evidence shows that perfectionism can lead to psychiatric problems such as anxiety, depression, and burnout. It often leads to internal strife in teams within organizations when perfection is the stated goal. Perfectionism can impede real progress in pursuing goals and accomplishing objectives, especially when a simpler solution is evident. This is not to say that doing the bare minimum is always acceptable, but needlessly tweaking something is more neurotic than a positive contribution.
Much like medical procedures, we often get distracted by efforts to constantly improve something that doesn’t need it, wasting time, energy, and money in the process. If something is effective or accomplishes its intended goals, any extra attention may only make it worse. We see this in art and cooking but also in our relationships and business dealings. Sometimes it is difficult to know when to stop and have the wisdom to know when the project, meeting, or conversation has achieved its purpose – that comes with experience and truly understanding your own goals.
But it also comes with humility. Humility to put the importance of the outcome and the objective over whatever self-centered goals you may seek through perfectionism. Good leaders know this, and empower others on their team to accomplish whatever will improve the organization, not what makes the team or the leader look the best.
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