For a long time, I thought I was doing the work.
I walked with a friend once a week. I ran three days a week. From the outside, that looked like a woman investing in herself. I felt good about it.
But I hadn’t asked what my body actually needed. Some of that running had more to do with wanting to look a certain way than with improving my health. I hadn’t done the harder work: figuring out what I actually needed to feel like myself again.
If you’re a physician leader who’s already doing the things that are supposed to fix your overwhelm — the workouts, the walks, the boundaries you’ve read about — and you still don’t feel like yourself, stay with me.
The problem might not be effort. It might be that you’re solving the wrong problem entirely.
Physician Burnout and the Structural Trap Behind Self-Blame
Here’s what I want you to sit with.
It took me nearly two years to find out what I actually needed. Not two years of falling apart. Two years of quiet work almost nobody saw: sitting with a coach, reading everything I could find on leadership and on my own values, having hard conversations with my husband about what our family could afford to risk.
We looked at his retirement timeline against mine. We restructured our expenses so a big change would be possible if we needed it. None of that looked like restructuring a career from the outside. It looked like two people at a kitchen table, doing math.
And somewhere inside all that reading and reflecting, I got clear. Not on what I should value. On what actually mattered to me.
That clarity is what let me see the real problem. I had convinced myself the overnights were the issue, that any job in my field requiring them would eventually break me.
It wasn’t the overnights. It was the structure they were built inside of.
As a recovering perfectionist, my instinct was always to blame myself first. If I couldn’t keep pace with everything the job demanded, that was a personal failure. Not enough discipline. Not enough resilience.
But I was fine. I am fine. What wasn’t fine was the structure I kept trying to fit myself into.
A Real Story: Choosing a Different Structure as a Physician Leader
When I moved to locums work, I still take overnight call. But now it’s in blocks I choose, for a defined stretch, and then it’s over.
Same task. Different design.
The difference between those two things was the difference between drowning and functioning.
I know how this can sound from the outside: an opportunity to move across the country came up, and we took it. Clean story, tidy resolution.
But we didn’t get the opportunity and then figure out what to do with it. We spent two years getting ready to walk through a door before we knew it would open.
The financial groundwork and the values work weren’t preparation for a plan. They were the plan. So when the door did open, I could say yes without having to negotiate with my own fear first.
Two Questions for Women Physician Leaders Ready to Choose Themselves
Medicine has always told physicians where our limits are. It has never once asked us where we needed them. When a system sets every boundary for you, it’s easy to mistake its limits for your own failures.
Before you reach for one more strategy to push through, ask yourself two questions instead.
The first: is this actually a personal failing? Or is it a structure I’ve never been given permission to question? Most of us never stop to ask that.
We assume if something isn’t working, the fix has to be us. Sometimes it is. But sometimes what’s breaking you isn’t a lack of resilience. It’s a structure nobody built with you in mind.
The second: what would I need in place to act on what I actually value, if the door opened tomorrow?
Not someday. Tomorrow.
You don’t need a cross-country move to start this work. You need clarity on what you actually value, and an honest look at what you’d need in place to act on it.
Next Steps for Women Physician Leaders Ready to Choose Structure Over Self-Blame
Start there. The door doesn’t have to be open yet for the work to count.
If you’re not sure where to start with the values piece, I built a Values Journal with prompts to help you get clear on what actually matters to you, not what you’ve been told should matter. You’ll find it at womenmdleaders.com/valuesguide.
And if you’re ready to do the deeper work, the kind that gets you ready before the door opens, that’s exactly what coaching is for. You can apply at womenmdleaders.com/work-with-stephanie.
I’m Dr. Stephanie Yamout. Thank you for listening, and for leading with heart.