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Setting boundaries and the power of saying no

Christina Long, MD
Physician
January 26, 2022
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As a working mom of three kids and an emergency medicine physician, I have had to embrace home workouts since before the pandemic. I am a huge Peloton fan! In December of 2020, Robin Arzón, VP of fitness and an instructor for Peloton, partnered with Shonda Rhimes (creator of Grey’s Anatomy) to do a series about Rhimes’ book Year of Yes.

The power of saying yes. In 2020, just pre-pandemic, I was already in over my head with work-related commitments as I tried to go up for academic promotion while juggling three kids under age five years old, trying to maintain my fitness and health, and do my part in the community. And my marriage, that was totally on the backburner.

As I thought about my own New Year’s resolution or intentions, I thought, “You know what, I am going to have a ‘Year of No.'”

I was tired of saying yes to everyone and every opportunity. I was tired of feeling like no matter how much I took on. It was never enough. I made sacrifices while tired and pregnant to prove myself. But it was still not enough. So, I wanted to embrace the power of saying “no.” It turns out the sentiment was the same. Saying “yes” to yourself often means saying “no” to others.

Self-care is not selfish.

Fast forward to January 2022, Robin Arzón is now a mother and wrote her own book being released this month entitled Strong Mama. In her book signing, she talks about setting boundaries, not just in your professional life.

It is important to set boundaries at home with your significant other, your children and your friends. Even young children need to learn the importance of setting boundaries. For me, it might be an hour to work out uninterrupted. Or to shower without a kid asking me for another snack. It is also important to schedule time for self-care. Self-care looks different for everyone. “You must fill your own cup before you can fill others.” But you will need boundaries to make time for self-care.

The ladder

As physicians, we are under tremendous pressure to do it all — professionally and personally. We are constantly checking the boxes, building our CVs and climbing that proverbial ladder. In undergraduate, you probably spent every waking minute studying while also doing community service, learning to speak more languages, while also playing an instrument or competing in collegiate sports.

Getting into medical school was extremely competitive. Once in medical school, you continued studying every waking moment, but now also working long hours in the hospital, still doing community service, joining all the professional organizations — to be sure to match into the best residency program.

During residency, you continue to take on more, so you can land that fellowship spot or attending position. At last — you are hired. You have a great academic job. But now you have another ladder to climb: the dreaded professorship ladder. As academic physicians, we live a life where we perpetually take on more and more without really taking a pause to think about our why.

Does it bring you joy?

So what does saying “no” look like? Inspired by the famous Japanese consultant Marie Kondo, when an opportunity presents itself, ask yourself, “Does this bring me joy?”

If the answer is “yes,” then ask yourself: “Do I have time to commit myself to this, or will it clutter my mental to-do list?”

When I see patients in the ER before I take on a new patient, I scan my list to see if there is anyone else who can be dispositioned — otherwise, my list grows. And as my list grows, my anxiety grows. My ability to be the best physician for that next patient will be hindered if I don’t create the space and capacity to take on a new patient. The same holds true with obligations in life.

Before you take on a new research project, ask yourself, do you still have ongoing projects? What does your schedule look like? Do you really have time to take this on? Or maybe someone asked you to join a committee. What is the time commitment, is it a required responsibility, and would you enjoy being a member?

Being “voluntold”

I find that younger physicians, or the newest member of a group, are more susceptible to falling victim to being “voluntold.” It is especially important to set boundaries early on. The season of your life also matters equally. Having a newborn at home or experiencing a major life change is not the right season to take on a big new role or project. It is OK to say “no.” Even if you feel uncomfortable saying no, don’t be the first to say yes. Let someone else step up. More opportunities will arise when you are ready.

A Harvard Business Review article, titled “Happy Workaholics Need Boundaries, Not Balance,” recommends managing these levels of obligations with three categories of boundaries: temporal, physical and cognitive.

Temporal boundaries: Set aside specific times for non-work activities like family, friends and exercise.

Physical boundaries: Create distance between work and the rest of life — a consistent separation can keep these two worlds from becoming intertwined.

Cognitive boundaries: Leave work behind mentally and physically so that the thought of work doesn’t impede important time to refresh and recharge.

As a closing statement, I will leave you with my favorite Robin quote, often shared in her rides:

“Whatever you did today was enough. You are enough.”

Christina Long is an emergency physician.

Image credit: Shutterstock.com

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