Decision Fatigue, People-Pleasing, and Values Alignment for Women Physician Leaders
Have you ever noticed how much time you can spend thinking about a decision — without actually getting any closer to making it?
You replay it in your head.
You talk it through repeatedly with the people you trust.
You journal. You revisit it. You second-guess it.
And somehow, after all that effort, you’re more exhausted — and no clearer — than when you started.
For people-pleasers, especially in medicine, difficult decisions don’t just feel hard. They feel loaded.
Because it’s not only about what you want. It’s about how it will land with everyone else.
- Who might be disappointed.
- What might change.
- What you can’t undo once you choose.
So instead of deciding, we circle — hoping that if we think about it long enough, the “right” answer will finally appear.
Today, I want to talk about why that circling is so draining… and how a values-based lens can bring clarity faster than all the rehashing ever will.
Difficult decisions are difficult. Period.
Some more than others — but for people-pleasers, they often feel even heavier. Like there’s more at stake. Other people’s feelings. Future consequences. Relationships we don’t want to disrupt.
And we make so many decisions over a lifetime in medicine that you’d think this would get easier somehow.
Medicine or something else?
What specialty?
Which programs do I rank?
Fellowship or no fellowship?
Do I want kids — and if so, when is there ever time?
Do I take on that leadership role?
Do I set that boundary with my family?
And more often than I ever expected — for me and for my clients— Do I stay in medicine? Will I miss it if I leave?
So many times in my life, I’ve found myself circling these questions.
I’ve talked them through with my best friend. Then my mom. Then my grandmother. Then my journal. And please — let’s not even talk about how patient my husband has been.
And here’s the exhausting part:
From the outside, the answer often seems obvious.
But when you’re inside the decision, the circling is exhausting.
I used to believe that if I just thought about it long enough — if I rehashed it one more time — I’d land on the “right” choice.
One thing has become clear to me with time… circling doesn’t bring clarity. It erodes it.
These decisions are infinitely easier when you stop viewing them through fear, expectation, or obligation — and instead look at them through a values-based lens.
Suffering with Indecision Fatigue
I once worked with a client who had finished residency but hadn’t yet practiced clinically as an attending. To everyone around her, the path forward seemed obvious. So why was she so conflicted?
When we slowed down and really explored her values — what kind of life she wanted, what energized her, what sustainability actually meant — it became clear that a traditional clinical path would burn her out quickly.
Once she saw that, the decision stopped feeling dramatic.
It simply became aligned. Even though she was still worried about what others would think.
She was wishing for this clarity 2 years ago before her indecision fatigue even started.
Personal Fear and Indecision
I felt this same tension when my family moved across the country and I stepped away from my previous job that I truly loved — a mix of clinical medicine and hospital leadership.
My mentors gave thoughtful, generous advice about continuing my trajectory. And they weren’t wrong.
But we were looking at my future through different lenses.
Yes — I had the drive and potential to fulfill the vision they saw.
And also — my own lens was changing.
I was craving control and balance.
I wanted novelty and longevity.
I needed a healthier biosphere for me and my nuclear family.
Once I honored that, my decisions stopped taking weeks.
Not because they were easier, because it absolutely was not easy — but because the path toward my values was much clearer.
I wasn’t debating every option anymore.
I was simply asking, How does this align?
Finding Your Personal Core Values
So let’s talk about how you can start doing the same.
One of the most powerful places to look is friction.
- Where in your life are your values being rubbed the wrong way?
- What is draining you? and Why?
- What makes you resentful?
- What do you tolerate now that costs you energy later?
I have found that resentment is a data point. It points directly to your violated values.
For example, I once held a leadership role that I loved, but over time it started to feel exhausting.
When I started to look closely, I realized that I was putting in way more time than I was being compensated for. On top of that, some of my direct peers in the role were making significantly more than I was.
Now, I don’t need to make a ton of money, but I do need to feel valued for the effort and passion I pour in. And I need equity. Fairness is a core value for me.
Despite loving this role, these values were being stepped on.
For you, on the flip side – you can find your values from a positive light too.
- What do you always make time for?
- Where do you say “yes” the fastest?
- What gives you energy instead of taking it?
These reflections won’t give you an instant answer — but they’ll start sharpening your lens.
And once your values are clear, the decisions you’ve been circling?
They become much more obvious.
If you want to uncover your true values, I’ve created a simple guide with journaling prompts to help you. You can find it at womenmdleaders.com/valuesguide. This guide utilizes the same tools I often use with my coaching clients – provided to you as a “Thank you” for tuning in.
Appreciate you spending your time here and for leading with heart.