One of the biggest lessons I’ve learned about perfectionism is that done is better than perfect. 

In my medical school and residency, we learned about “The Enemy”, a shortened version of “The enemy of good is better.” This is a well-known aphorism that originated in the 1700s and not in medicine. This means it is often better to finish something, to the best of your current ability, than continue to tinker with it until it becomes “perfect”.

Because perfect is unattainable and because something far worse can happen on the way to attempted perfection. 

This concept became crystal clear to me one day while doing an ankle fracture. I had gotten the ankle fixed pretty close to perfect, but thought I could do better (despite having heard this phrase MANY times). So I took down the fixation and re-manipulated it, only to have one of the pieces fragment further with my next attempt at more perfect alignment and fixation. 

In retrospect, it would have healed fine in its initial position, but I was concerned about any criticism from the chief residents or attendings, and I also didn’t have the experience of fixing many, many ankle fractures and seeing that near perfect but well fixed is in fact perfectly fine in real life. As an older colleague in practice once told me, “People don’t walk on their X-rays.”

I was able to get the fracture well-fixed again, albeit less perfect looking than before. But now I had personally experienced “the enemy”, the tendency to make was good even better when good results in, well, a good outcome. I worried about whether the fixation would hold. It did. It healed just fine.

And I learned a valuable lesson about trying to always make good-and-done better. 

I’ve learned the same lesson with writing blogs. Getting it done and finished is better than getting it perfect. Sometimes I’m working on my website and I see where I could use a better phrase. I will usually change it at that point, but I no longer stress about whether what I’ve written is absolutely perfect before I send it out into the world. It doesn’t have to be. It has to be done and express my ideas, as they are in the moment. And if I realize something later on, then I change it without obsessing. Because my goal is to improve how I express ideas.

I recently heard several other coaches talking about doing B+ work. The very first time I heard it, I was scandalized. B+ work hasn’t been acceptable in my eyes. It’s practically failing. It has felt like failure. And medicine is different, right? 

Except most of the time, it’s not. It’s not in any course I’ve ever taken and it’s not in the world. It’s fine. Save your A+ work effort and energy for the times it is most critical. Elsewhere, your B+ work is going to suffice. Because your B+ work is above average (literally and figuratively).

What’s more, the effort to try to be perfect all the time is exhausting. It’s not enjoyable. It’s stressful. Do you do your best work when you’re stressed? When the anesthesiologist asks every few minutes how much longer you think you’ll be does it improve how the case is going? When your office staff tells you that many patients are waiting, you’re really, really behind, and Dr. So-and-so is on the phone do you suddenly perform at a better level? 

I know I don’t. Do a good job. Get it done. Pay attention to the things that matter and let things that aren’t critical slide. And move on to the next thing. You will feel less stress. You will be more productive. You may even enjoy your life more.

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