Lean Out Podcast

Doing Hard Things

• Dawn Baker • Season 3 • Episode 16

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In this episode of the Lean Out Podcast, Dawn Baker reads Chapter 9 of Lean Out: A Professional Woman's Guide to Finding Authentic Work-Life Balance. This chapter is titled, "Doing Hard Things." 

Doing hard things is not about gritting your teeth, suffering, proving something to someone or being a badass. It's about leaving your comfort zone and embracing challenge for the enjoyment of the challenge. It’s about reminding yourself that you’ve done hard things and you will do them again. Leaning out will involve discomfort, and you’ll be ready for it because you will have practiced. 

This chapter also profiles Dr. Kara Pepper, who leaned out with her own specialty micropractice and now teaches other physicians how to do the same. 

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Get in touch with Dawn:

 


=Welcome to the lean out podcast. I'm your host, Dr. Don baker. Are you looking for a new approach to finding authentic and sustainable work-life balance? You've come to the right. Place. For inspiration. information. and a community. community. of like-minded. Professionals. Let's get to the show. Hello. Hello. Thanks for being here today. I'm sharing with you chapter nine of the book Lean Out a Professional Woman's Guide to Finding Authentic Work-Life Balance. This chapter is titled Doing Hard Things. What Is Hard Exactly. Just like balance. Hard is a relative term. It's different for everyone, and what is hard at one time in your life might shift to not being so hard at another time. I was recently asked in an interview, what do you think is harder writing a book or doing a 24 hour call shift? I. Now, these two things have vastly different timelines, and it might be automatic for many people to say the book is harder because it's a much longer period of time. But for me, a natural writer who's been writing things since I was a child, I'd say the 24 hour call shift is harder. I don't do well, staying up late at night, and I never really have. But it's even worse now that I have no pituitary gland and can get hypoglycemic in the wee hours if I'm not careful. Writing my book was enjoyable and I wrote most of the main draft by spending at least an hour every night after my daughter went to bed. Tinkering and just writing bite-sized time periods is really what it took. For someone else, they might say writing a book is the harder thing because writing doesn't come natural for them, or they don't really know what they wanna write about. When I talk about doing hard things, I'm talking about leaving your comfort zone and embracing challenge for the sheer enjoyment of a challenge. What is the benefit of this? It cultivates confidence. This concept is an entire module in my new Lean Out Confidence course, and it's been the favorite module in all the course feedback I've received. If you think about it, we're built for challenge, but we're living in an age of comfort and ease. So doing hard things is not about gritting your teeth, proving something or being a badass. It's about reminding yourself that you have done hard things and you will do them again. Leaning out will involve discomfort and you'll be ready for it because you will have practiced. In this chapter, I give ideas for challenges that you can practice yourself. They're not lofty resource heavy ideas. They're everyday things that you can do now that will help your confidence. If you like this book chapter and want to go deeper, you'll love the Lean Out Confidence course. Module three goes into much more detail and gives many more examples on challenges you can try. They're categorized by type, from physical to mental, to social to financial. Because I'm lazy and I haven't removed the coupon code from my introductory special in March, I'm going to share it with you again here. Use the code confident that ends in a T and save$100 off all course options. One more thing before I go on to reading the chapter. I want to remind you that if you've been considering work-life balance and career transition coaching or just general life coaching, now is the time. 100 days have passed in 2025 already. The 100th day of this year was last Thursday. Don't let this year slip away from you without making some changes to your work-life balance, and I would love to help you with this. If you signed up for one-on-one coaching during the month of April or May, I have special pricing for you. That is basically like getting one session for free. Okay. Onto chapter nine of Lean Out. Also, this chapter features the story of Dr. Kara Pepper, who's been on the Lean Out Podcast twice now and is always evolving her work-life balance. It's fun to see how she's shifted things between the profile and this chapter and what she's doing now. I'll link our most recent conversation in the show notes as well. I hope you enjoy chapter nine. Chapter nine, doing hard things. You don't need confidence to pursue a challenging goal. You build your confidence through pursuing challenging goals. Adam Grant, Willa is an architect and the breadwinner of her family. Her children have lived their entire lives in their suburban home on a busy street of a relatively large city. Over the years, they've grown tired of their lack of ability to move about in their own yard, let alone their neighborhood. The kids don't feel safe playing outside anymore. They've had one break in and on another occasion, a brick came flying through their front window while they were eating dinner. After my family and I moved to the mountains, she and her family came to stay for a weekend. The children loved frolicking in the stream, hunting for horny toads and running on dirt roads where no cars ever drive. Willa and her husband sat in our Adirondack chairs, peered up at the a hundred foot tall pines and both side. The forest environment brought back childhood memories for each of them. I could see the wheels turning while they couldn't wrap their heads around the idea of living off grid, an hour from civilization and six miles