When We Believe There is One Right Way to Do Things

Perfectionism and People-Pleasing Strike Again!

This one comes up a lot in my conversations with physicians. A belief that there is one right way to do something.

I don’t think I have to tell you where this comes from. Years of training have often drilled this into us, though interestingly, depending on who was teaching us, we may have each learned different one right ways.

But outside of medical training, people-pleasing pops up here too (damn, it really is sneaky). You were likely praised for a behavior, perhaps over and over again, that reinforced your belief in one right way. And not usually something medical, where we may have science to back us up. You were likely praised for your willingness to help, the quality/thoroughness of your notes, etc in such a way that you now believe that it’s necessary to repeat that behavior.

Think about it; as a learner, what was the praise you received?

I’ve shared the story before that as a resident, I firmly believed that I would never be the smartest physician or the best diagnostician; I knew that I was no House MD. But I also believed that what I could/would/should give my patients was more time, more patient listening. And this belief spun the story in my mind that I owed my patients more time because I wasn’t the smartest one out there. And patients loved me for it, except when they were waiting for me, because of course, I ran late.

But when I tried to make changes, I flailed. Because if I wasn’t the best doctor, then what else could I do but give them extra time? That was the right thing to do, wasn’t it?

I’ve encountered others who were praised for writing excellent, highly-detailed, thoughtful notes. And likely, as students, when they were required to do less, they poured lots of energy into these notes and were lauded for their labors with praise. And now? They have so many more notes to write and still write long, overly-detailed notes, perhaps still lauded for their thoroughness, but ultimately incredibly unsustainable. But here again, if they believe that this level of notes is required, that it is the right way to write notes, they will struggle to change.

It’s a vicious cycle.

So let’s reframe. There may be clinical situations where the evidence points us towards a first-line strategy. But, MOST areas in our lives are not this way, and it’s necessary for us to evaluate these areas where we know we are putting in too much effort compared to what is required. 

What is it for you? 

Maybe it’s notes. 

Maybe you believe that work-outs have to be an hour to be effective, and if you can’t commit to that it’s not worth it to exercise.

Maybe you believe you can’t delegate or hire help at home because you *should* be able to keep your house spotless, have polite children who eat home-cooked meals, all while working full-time as a physician.

There’s nearly always areas in our lives that are harder than they need to be because we believe that we have to do things a certain way (or keep up with others). Find those spots in your life, and decide now that you don’t have to hang on to the belief that there is one right way.

Start a tiny exercise habit.

Stop writing elaborate paragraphs in your notes.

Be cool with weekly PB&J dinners on your busiest days.

You have full permission to let go of your beliefs that things have to be done this way, especially about things that really bog you down, taking too much time or energy, without really mattering. Your notes need to just be good enough, not exquisite. The house doesn’t need to be sterile and “photo-shoot ready”; “lived in” is just fine.

Unburden yourself from the one right way belief, and see some of the pressure melt away. Expect that it may feel weird at first, it may feel uncomfortable too. But if the goal is for things to be easier, to feel more relaxed, to create space for you in your life, you have to give yourself permission to change your beliefs.