This article presents some observations from a workshop setting about the role of compulsiveness in the normal physician. Case examples illustrate the effect of this character trait on the professional, personal, and family life of the typical physician. Doubt, guilt feelings, and an exaggerated sense of responsibility form a compulsive triad in the personality of the physician. This triad manifests itself in both adaptive and maladaptive ways. This article focuses primarily on the maladaptive, including difficulty in relaxing, reluctance to take vacations from work, problems in allocating time to family, an inappropriate and excessive sense of responsibility for things beyond one's control, chronic feelings of "not doing enough," difficulty setting limits, hypertrophied guilt feelings that interfere with the healthy pursuit of pleasure, and the confusion of selfishness with healthy self-interest.
(JAMA 1985;254:2926-2929)