I wasn't in a formal leadership role when this happened, but I was the senior physician in the room most days, which turns out to be close enough.

A colleague — a few years behind me in practice — mentioned offhandedly one afternoon that they'd started finishing their notes at home because they assumed that's what you had to do. They'd seen me do it. They assumed it was normal.

That landed harder than I expected.

I had been staying late, charting after hours, carrying the work home — not as a deliberate choice but as a default I'd never examined. I wasn't performing dedication. I was just doing what the volume seemed to require. And I'd never thought about what that looked like from the outside.

From the outside, it looked like the answer to the question: is it possible to contain this work, or does it always follow you home? My behavior was answering that question without my intending it as an answer. The answer was: it follows you home. That's what this job is.

The colleague wasn't reading me wrong. They were reading me accurately. And what I was modeling wasn't sustainable for me, let alone for someone earlier in their career building their baseline expectations of what practice should look like.

I changed my behavior for my own structural reasons. But the collateral effect was that the signal changed. What I modeled changed. And that mattered in ways I hadn't anticipated — not because I said anything different, but because what was visible changed.

Your structure is always on display. That's not a burden. It's an opportunity.

— Ryan

P.S. If you lead a team and want to work on this, coaching is the conversation: mededwell.com/coaching