If you’re anything like me, you feel most steady when you have a plan. A routine. Something you had a hand in shaping. Right now, my work and life schedule is the most sorted it has ever been — and it feels good, even if I keep myself a little too busy sometimes. That’s how I like it.
But here’s the thing. Very soon, all of this perfectly calendared and arranged life of mine is going to go up in flames. The kids are about to be on summer break. They’re overflowing with anticipation, and honestly, I’m dreading it. I’ve been overpacking my schedule right now in hopes that it’ll soften the chaos later.
If you’re a high-achieving woman in medicine, you know exactly what I’m talking about. The grip we keep on our calendars. The way it slips the moment life does what life does. So today, I want to talk about something I’ve been wrestling with — the difference between control and agency, and a few practical things you can actually do the next time the structure that keeps you afloat falls away.
The Difference Between Control and Agency for Women Physician Leaders
Here’s what I’ve come to. The only thing we ever really have control over is our own response. That’s it.
As high-achieving women — and especially as women in medicine — we have been trained to value control. And for good reason. For most of our careers, we didn’t have it.
We didn’t control whether we got into medical school. We didn’t control where we matched. The algorithm did. We didn’t really get to choose our schedules until we were 30-something years old, and even then, being employed or running a hospital open 24/7 took most of that choice back.
So we learned to grip what little we could. And we became very, very good at it.
But control is fragile. It depends on the world turning the way we expect it to — and it never quite does. Agency is different. Agency is internal. It’s your capacity to choose how you respond, where you direct your energy, and how you act in alignment with what you actually value. Control asks, “How do I make everything fit?” Agency asks, “What am I choosing to make room for?”
Why Summer Break Exposes the High-Achieving Woman’s Grip on Control
Let me make this concrete. Summer break is my annual case study in the difference between control and agency.
I have been planning for this summer since October. That’s when camp sign-ups start — and don’t get me started on that whole industry. So by the time the kids are out of school, I have it all mapped. Camps booked. Schedules color-coded. The week is a fortress.
And then it falls apart. Because I am a quality-time person — that’s my love language. So even with the camps, I want to be present with my kids when they’re home. But I also want to keep growing my business. I want client time. I want creative time. I want focused work. And what I’ve noticed is that when someone is in my space — hungry, asking permission for something, just being a kid — my brain starts hopping. I’m not really present for any of it.
I used to call this a scheduling problem. I’d tell myself if I just planned harder, woke up earlier, or organized better, I could make it all fit. But that’s not what was happening. The problem wasn’t poor organization. The problem was that I had too many legitimate things competing for the same finite human being — and I was using control to avoid the harder question.
The harder question is the agency question. Not how do I make it all fit. But what kind of woman do I want to be in this season?
Four Practical Tools for Women Physician Leaders to Trade Control for Agency
So here are four things I’ve started actually doing — just four moves you can use the next time you feel your grip slipping.
First, ask the better question. In the middle of chaos, our brain reaches for certainty. We want our plan back. But the more powerful question isn’t, How do I get back control here? It’s, What is still mine to choose?
Maybe you can’t control the meeting that ran late. But you can choose not to spiral. You can choose to send the short email instead of the perfect one. You can choose to move one commitment. You can choose to tell your family, I need ten minutes to transition so I can actually be with you. You can choose not to punish yourself for being human.
Second, protect your identity-based non-negotiables. High performers will protect tasks before they protect identity. We schedule the meetings, the patient care, the deadlines, the emails. And somehow family dinner, sleep, exercise, reflection — the things that make us feel like ourselves — become optional.
Pick two or three blocks each week. Not fifty. Just the few that say, “This is the kind of mother I am.” This is the kind of leader I am. This is what I protect because it protects me.
Agency grows when your calendar reflects who you say you are.
Third, use your boundaries as agency statements, not control tactics. A boundary is not you trying to control someone else. It’s you declaring how you will participate.
Control sounds like, “You need to stop asking so much of me.”
Agency sounds like, “I’m not available for that timeline, but I can do Friday.” Or “I can attend the first 30 minutes, but I’ll need to leave at four.” Or “I want to help, but I cannot be the owner of this.”
This matters especially for high-achieving women, because we so often confuse being needed with being valuable.
Your value is not proven by your availability.
Fourth, build a transition ritual. One of the hardest parts of a high-performing life is that your body leaves work before your nervous system does. You walk into your home, but part of you is still in the meeting, the inbox, the chart, the unresolved decision or unsent email.
Before you step into your next role — parent, spouse, friend, leader — pause and ask, “Who needs me now, and how do I want to show up?”
Then take one physical action. Breathe. Wash your hands. Change clothes. Step outside for two minutes. Put your phone in another room. Or just say out loud, Work is done for now.
Presence is not automatic. It’s a deliberate re-entry.
Next Steps for Women Physician Leaders Ready to Lead With Clarity Instead of Control
Here’s what I want to leave you with. The most powerful women I know — the ones I look up to, the ones I coach — are not the women who control everything. They are the women who stay deeply connected to themselves when everything cannot be controlled.
If you’re in a season where you are gripping the calendar with both hands and it is still slipping, I want you to know two things.
First, you are not failing. You are over-functioning in a system that asks too much of you.
And second, there is another way to lead — through your own life and your own work — that doesn’t require you to white-knuckle every hour.
If you’re ready to stop spinning and start leading with clarity, apply to work with me at womenmdleaders.com/work-with-stephanie.
I coach women physician leaders one-on-one, and this is exactly the kind of work we do together — moving you out of control and into agency, on purpose.
Until next time. Protect your peace.