What Do You Actually Value?
She described it carefully, the way physicians describe things 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 genuinely love my work. So why does it feel like I'm disappearing inside it?'
Not burnout, exactly. Not depression. Something quieter and harder to name: the sense that the version of herself showing up every day had drifted — slowly, incrementally, almost imperceptibly — from something essential.
What she was describing is values misalignment. And in my experience working with female physicians, it's one of the most common and least discussed experiences in medicine.
The Particular Weight of Being a Woman in Medicine
Female physicians navigate a specific kind of values pressure that doesn't get named often enough.
From the beginning of training, the message is layered: be excellent, be likeable, be accommodating, don't take up too much space, prove you belong here, don't let your personal life show, be available, be grateful, work twice as hard for the same credibility. These aren't always spoken. They're embedded in the culture — in what gets rewarded, what gets penalized, what gets commented on and what doesn't.
Over time, many female physicians become extraordinarily good at shapeshifting — reading what each situation requires and delivering it, often at the expense of their own clarity about what they actually want, need, or believe. The adaptability that helped them survive training becomes, mid-career, a source of drift. They've been so responsive to external expectations for so long that their own internal signal has gotten quiet.
You can be excellent at your work, devoted to your family, respected by your colleagues — and still feel like you're disappearing. That's not ingratitude. That's what happens when you've been orienting outward for long enough that you've lost track of your own direction.
Values and Goals Are Not the Same Thing
This is the distinction that changes the conversation — and almost no professional training makes it clearly.
A goal is something you achieve. It has a finish line. Get into medical school. Match into the right program. Make attending. Get promoted. Goals are external markers — useful for direction, but incomplete as a life. Medicine is extraordinarily good at producing goals. It hands you a sequence of them and rewards achieving each one.
A value is a direction, not a destination. It's a quality of engagement you keep moving toward but never fully arrive at. 'Lead with integrity' is a value. 'Get promoted to division chief' is a goal. 'Be genuinely present with my patients' is a value. 'See fewer patients per day' is a goal. Neither is better. But when we pursue goals as substitutes for values — when achievement becomes the metric for a life that was actually about something else — something goes quietly wrong.
For many female physicians, the goals were handed to them before they had the chance to interrogate whether they reflected anything they actually cared about. They pursued them successfully. And then, somewhere in mid-career, the scaffolding shifted — and the question they'd never been asked finally surfaced: what do I actually want this to be about?
The Calendar Test
Here is the most clarifying — and most uncomfortable — values exercise I use in coaching.
Look at where your time, energy, and attention actually went last week. Not where you intended for them to go. Not your aspirational schedule. Where they actually went — including the invisible labor that doesn't appear on any calendar: the emotional management, the covering for a colleague, the mental load carried home, the needs of everyone around you that got attended to before your own.
Then hold that against what you said you value — or what you believe you value — when you answer the question honestly.
Your calendar is your values document — whether you wrote it that way or not. For most female physicians, it's also a document that tells a story about whose needs got prioritized.
The gap between stated values and actual behavior is not a character flaw. It's information. And for female physicians in particular, that gap is often widened by the invisible weight of accommodation — the years of saying yes when no was the honest answer, of making themselves smaller to make the room more comfortable, of carrying what wasn't theirs to carry because no one else was going to.
Values that aren't expressed in behavior aren't actually guiding anything. They're things you believe you believe. The work is to close the gap — not by adding more to an already full life, but by getting honest about what's actually there and what, if anything, needs to go.
When Values Conflict — And They Will
One thing clarification surfaces, sometimes uncomfortably, is that your most important values don't always point in the same direction.
Excellence versus sustainability: the commitment to doing the best possible work, held against the recognition that the person doing the work has real limits. Autonomy versus belonging: holding your own clinical judgment while remaining a genuinely connected member of a team that may not always agree. Ambition versus presence: caring about your career trajectory while also wanting to actually be there — for your children, your partner, yourself.
These tensions are not problems to solve. They are features of being a female physician in a system that was not designed with you in mind. The goal isn't to resolve them — it's to choose consciously within them. To make intentional tradeoffs rather than ones made by default, exhaustion, or the path of least resistance.
A physician who has done this work — who knows her actual values, who has looked honestly at where her time goes, who has named the tensions and made some peace with them — is different in ways that matter. Not because she's solved anything. Because she's operating from something real, rather than from a set of expectations she inherited and never examined.
A Practical Starting Point
If this resonates and you're not sure where to begin, here is the simplest version of the exercise:
Name three moments: in the last year when you felt genuinely aligned in your work. Not performing. Not managing everyone else. Actually present and purposeful — like yourself.
For each moment: identify one quality that was present. What made it feel that way? What does that quality tell you about what you value?
Look at your calendar: from last week. Where does that quality show up? Where is it absent — and whose needs filled that space instead?
Name one thing: you could protect, reclaim, or move toward. Not as a goal to achieve, but as a direction to orient toward — one small, real shift.
That's the beginning of values clarification. Not a definitive list. Not a life overhaul. A direction — something to move toward rather than a box to check.
This work is ongoing. It doesn't have a finish line — which is the point. It's the practice of staying honest with yourself about what matters, and keeping enough of your actual life in contact with those things that the work remains worth doing.
The physician I described at the beginning eventually identified something she'd been circling for years without naming directly: the thing she valued most was depth. Not volume. Not speed. The long conversation with a patient that actually changed something. The relationship with a resident she could genuinely develop over time. The kind of medicine that the system kept crowding out.
She couldn't get all of it back. But naming it changed what she was looking for — and what she was willing to protect. It also changed how she led: with more clarity about what she was actually there to do, and less tolerance for the noise that had been drowning it out.
That's what values clarification actually does. Not solve the problem. Give you something accurate to orient toward — in your own voice, finally, rather than someone else's.
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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.
