How Am I Supposed To Do This? (The Question That's Quietly Wrecking You)

You know the question. It shows up at 4:45pm when you're staring at an inbox you haven't touched, a stack of unfinished notes, and a patient list that somehow keeps growing. How am I supposed to do all of this? How am I supposed to remember the right billing modifier, finish charting, be fully present with the person in front of me, and still be a decent human being to the people waiting for me at home?

If you're a physician, you've asked this question more times than you can count. I have too. And I want to tell you something that might sting a little at first, but I promise gets better: you are not supposed to be able to do all of it. Nobody is. There is no version of you, no matter how organized, disciplined, or gifted, who can carry everything that gets handed to you and still come out the other side okay.

That's not a personal failing. That's math.

I was recently working with a client who'd received an email from a senior leader about her note closure rate. She was at 82%, the target was 90%, and the email came with a list ranking her against her colleagues, best to worst. It's the kind of message designed to make you feel small enough to fall in line.

But in our session, what she kept coming back to wasn't the note metric. It was a garbage can. Specifically, the one in her exam room that only accepted biohazard waste, something she almost never generates, while the regular trash sat clear across the room. She'd been told before that she wasn't disposing of things correctly, and it had lodged itself in her brain as one more thing she was failing at.

Here's what's actually happening in moments like this. You've got a real, legitimate priority (the note closure conversation, which affects clinical continuity and how the practice gets paid) tangled up with something that was never actually yours to manage (the layout of a garbage can you didn't design and can't move). And when everything lands in your brain with equal weight, you don't have the bandwidth to tell the difference. You just feel like you're failing at everything, all the time.

The way out isn't better time management. It's a practice of sorting.

When you catch yourself in that "how am I supposed to" spiral, sit down with these questions:

What is my load like right now, really? What feels truly important to me, not to everyone else, to me? What are the external demands actually landing on my plate? Which of those feel important, and which don't? What feels like it's genuinely not mine to carry? How do I want to show up if someone doesn't love the boundary I set? And how am I going to have my own back when they push back?

That last one matters more than people think. Because when you start setting boundaries, even reasonable ones, you will get pushback. That's not a sign you did it wrong. That's just what happens when you stop absorbing every expectation without question. You get to decide in advance how you'll support yourself through that moment instead of being caught off guard by it.

My client walked out of that session with a plan: address the note closure conversation directly and honestly, and let the garbage can go. Not because it didn't matter to anyone, but because it wasn't hers to solve, and she had more important things to protect her energy for.

You get to make that same call. Over and over, in a hundred small ways, every week of your career. This is not a system that will hand you clear boundaries. You have to build the practice yourself.

If you want to hear the full conversation and get all eight questions laid out step by step, you can listen to Ending Physician Overwhelm wherever you get your podcasts.

And if you're ready to stop carrying all of it alone, let's talk. You can schedule a free discovery call here: https://calendly.com/healthierforgood/coaching-discovery-call

Life really is better on the other side.