I hold a specific memory about senior leader from my hospital at opening day for baseball. All of our kids were there. He said, “Yeah, I left my phone in the car so I’d be forced not to look at it for an hour.”
I’ve heard versions of this so many times. Hanging out at the 4th of July barbecue while checking messages about the overcrowded ER. Stepping away from the kids’ table to take the call. Physically present, mentally elsewhere, and somehow that’s just… the norm. The mentality we absorb when we step into leadership.
I remember standing there thinking: that is not how I want to end up. And for probably the first time in my career, I consciously decided that was not the direction I wanted to go. It made me wonder — had someone in that role modeled something different, would I have been interested in staying on course?
That moment is really what this episode is about. The difference between independence and freedom. Because for all intents and purposes, we have independence. What we really want is something else entirely.
Independence vs. Freedom: What Women Physician Leaders Are Actually Missing
Women physician leaders have independence. We have a career, financial security, and we’re “free to move about the cabin,” so to speak. That independence is structural. It comes with the degrees, the bank account, the maturity, the title.
But what we really desire? Freedom.
Freedom to make the decisions we actually want to make. Freedom to set a boundary and say no without guilt. Freedom to take chances and try new things. Freedom to speak up with our full confidence, without fear of judgment or misperception.
Independence is what the system handed us when we crossed the finish line. Freedom is what we have to claim ourselves. And most of us were never taught how.
Physician Burnout and the Black-or-White Trap: A Story from the Trenches
In the darkest days of my burnout, my neurologist told me I needed regular sleep to stop my migraines. She actually prescribed it. The first time she said it, I told her it was impossible — I’m a hospitalist, hospitals are open 24/7, it was never going to happen.
I kept coming back with little improvement despite her treatment plan. Finally, at the end of my rope, I gave in. I needed sleep. I couldn’t get it working overnights. So I turned in my resignation. Then left for vacation with a weight lifted that I hadn’t felt in years. I never even talked to my chief about possible accommodations. I was a leader in that department. I felt I could no longer do the job. So I left.
When I returned home from vacation, he called me into his office. He had a plan: would I hear him out? He’d found a way for me to stop taking night call.
I was speechless.
For so long I had believed it was overnight call or quit. That was it. Black or white. I didn’t have enough bandwidth or creativity to see that things could be more flexible. I lived very much inside the box, the one our typical career path creates for us. And seeing that I could choose my health and my job — that was where the true freedom was.
That experience changed so much. I was able to slowly make all the changes that helped me dig out of the burnout hole. And for the first time, probably in my whole career, I was actually free. Free in the sense that I was brave enough to walk away if something stopped being aligned. That same inner freedom let me set better boundaries, at home and at work. It let me see where resentment was hiding and question it, address it, or change it.
It was the type of freedom I always thought would just come with the attending title. I didn’t realize I’d have to struggle for it. I guess that’s the difference.
What Inner Freedom Actually Requires: Boundaries, Systems, and Creativity
Here’s what I’ve come to understand. Real freedom — not the structural kind, the inner kind — rests on 3 things working together.
The first is boundaries you actually keep. Not the ones you announce on Monday and quietly abandon by Wednesday. Boundaries that hold even when it’s uncomfortable, because you know what you’re protecting. That kind of boundary only comes when you’re clear on your values. Otherwise it’s just a rule, and rules bend.
The second is the ability to name resentment when it shows up. Resentment is almost always a signal that something you value is being violated. When I was burned out, I was full of it and had no idea. When I started to feel better, I could actually get curious about it. Ask: what is this telling me? Where did I stop being honest about what I need?
The third is creativity in the face of constraint. I had zero creativity when I was at my lowest. I could not see past the 2 options in front of me. The black or white. That’s what burnout does — it collapses your field of vision. Inner freedom opens it back up. You can negotiate. Redesign. Ask for something you’ve never asked for before.
I’m starting to believe that the senior leader at opening day — the one with the phone in the car — wasn’t just exhausted. He was out of freedom. And he didn’t know it because no one around him had modeled anything different.
So here’s what I want you to sit with. Not independence. You’ve already proven that.
- Where in your life right now are you operating without freedom?
- Where are you stuck in black-or-white thinking?
- Where are you tolerating something you’ve never even thought to question?
Next Steps for Women Physician Leaders Ready to Lead on Their Own Terms
If this landed for you, my values journal is a good place to start. It’s a 7-part reflection that gets underneath what you’ve been tolerating and helps you figure out what you actually want. You can find it at womenmdleaders.com/valuesguide.
And if you’re ready to do this work directly, I’d love to chat. I work with women physician leaders who are done proving themselves and ready to lead in a way that actually feels like them. Apply to work with me at womenmdleaders.com/work-with-stephanie.
Thank you for being here. I’ll see you next week.
Protect your peace.