Picture this: You’re sitting on a white sand beach, enjoying the breeze in your hair and the bright blue skies. You take a deep breath, about to breathe in some much-needed vacation vibes. Suddenly, your phone pings. It’s a message from work. Your patient has an issue and needs your help.
Or maybe you never get a message from work, but as you try to enjoy family time or adventures, you find it hard to relax. You just know that your inbox is exploding during your time away. You think about how you’re going to return to mountains of work, and your chest tightens. It’s hard to disconnect.
Has your role as a clinician ever overlapped with your vacation time? How about dinner time or weekends? Do you welcome the opportunity to provide a service during “off” hours, or do you find yourself feeling angry and resentful?
Maybe a bit of both?
Introducing: Only Human
Join Neda Frayha on our very special mini-audio series “Only Human: Real Clinician Stories, Unfiltered.” This series takes a deep dive into what clinicians think and feel but don’t always say about working in medicine. It’s free for everyone — subscribers and non, clinicians and anyone curious about what it’s like to practice medicine these days. It’s not just for pediatricians. But as I listened to this wonderful collection of conversations, one episode in particular felt like it should be mandatory listening for all pediatricians: chapter 2, Boundary Issues.
When I did my pediatrics rotation in medical school, I knew that I’d not only found my calling, but also my people. Pediatricians are known for being nice. Yes, we’re thoughtful and thorough and smart. But it’s the niceness that sets us apart. I love that my colleagues are naturally empathetic people.
But personally, I have always felt like my empathy made it hard for me to know when and how to create boundaries with patients and work. Should I give patients my email? Check the portal on the weekend? Should I double-book another patient to squeeze in a last-minute sick child? I have often felt caught between a rock and a hard place: do I want to feel guilty or overwhelmed?
Imagine my surprise when I listened to this episode of the “Only Human” series and heard that boundaries and empathy go hand in hand. I absolutely loved this podcast and feel every clinician — and especially every pediatrician — should listen to it. I wish I could go back in time and offer this as a gift to my former self from a decade ago.
Some of the insights I found so mind-blowing:
Boundaries are a gift to the patient.
Yes, you read that right. I’ve always thought of boundaries as something that might be necessary for my well-being, which inevitably short-changes the patient. But maybe I’ve been thinking about it all wrong. In this episode, Neda and Dr. Delia Chiaramonte discuss the idea that creating a healthy boundary can be viewed as an act of generosity.
By setting clear boundaries, you help your patient know what to expect. Which can help them feel more at ease. Boundaries help you avoid feeling resentful, so you have a healthier patient-doctor relationship. And fundamentally, it allows you to remain in medicine and continue providing excellent care. With burnout on the rise and some clinicians choosing to leave medicine altogether, boundaries can be essential for a long-lasting life in medicine. Which is your ultimate gift to your patient.
Boundaries will usually be received much more smoothly than we think.
You might find yourself ruminating on how hard it would be to say no. Maybe it feels impossible to protect your treasured time. Perhaps that fear prevents you from trying to create limits. But often patients and others receive it so much better than we expect. Most of the doctors interviewed on this episode talked about how much easier it was to create a boundary compared to what they had anticipated.
And for those less-common instances in which a new boundary isn’t received well? I loved this insight from Dr. Chiaramonte: “It’s not the other person’s responsibility to make you feel good about your boundaries.” As much as you’d love that validation, sometimes people will be upset (especially at first). And that’s okay, too.
We teach others how to treat us.
That patient paging the on-call doctor for a non-urgent issue on a Friday night at 10pm might trigger resentment or frustration. But that same patient might have learned in the past that this was an acceptable way to access care. They might have no idea that their request is anything other than routine. By clearly communicating expectations, you can teach your patients how to treat you and other clinicians in the future.
What’s more, by teaching others how to adapt to certain boundaries, you can also teach colleagues about boundary setting through your modeling. Slowly, this can help change the culture of medicine for the better.
We do NOT all need the same boundaries.
For some people, the healthiest, most authentic approach involves giving out their cell phone number and email address and being accessible to patients at all times. We get to hear more in-depth reflections from a physician who has forged his path doing just this. What’s more, he does it with joy.
Others like to have a clear sense of “work at work and home at home.” And if you’re somewhere in between, it could be evenings, weekends, or vacations that are untouchable. It’s not going to be the same for everyone. All of these approaches can be aligned with a life of purpose, meaning and wholehearted giving.
Another a-ha moment: The boundaries we don’t choose can make us feel depleted and exhausted. The boundaries we choose can keep us energized and present.
Healthy boundaries require self-reflection.
The first step toward knowing where to draw a line involves some self-reflection about what you really want. Sounds easy, right? Just get clear on what you want. But it turns out that all sorts of things make that hard. Things like:
- People-pleasing tendencies: Maybe I’m not the only pediatrician who got attached to the “nice” identity? If you’re focused on making everyone around you happy, the idea of disappointing someone can be scary.
- The culture of medicine: For many of us, residency training effectively taught us to have no boundaries. So we often need to unlearn a few things.
- Difficulty going against the grain: When the people around you are doing the same thing, it can feel especially hard to forge your own path.
- You have to figure out what you really want, not what you want to want: It can take some time to truly hear your inner voice and tease out your core values.
The good news? Creating healthy boundaries is absolutely doable. Check out the episode for more tangible tips and guidance on how (and when) to create healthy boundaries between work and the rest of your life. Listening to other clinicians share their honest, unique approaches to work-life balance feels like joining a conversation with close friends… and may just leave you feeling empowered to put new strategies into practice.
So that the next time you’re on vacation, you can feel refreshed and present — no matter what you choose to do with your workload.
