Module 1: Boundaries for Women Physicians

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Boundaries for Women Physicians Group Coaching Program Tammie Chang, MD 1

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What brought you here? What do you most hope to get out of the next 12 weeks? 2

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a little about me and my Why

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MODULE 1 • Why Boundaries • How do we think about boundaries • Boundaries and the life you crave • Know who you are: values, impact statement, your Why, your non-negotiables

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Why Boundaries?

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Why Boundaries? • 60% increased odds of burnout compared to male physicians • 400% higher risk of dying by suicide than women in the general population • 40% of women physicians go part-time or quit medicine altogether within…6 years of completing their residency training • While the majority of U.S. medical students are now women (51%) • Only 34% of physicians in the workforce are women • Only 16% of hospital C-suite leaders • Only 18% of deans and department chairs are women  The leadership funnel narrows early for women 6

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West, et al. J Int Med, 2018 Houkes, et al BMC Public Health 2011 Hampton, JAMA 2005 physicians Paturel, AAMC 2019 Mangurian, et al. HBR 2018


Why Boundaries? • Female physicians score lower in all 4 areas of decompression, compared with work colleagues: • • • •

Enjoying personal time without worrying about work Freeing mind from work while away Disconnecting from work communications Rarely losing sleep over work issues

• The gap persisted across all female physicians age 30 – 65  Difference can’t be explained as time-limited challenges due to child-rearing responsibilities Dudley, et al. HBR 2022 7

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What are Boundaries? • Concept introduced in 1980s • Popularized by Dr. Henry Cloud and Dr. John Townsend, clinical psychologists, in 1990s in their first book, Boundaries: When to Say Yes, How to Say No to Take Control of Your Life • Boundaries are the line between what is ours and what is not. What is our responsibility and what is not. 8

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Why can Boundaries be so hard? • The word “Boundaries” can be fraught with stress or discomfort for most of us as women. • This normal and natural, we were not raised to have boundaries, and boundaries were not necessarily modeled well for us.

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Why can Boundaries be so hard especially for women physicians? • As women, and women physicians, we experience the Double Whammy of Human Giver Syndrome, described by Drs. Amelia and Emily Nagoski in Burnout: The Secret to Unlocking the Stress Cycle • High achieving, perfectionistic traits

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Peters et al, Perfectionism in Doctors, BMJ 2012


My Own Boundaries Story

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How Do We Think About Boundaries?

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What words come to mind when you hear the word Boundaries?

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Dyads What do “boundaries” mean to you?

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Questions to consider How were boundaries modeled for me as a child? When did I first learn about boundaries? What is an example in my life now where I am setting good boundaries? What is an example in my now where I’m not setting good boundaries?

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Boundaries and the Life You Crave

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Visualizin g Your Future Self

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5 Years From Now

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Worksheet #1 Boundaries and the life you crave: Your Future Self Visualization

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Worksheet #1 What did you feel like in this version of you? What was she like? How did she approach boundaries in her life? What about her most inspires you?

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Know Who You Are:

Values, impact statement, your Why, your non-negotiables

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Mining for Your Core Values • What are the peak experiences in your life so far? • When have you felt most alive? • What makes you mad—like MAD—enough to stand up for something? • What common themes do you notice in your life? 26

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Worksheet #2 Core Values Exercise

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Dyads How was this exercise for you? What are your top 5 core values?

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What is Your Why?

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Sinek, S. Start With Why. Portfolio, 2011.


Worksheet #3 Your Personal Impact Statement

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I am ___________ (metaphor) who ___________ (impact).

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What is the #1 thing you commit to from today?

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Getting CME credit for today’s session! Reflect on how it applies to your day-today and engage to earn AMA PRA Category 1 Credit(s)™ from point-ofcare learning activities here: https://earnc.me/ZqcfyD 33

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Your personal program portal

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Voxer walkie talkie messenger

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Our Private Facebook Group

https://www.facebook.com/groups/ 1173073933432714

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Our weekly accountability coaching & check-in sessions! Thursday 3/10 @12-1pm PT Thursday 3/17 @12-1pm PT 37

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Module 2 Session: Monday 3/21 @5:30-7pm PT Developing self-compassion & understanding negative self-talk Defining Self-Care for you Emotional regulation: Respond, don’t react 38

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Questions? Voxer or email info@tammiechangmd.com

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