John D. Kelly IV, MD, is a professor of orthopedic surgery at the University of Pennsylvania. He focuses his blog on helping surgeons reduce stress while achieving balance in their practices and families.

BLOG: Perfectionism is the fast track to burnout

As the burnout epidemic rages on and as I continue to study ways in which physicians can attain resiliency, one truth repeatedly emerges: perfectionists are at considerable risk for emotional exhaustion. I have written on the demon of perfectionism in the past but feel compelled to reinforce some truths as so many physicians struggle from this affliction.

In simple terms, being a perfectionist is stressful. Those who continually seek perfection always feel that they are missing the mark. Their efforts seem to constantly fall short of some elusive goal. Chronic frustration ensues, self-esteem erodes and emotional energy runs dry. Workaholism is a natural result as afflicted individuals strive harder and harder to prove their worth.

Origins of perfectionism

The internal voice or critic that continually asserts ‘you need to be perfect’ likely arose from a critical parent or caretaker. Somewhere during one’s formation the message that ‘you are not good enough’ was conveyed. Many have spent their entire lives trying to validate their worth through attainment of unrealistic goals. While there are countless testimonies of great achievement compiled by perfectionists, closer examination reveals that many, if not most, super achievers are in fact miserable.

Strive for excellence: Don’t obsess over it

In their meta-analysis of perfectionism, Hill and Curran identified that perfectionism was clearly correlated with burnout in sports, school and at work. However, they made the distinction of perfectionist strivings and concerns.

Perfectionistic strivings are simply the setting of high personal goals and proactively striving toward their realization. Strivings were not correlated with burnout prevalence. This aspect of perfectionism may in fact confer some protective effect by contributing to a sense of personal accomplishment.

Conversely, perfectionistic concerns — including fear of failure, preoccupation with mistakes, fear of disappointing oneself and others, and the need for continual self-validation — were significantly correlated with burnout.

Bottom line is it is noble and productive to strive for excellence, if one doesn’t have to.

Additional burdens

Perfectionists stifle inspiration and creativity. When one tries so hard to do everything perfectly, sympathetic activity increases, tension mounts and the ZONE or flow state where optimal performance is attained, is averted. Trying too hard suffocates any connection to one’s source, or higher power and throttles the emergence of inspired thought. Some of the most innovative ideas ever conceived were germinated in the presence of a relaxed and peaceful state. For example, Cuban physician Carlos Finlay, while immersed in prayer, recognized that the mosquito was the disease vector for both malaria and yellow fever.

The way out

I am a self-proclaimed perfectionist in recovery. To overcome perfectionism, I recommend the following steps which have worked for me:

Take an inventory of the toll perfectionism has taken or your life. Are relationships suffering because you keep looking for perfection in your spouse/partner? Are you delaying certain meaningful projects because you are waiting for the ‘perfect time’? Do you beat yourself up after even the slightest surgical ‘misadventure’? Are routine knee arthroscopies taxing and arduous as you endeavor to perform the ‘perfect’ meniscectomy?

Next create some space between you and your dysfunctional thoughts. The voice that haunts you and is relentless in reminding you that you are not ‘good enough’ is simply a distorted thought that is not arising from your source or higher self. The ‘voice’ is a result of some pain in your past and it is not to be trusted. It is only a thought.

Remind yourself that no one is perfect. Imperfection is part of the human condition and we all make mistakes. We need to recognize that mistake and ‘failure’ are lessons for us to incorporate in the future.

Affirm the truth that you are already ‘good enough’ and that no achievement, fame or fortune will increase your intrinsic worth. We are all endowed by our Creator with immutable dignity and value. Nothing can undermine that.

Perfectionists tend to hold one basic fear to be true: that without extraordinary achievement or acclaim they are intrinsically flawed. Nothing could be further from the truth!

 It’s time to reclaim your life and let passion, enthusiasm, and inspiration motivate you – not fear of failure.

You will accomplish much more and have a lot more fun in doing so.


Clark M, et al. J of Management. 2016;doi:10.1177/0149206314522301.

Yu JH, et al. Korean J Med Educ. 2016;doi:10.3946/kjme.2016.9.

Hill A, et al. Pers Soc Psychol Rev. 2015;doi:10.1177/1088868315596286.

Beyer R. Catholic Heart Day by Day: Uplifting Stories for Courageous Living. Brewster, MA: Paraclete Press; 2011.

Disclosure: Kelly reports no relevant financial disclosures.

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