Balanced Physician Blog

In my articles, I share valuable and practical solutions around work-life balance, performance, and leadership in medical practices and health systems.

Tighten up those boundaries or else…

Tighten up those boundaries or else…

It is almost summer which is the time for weekly lawn mowing. When you instruct your landscape company to take care of your lawn, where do they stop with mowing? At the boundary line. I assume you don’t instruct them to mow your neighbor’s back lawn as well. After all, people need to be responsible for their own properties and need to learn boundaries in their own lives too.

Meet Mary (name changed) who is a female physician who was exposed to this life lessons several times in the last few months. As the department chair in her organization, she was constantly struggling with the workload to keep up with her clinical performance and stay current with her administrative responsibilities. Recently, there has been a lot of turmoil in the department. A staff member was going through a lot of personal issues, and that had a big impact not only on her work performance but on the entire harmony within the team (this individual has a way to involve everyone else into her stories).

As a caring physician and leader of the department, Mary went beyond her line of duty to assist this individual. She listened to her problems, coached her around the issue, provided transportation a couple of times, and even accepted phone conversations in the late evenings to help her assistant. This situation had been going on for several weeks, and Mary arrived at a point where she just couldn’t take it anymore. She felt like she was caught in the middle of all of this and couldn’t get out. This situation even dominated her nightly conversations with her husband.

The tipping point arrived for Mary when she was out helping this person (who by the way is a delightful person; just had been caught up in all kind of personal drama) while her own child was feeling sick at home.

Knowing your boundaries and reinforcing boundaries is absolutely essential when you want to maintain your sanity, health, well-being, and performance. A boundary is a personal property line that marks those things which are ours and which are not. Everything inside our skin is within our own boundary. Boundaries need to be in effect in the emotional, physical, spiritual and mental areas of our life. As women, we tend to extend ourselves beyond capacity to please others, be of service to others, nurture, be acknowledged, and feel that we need to prove ourselves. Add to that the calling of a physician where you put the health and care of others before your own, and you can have the perfect formula for personal exhaustion. These lose boundaries can be connected to a heavy price – loss of personal priorities, overwhelm, stress, taking responsibility for something that isn’t ours and feeling bad when things fail.

Overstepped boundaries come in many forms. They are not caused by others and can include a variety of situations:

- Taking on more work than you can handle
- Taking on other people’s problems and wanting to solve them
-  Volunteering at different committees even though you are already tapped out schedule-wise
- Worrying about patient’s well-being while sitting in your living room in the evening and not acknowledging that the patient also has responsibility for their health
- People insulting you and you don’t address it.

So how do you know you might have a boundary problem? According to Dr. Henry Cloud and Dr. John Townsend, who wrote the book “Boundaries” there are symptoms and problems associated with taking on burdens that are not your own. They can include depression, resentment, anger problems, obsessive or compulsive behavior, low energy levels and extreme disorganization – taking on too much and finding not enough hours in the day, especially when it comes to spending time with your children.

Do you feel that you have a boundary problem? Do you experience one or more of the symptoms mentioned above? If so, please share your tips in the comment box and let us know how you corrected them.

If you haven’t been able to address them yet, it may be that you just don’t know how to say no to people, or if you do, you immediately feel bad and guilty afterward. Or you have been programmed with outdated life principles, parental doctrines, or societal values that just don’t work anymore.

In Mary’s case, she now knows the boundaries of her role as a leader, she rewrote some of the principles that guide her work, and she now knows how to say “no” eloquently” and not feel guilty about it at all. It isn’t always easy, but it is still simple. 

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