Advocating for Yourself in Medicine: Setting Boundaries for Sustainable Careers

Diana Savitzky, MD
Chair, ACEP Professional Wellness Section
Jen Goebel, DO
Chair-Elect, ACEP Professional Wellness Section

For female physicians, advocating for yourself in medicine is often uncomfortable and too often it is something physicians learn only after experiencing unnecessary strain, burnout, or inequity. Many of us are trained to prioritize patients, teams, and systems before ourselves, yet sustainable careers require the skills, language, and confidence to speak up for our own needs, boundaries, and professional growth.

Self-advocacy for female physicians is often complicated by a hidden burden that remains largely unrecognized and unmeasured. Women in medicine frequently shoulder disproportionate expectations related to emotional labor, caregiving, mentorship, and “office housework,” while simultaneously navigating gender bias, pay inequities, and cultural norms that discourage speaking up. Although unjust, this cumulative stress may be misinterpreted by male leaders as distraction or an inability to keep pace at work. These invisible demands can also make self-advocacy feel risky or selfish, even when it is essential. Naming and acknowledging this hidden burden is a critical first step toward empowering women physicians to protect their well-being and sustain meaningful, long-term careers.

Setting boundaries at work is challenging—particularly for women physicians. The first and most essential step is understanding what matters most to you. This requires intentional reflection: slowing down enough to notice what brings you joy, fulfillment, and a sense of purpose. When we remain constantly busy, that clarity can easily be lost.

Being clear about your values helps guide how you allocate your time and energy, especially when competing goals and obligations pull you in many directions. Thoughtful boundary-setting means ensuring that professional commitments do not undermine your most important priorities. For example, if meaningful time with family is a core value, taking on additional work should not leave you so depleted that you are unable to be present or connected at home. Boundaries are not about doing less, they are about protecting what matters most.

Ways to Set Boundaries and Advocate for Yourself at Work

• Clarify expectations: Define your role and limits.
• Say no simply: Boundaries do not require justification.
• Set availability limits: Protect off-duty time and response expectations.
• Protect non-clinical time: Treat it as essential work.
• Advocate for schedule equity: Address imbalance early.
• Name invisible work: Track and elevate uncompensated labor.
• Ask for support: Request resources when demands increase.
• Use data: Metrics strengthen advocacy.
• Prepare scripts: Practice clear, calm boundary language.
• Build allies: Shared advocacy is more effective.
• Use policies: Institutional tools exist to support you.
• Document decisions: Written clarity protects you.
• Reframe advocacy: Boundaries are professionalism, not selfishness.

Self-advocacy is not a single conversation or a one-time decision, but an ongoing practice that evolves across a career. By recognizing the hidden burdens many physicians, particularly women, carry and by intentionally setting boundaries and speaking up for our needs, we create more sustainable careers for ourselves and those who follow. When physicians advocate for themselves, they are not stepping away from professionalism or patient care; they are strengthening both.

If you’re struggling to enact change to promote well-being or improve the culture in your emergency department, the ACEP Well Workplace Policy can serve as a tool to advocate for organizational responsibilities necessary to support emergency physician well-being, safety, engagement, and retention. It serves as a framework for departments and institutions committed to creating sustainable, healthy work environments. It emphasizes that clinician well-being is driven primarily by organizational culture, policies, and systems rather than individual resilience alone. By promoting fair scheduling practices, transparent leadership, adequate resources, and a culture of respect and inclusion, the ACEP Well Workplace framework reinforces the idea that self-advocacy is not a personal failing but a professional responsibility. When physicians speak up about workload, boundaries, and equity, they are actively participating in the shared accountability that underpins a healthy, sustainable workplace.

What is one small step you could take this month to better advocate for yourself at work?