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Protecting boundaries in private practice: a vital key to sustainable success

Tomi Mitchell, MD
Physician
November 13, 2024
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After more than a decade in private practice, taking care of tens of thousands of patients—everything from preconception to hospice care—I’ve learned how important it is to set and protect your boundaries. I’ve worked in various environments throughout my career, from running my own multidisciplinary medical center to being part of other practices. If I had to choose, I would prefer to be part of an established practice. Running my center came with its own set of challenges, many of which stemmed from toxic environments I encountered early on in my career. In those environments, I faced sexism, inappropriate comments, and a general lack of respect.

Growing up, I was taught to be obedient and never question authority, a mindset that proved difficult in medicine. Being too compliant can make you an easy target for exploitation. These experiences in private practice led me to realize that boundaries aren’t just helpful—they’re essential. Without them, medicine can quickly become draining, both mentally and physically. Here are six key areas that every professional in private practice should evaluate and protect with solid boundaries to maintain their health and well-being:

1. Make time to eat and use the bathroom

It might seem small, but in private practice, doctors often put their basic needs at the bottom of the list. Skipping meals or bathroom breaks to accommodate back-to-back appointments might feel like a quick fix, but it can lead to burnout fast. Setting boundaries around break times is non-negotiable. Treat these breaks as you would any other appointment—schedule them and stick to them. Remember, you can’t care for your patients if you’re running on empty. Prioritize your health to provide the best care possible.

2. Set and respect your schedule

In the early days of my practice, I was motivated to see as many patients as possible because of financial constraints and my desire to provide care. However, this situation turned into overbooking with exhaustion and frustration. Now, I am well aware of the significance of developing a timetable that fits me and adhering to it. It’s about avoiding burnout and sticking to your schedule to ensure the best quality you can bring to every patient. Define official working hours and do not yield to the pressure of extending them beyond what you planned.

3. Educate patients and staff about your schedule

Establishing boundaries is one of the most significant aspects of the process; ensuring your patients and personnel understand and honor your schedule is crucial. If your practice regularly overbooks, it might lead your team and patients to see this as the norm. Consequently, setting more boundaries could become an issue. Make them understand that although you care deeply for your patients, you need time to recharge. If a boundary is ignored, be direct and address it clearly. Safeguarding your schedule is of primary importance to your health and the quality of care you deliver.

4. Assert the importance of your home life

For a long time, I treated my personal time as an afterthought, consistently putting work first. Over time, I realized the importance of setting boundaries to protect my home life. Let your patients, colleagues, and staff know that while you are dedicated to your work, your personal time is equally important. Reminding yourself and others that you need time outside of work to recharge is essential. You don’t owe anyone an explanation for needing time to yourself.

5. Draw a line around non-work communication

In today’s interconnected world, patients or colleagues can easily reach you outside of office hours. While emergencies are natural and sometimes unavoidable, setting rules for non-urgent communication is necessary to avoid physician burnout. Let your patients know when and how they should best contact you, and if you have office staff, train them to handle after-hours questions. Maintaining these boundaries from the start will help ensure your work schedule remains balanced and productive.

6. Set limits on administrative tasks

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Private practice often involves a significant amount of administrative work, which can become overwhelming. It is crucial to set limits around this. Dedicate specific hours for administrative tasks and ask your staff to assist with some of the workload. Establishing a timetable helps ensure that administrative tasks don’t encroach on time reserved for yourself or your patients. This contributes to a healthier work-life balance.

Final thoughts

Protecting boundaries in private practice isn’t selfish—it’s essential. Set your expectations around time, communication, and schedules so that you have the energy and compassion needed to meet your patients’ needs. Many of us in health care are driven by an urge to help others out of empathy. However, we should not let this lead to the decline of our own health or happiness. Sustaining a practice with healthy boundaries contributes to better care and, most importantly, strengthens our well-being by making it a priority.

Tomi Mitchell is a board-certified family physician and certified health and wellness coach with extensive experience in clinical practice and holistic well-being. She is also an acclaimed international keynote speaker and a passionate advocate for mental health and physician well-being. She leverages over a decade of private practice experience to drive meaningful change.

Dr. Mitchell is the founder of Holistic Wellness Strategies, where she empowers individuals through comprehensive, evidence-based approaches to well-being. Her career is dedicated to transforming lives by addressing personal challenges and enhancing relationships with practical, holistic strategies.

Connect with her on Facebook, Instagram, and LinkedIn, and book a discovery call to explore how she can support your wellness journey. For those interested in purchasing her book, please click here for the payment link. Check out her YouTube channel for more insights and valuable content on mental health and well-being.

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