What Value Do Your Values Hold?
She chose her words carefully, the way physicians do when they're describing something they haven't fully let themselves feel yet. "I have everything I was supposed to want. The career, the family, the respect of my colleagues. I love my work. So why does it feel like I'm disappearing inside it?"
What she described was harder to name than burnout or depression. Over years, slowly enough that she barely noticed, the version of herself showing up every day had drifted away from something that mattered to her.
That's values misalignment. In my work with female physicians, it's one of the most common experiences I see and one of the least discussed.
The Particular Weight of Being a Woman in Medicine
Female physicians face a specific kind of values pressure that rarely gets named.
From the start of training, the messages pile up:
be excellent, be likeable, be accommodating
take up less space and prove you belong
keep your personal life out of sight
be available and be grateful
work twice as hard for the same credibility
Few of these are said out loud. They live in the culture, in what gets rewarded, what gets penalized, and what gets commented on.
Over time, many female physicians get extremely good at reading what each situation needs and delivering it. That skill costs them clarity about what they themselves want, need or believe. The adaptability that got them through training becomes a source of drift by mid-career. After years of responding to outside expectations, their own internal signal has gone quiet.
You can be excellent at your work, devoted to your family and respected by your colleagues, and still feel like you're disappearing. That feeling comes from spending a long time focused on other people's expectations and losing track of your own direction.
Values and goals are different things
Almost no professional training explains this distinction clearly, and it changes the conversation.
A goal is something you achieve. It has a finish line: get into medical school, match, make attending, get promoted. Medicine is very good at handing you goals one after another and rewarding you for reaching each one. Goals give direction, and they leave a lot of a life unaccounted for.
A value is a direction you keep moving in, and you never finish it. "Lead with integrity" is a value; "become division chief" is a goal. "Be present with my patients" is a value; "see fewer patients per day" is a goal. Both have a place. Trouble starts when goals stand in for values, and achievement becomes the measure of a life that was meant to be about something else.
Many female physicians were handed their goals before they had a chance to ask whether those goals reflected anything they cared about. They reached them anyway. Then, somewhere in mid-career, a question they'd never been asked came up: what do I want this to be about?
The calendar test
People find this the most clarifying values exercise I use in coaching, and the most uncomfortable.
Look at where your time, energy and attention went last week. Use what actually happened, including the work that never shows up on a calendar:
managing other people's emotions
covering for a colleague
the mental load you carried home
everyone else's needs that got handled before yours
Then compare that with what you say you value, answering as honestly as you can.
Your calendar is a values document, whether or not you wrote it as one. For most female physicians, it also shows whose needs came first.
The gap between what you say you value and what you do is useful information. For female physicians, years of accommodation often widen it:
saying yes when the honest answer was no
making yourself smaller so the room stays comfortable
carrying what belonged to someone else because nobody else would
A value only guides you once it shows up in what you do. The work is to close that gap, starting with an honest look at what's already in your life and what, if anything, needs to go.
When values conflict, and they will
Clarifying your values often surfaces an uncomfortable fact: your most important values sometimes pull in different directions.
Excellence and sustainability. Your commitment to doing your best work, held against the limits of the person doing it.
Autonomy and belonging. Trusting your own clinical judgment while staying connected to a team that won't always agree.
Ambition and presence. Caring about your career while also wanting to be there for your children, your partner and yourself.
These tensions come with being a female physician in a system that wasn't designed with you in mind, and you won't resolve them. You can choose consciously within them. Make your tradeoffs on purpose, so exhaustion, habit or the path of least resistance doesn't make them for you.
A physician who has done this work knows her values. She has looked honestly at where her time goes, named the tensions, and made some peace with them. She's different in ways that matter, because she's working from values she has examined and chosen for herself.
A practical starting point
If this resonates and you're not sure where to start, here's the simplest version of the exercise.
Name three moments from the last year when you felt aligned in your work: present, purposeful, like yourself.
For each moment, identify one quality that was there. What made it feel that way, and what does that tell you about what you value?
Look at last week's calendar. Where does that quality show up? Where is it missing, and whose needs filled that space?
Name one thing you could protect, reclaim or move toward, and treat it as a direction for one small, real shift.
That's the beginning of values clarification. You're looking for a direction to move in, and a small shift is enough to start.
The work keeps going, and that's the point. It's the practice of staying honest with yourself about what matters and keeping enough of your actual life in touch with those things that the work stays worth doing.
The physician I described at the start eventually named something she'd been circling for years: what she valued most was depth. That meant the long conversation with a patient that changed something, and a relationship with a resident she could develop over time. It was the kind of medicine the system kept crowding out.
She couldn't get all of it back. Naming it changed what she looked for and what she was willing to protect. It changed how she led, too. She got clearer about what she was there to do and had less patience for the noise that had been drowning it out.
That's what values clarification gives you: something accurate to steer by, in your own voice.
—
Coral Edwards, MS, PCC, is the founder of Root & Rise Strategies, a physician leadership development and coaching practice for individuals and academic medical centers. This post is part of an ongoing series on physician leadership, identity, and sustainable practice.
Sources: Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. Deci, E. L., & Ryan, R. M. (2000). Self-determination theory. Richman, L. S. et al. (2008). The relationship between workplace discrimination and stress. Guille, C. et al. (2017). Work-family conflict and the sex difference in depression among training physicians.