down a dirt road like we do. They fell in love with a nearby small town. They casually began researching homes in the area. Then they traveled to csun. There was only one big wrinkle. Willa loves her job at the big city design firm, and the CEO had recently placed a moratorium on remote work positions. It would be glorious if situations like this, the ones that become tied to a decision we can't un envision came and went without drama and difficulty. Instead, leaning out often involves big conflict and uncertainty. Sacrifice and discomfort are inevitable. The good news is you can train yourself to handle anything difficult that comes your way on this journey, high achievers are by definition, strong and resilient. You have done and can already do hard things. And this begets doing more hard things, doing hard things of any type will give you confidence. It will also open your brain to more creative thinking. As author and speaker Jen Sincero said, obstacles and challenges are the agents of growth. There are a few principles about hard to get clear. First, hard is relative, so your specific level of hard will be different from someone else's. Also, hard can mean many different things. Hard can be technically difficult, uncomfortable, scary, or awkward. It can also mean new awe inspiring, amazing, and creative. Below our thoughts and information on different types of hard things. Try experimenting with some of these in low state situations, and if you recognize that you've already done work in some of these areas, give yourself credit for cultivating courage. Try something new. Confidence is an elusive quality we all crave. Confidence to ask for what you want to take your own path to sustainable work-life balance to seize opportunities when they present themselves. True confidence is knowing that you can experience any feeling or emotion, whether it's fear, love, or anything in between. Psychologist Susan David PhD describes this as emotional agility. What better way is there to test emotional agility than to simply try something new? As creatures of comfort and habit, trying something new is the quintessential hard thing. Newness can help you get into a flow state and it can foster growth and joy. Trying new things helps achievement. Addicted people learn to separate their worth from their achievements and or failures. If it's new, what do you have to lose? Start with something small and fun. Consider taking a class about a subject you've always wanted to learn, such as an art, a craft, an instrument, or a new fitness class. Try making a food dish you've never eaten in your life. Travel to a place you've never been with no itinerary other than simple exploration, or just make an effort to take a different route between work and home or to other places you frequently go. If you have trouble fitting something new into your routine, identify ways to increase your accountability. Consider hiring a coach or joining a team organization. Volunteer to give a presentation to a group of people. If this is not something you do as part of your regular work, novelty can bring about exhilaration, reticence, or anything in between. Experiment with new things that let you feel on both sides. Work up to leaning out by increasing the intensity of the new things you try learn to rest. If you watch an elite rock climber scale, a challenging cliff face, solving the riddle of sequences to reach the top without falling. It might take a while, it might even get a little boring because she will take rests wherever she can find them. A shake of the hand here, a heel hook on the rock. There rests are key steps in her journey to the top. The same goes for power lifters. In between their attempts at lifting heavier and heavier weight, it is often imperative that they rest for several minutes. Athletes know that rest is integral to high performance. Without rest, the body will not cooperate with progression. At worst, it might become injured or ill. Journalist and digital entrepreneur, Ariana Huffington, collapsed from lack of sleep and exhaustion in 2007. Suffering facial fractures from the fall. She made it her mission to overhaul her personal sleep and rest habits, and also to change the culture of insomniac corporate automatons for the human operating system. Downtime is not a bug. It's a feature. She said. She even wrote a book about the subject in 2015 called Thrive, despite more attention from mainstream media, such as Wall Street Journal and Harvard Business Review. Adequate rest is still elusive for many professionals. How many of us say I'll rest when I'm done with blank instead of prioritizing? Rest as we go? According to Greg McEwen, author of Essentialism, rest is absolutely essential for everyone. Unfortunately, rest goes against the prevailing culture, and also it's a legitimately hard thing for many of us to do. We might resist rest out of virtue, but there are other sneaky reasons at play. Rest can feel lazy, indulgent, or impossible. Feelings of overwhelm and time scarcity might also contribute to the notion that we just can't rest. A good rule of thumb, if you've been struggling but you don't know why and you're feeling overwhelmed and can't tell what you need, what you likely need is rest. Rest can take many different forms. The most familiar type of rest is the physical kind, sleeping longer, taking naps and skipping the gym when you're tired. But taking even small breaks throughout the day can restore motivation, creativity and focus. Rest can also look like a break in the middle of the day, or a moment of looking away from your screen to focus your eyes on something in the distance. Rest can look like stepping outside for a short walk around the building. When you spend hours inside under artificial lighting, the warmth of the sun on your face can feel like a luxurious, restful treat. Maybe you need a few quiet moments to yourself to slow down your mind or to escape from the feeling of needing to perform or be on all the time. Maybe you need to rest from difficult or inauthentic moments to just feel your feelings. This kind of rest could look like