Last week I was at a birthday party — and a conversation with the host got me thinking. He told me his family didn’t really do birthday parties when he was growing up. It was more like, the neighborhood kids played in the yard, somebody brought a cake, and that was the day. He said he wanted that for his own kids. But somehow, the current culture of organized birthday parties — the venues, the favors, the invitations, the whole thing — kept sucking them back in.
I could relate to every word. The birthday party industry has boomed in our generation of parenting, and most of us got pulled right into the vortex without ever asking if we wanted to be there.
But here’s what I want to talk about today — because I don’t think this is really about birthday parties at all. I think it’s about a question we keep asking ourselves, quietly, in a hundred different ways: do I have to keep up with this? With the pace, the expectations, the way it’s always been done? Or am I allowed to do something different?
So today, I want to give you permission. Permission to stop trying to keep up with a culture that’s costing you something. Permission to lean into your values instead. And permission to change the culture — even if at first you’re only changing it for yourself.
Why Women Physician Leaders Are Tired of Keeping Up — And What to Do Instead
Here’s what I’ve learned, and I’ll say it plainly: you do not have to keep up with the culture. You get to choose your values, and you get to build a life — and a career — around them.
That sentence sounds simple. Living it is not. Because the culture is loud. The culture is everywhere. The culture has opinions about how you raise your kids, how you spend your weekends, how you practice medicine, how you run a meeting, how long you stay late, whose approval you need, and what success is supposed to look like.
And when you start choosing differently, you feel it. You feel the social pressure. You feel the FOMO. You feel the quiet judgment, real or imagined. You feel like you might be doing it wrong, even when every part of your gut is telling you you’re finally doing it right.
But here’s the reframe that changed everything for me:
- I’m not opting out of community.
- I’m not opting out of leadership.
- I’m not opting out of medicine.
I’m opting into a version of all three that’s actually aligned with what I value.
And every time I do, I’m quietly handing the same permission to someone else.
A Real Story: Choosing Values Over Culture in Family Life and Medical Career
Let me give you a real example, because this one cost me something.
When my kids were little, the culture in our town was soccer club and swim team. Big commitment, weekend tournaments, the whole shebang.
My husband and I, as physicians who both take call, work a lot of weekends. So I sat with it honestly — what would this actually look like for our family?
And what I saw was a nanny driving my kids to games while we worked, or us spending our rare and treasured weekend family time on the road, trying to catch the second half. That’s not the quality family time I was trying to build.
So I steered us a different direction. Activities we could do together. Hiking, biking, skiing. Things we could still be doing when we’re old. These days that includes pickleball, tennis, rock climbing, and running.
And here’s the part I’m going to be honest about: I am someone who wants to fit in.
This felt very unnatural to me. And there was a cost. I wasn’t included in the sideline banter that happens when everyone’s at the same game every Saturday. We were on the outside of some social circles because of these decisions.
That same fear came up later when I started doing locums work instead of being employed. Community is one of my core values. I worried I’d lose it. What I’m finding instead is a different kind of community. I return to the same hospitals often. I’m welcomed warmly almost everywhere I go. And I am now building a community of entrepreneurs and coaches that gives me a whole new perspective.
It doesn’t look like the community I thought I was supposed to want — it looks like the one that actually fits the life I’m building.
That’s the thing nobody tells you. When you choose your values over the culture, you don’t lose everything. You lose some things. And then you find what was meant for you.
A 3-Step Framework for Women Physicians to Lead Change From the Inside Out
So how do you actually do this? How do you start choosing your values instead of keeping up? Here’s the move I keep coming back to. It’s an inside-out shift, and it has three parts.
First, name the value, not the rule.
The culture gives you a rule — throw the big party, sign up for travel sports, take the W-2 job, run the meeting the way it’s always been run.
Your job is to look underneath the rule and ask: what is the value I actually care about here?
For me with birthday parties, the value isn’t “big party.” The value is making my kids feel celebrated and connected to the people who love them. Our greatest birthday tradition? It’s making the cake together. And go on and on about what a dynamic process this has become with time! But my point is…
Once you name the value, you stop arguing with the rule. You start asking better questions.
Second, choose the smallest aligned action.
You do not have to dismantle anything. You don’t have to announce that you’re opting out of the norm. You just choose one thing. Smaller party. Different sport. One locums shift. One meeting structured around what actually matters.
The smallest aligned action is the move.
Third — and this is the one I want you to sit with — protect what’s already working.
When I became chief of inpatient pediatrics, I was younger than most of the team and had less seniority. The way things had been done for years didn’t lend itself to the kind of progress I knew the department needed.
But I also knew the greatest strength of that department was the community and the relationships people had with each other. I wasn’t going to blow that up.
So instead of trying to change the culture to fit my agenda, I put what I valued — progress, growth, real action items — into the culture that already existed. I adapted my agendas. I changed the meeting cadence. I worked within what people loved and brought my priorities into it. I attempted to model values at every opportunity.
That’s how you lead change without destroying what made the place worth leading in the first place.
- Name the value.
- Choose the smallest aligned action.
- Protect what’s already working.
That’s how you change a culture from the inside — starting with yourself.
Next Steps for Women Physician Leaders Ready to Stop Keeping Up and Start Leading From Their Values
If you’re a woman physician leader who’s tired of keeping up, here’s what I want you to hear: you’re allowed to do this differently.
Your career, your leadership, your weekends, your meetings, your patient panel, your time. You get to design it from your values, not from a script you didn’t write.
And if you’re a younger physician — if you’re one of the women coming up behind me, watching the system and quietly thinking, this isn’t going to work for the life I want — I want to be the one telling you that you have options.
The system of medicine is broken in so many ways. We don’t fix it by burning ourselves out trying to keep up. We fix it by women like you choosing differently, and then showing the next one what that looks like.
If this is landing for you, I’d love to invite you to download my Values Journal. It’s a guide with prompts to help you get clear on your core values — so you can start making decisions from there instead of from default. You can find it at womenmdleaders.com/valuesguide.
And if you’re ready to stop trying to keep up and start leading from your values, I’d love to talk. Apply to work with me at womenmdleaders.com/work-with-stephanie.
You don’t need to keep up. You need to come home to yourself. Permission granted.