escaping to a quiet room for a few minutes to be with yourself. If you can't physically get away in the moment, a useful thing to try is focusing on one or more of your senses acutely. For a few minutes, you could rub your fingers or palms together. Notice the weight of your feet on the floor or pay exquisite attention to sight or sounds around you. This type of brain reset will short circuit the pathways your brain usually takes toward triggering thoughts. If you're struggling with burnout or feeling stuck, consider arranging a longer rest. A sabbatical. This could look like an official leave of one to 12 months in length. It can also simply mean taking advantage of an extended period of time between two jobs. I've taken both types of sabbaticals during my career and each experience brought tremendous perspective and clarity. Experiment with rests of different lengths and types. Allow the concept of rest to infiltrate your life and become part of the rule rather than the exception. Like rock climbers consider designing your life as a series of moves positioned between rests, spend time in nature, making a priority to spend time outside is the next level step to embracing rest. Being outside provides a much needed break from work and other tasks. It has also been shown to enhance time perception and overall wellbeing. A survey study found that when people experience the feeling of awe accompanying such events as seeing the vast beauty of the Grand Canyon, or witnessing a powerful thunderstorm, their perception of time shifts from scarcity to abundance. I don't know any woman who wouldn't love a sense of more time in her day. So making a priority to get outside more is a worthy challenge. I. Like mindfulness, rest, and anything you want to develop into a sustainable habit. Consider taking regular small steps to spend more time outside. These can be as simple as parking further away from your workplace so you enjoy a longer stroll into the building. If you can commute between workplaces or other locations by foot or bike, this would be a great way to work both activity and outside time into your days. Can you spend even a few hours on the weekend taking a walk with friends, loved ones or family members? What brown sign attractions can you visit near your home? Children love to explore new areas, and these are often free outside attractions to explore in your area. Camping is another option for people who have the means and time and even better camping experience would be one with no connectivity for a day or a weekend. Stay in the present moment. Mindfulness. You know you want it. Everyone's talking about it. At the same time, living in the present moment is a difficult thing for our runaway minds to do. Experimenting with mindfulness techniques will help train you to be calm and centered while you do hard things. At the same time, it will also benefit you in other ways. The benefits of mindfulness have been well studied. They include increased happiness, decreased anxiety, and decreased job burnout. There is also a negative association with the practice of mindfulness and the incidence of health issues such as heart disease, Alzheimer's disease, and chronic pain conditions. Mindfulness techniques run the gamut from a practice of noticing things around you to full blown transcendental meditation sessions. The thing that makes mindfulness seem hard is our desire to do it perfectly in reality, being mindful is something you'll never do perfectly. It's about cultivating a practice of noticing, observing, and letting go of your thoughts. It is not about the complete absence of thought, but instead about witnessing and releasing thoughts as they come. One of the most common techniques to try is guided meditation. There are many apps available, both free and paid that can assist with guided meditations. Spend a little time experimenting with some and see what you like. You can also do meditation on your own by simply sitting in silence for a specified period of time. It doesn't have to be long, and it can be increased slowly as you get used to the practice. Breath work is another approachable technique for mindfulness. Two breathing patterns to experiment with are box breathing and 4, 7, 8 breathing. With box breathing, you inhale for a chosen number of counts and exhale for the same number. Repeating the process for as long as you wish. 4, 7, 8 breathing is championed by integrative physician Andrew Weil, md, and it has been shown to increase parasympathetic rest and digest neural tone. Find your own cadence for how fast to count based on what feels right to you. Inhale for four counts. Hold the breath for seven counts and exhale for eight counts. I used to perform this breathing exercise in silence every time I commuted to and from work. It's a perfect time to experiment with breathing practices. One of my favorite ways to cultivate mindfulness is through the concept of mental fitness rooted in the science of neuroplasticity. Strengthening mental fitness means that you train your brain to take new neuronal paths to achieve its connections versus the tired, stale paths your brain usually follows. The exercises consist of focusing intently on one particular sense, touch, vision, or hearing, for example. I described this above in the rest section as well. The beauty of this is that it can be done in public and can make a difference in as little as two to five minutes. The key with mindfulness exercises is developing a consistent habit of doing them to reap the benefits you need to do them at least daily. However, the short exercises described here are easy to complete, one to three times a day, make decisions. Indecision can stem from a lack of confidence and clarity in what you really want. Aside from doing the deep self-inquiry work discussed in chapter six through eight, you can work up to making bigger decisions by practicing small deliberate ones. In turn, you will develop self-trust and intuition. You already make numerous decisions every day. Identify the ones you take for granted. Write them down and celebrate them. Reflect on them with gratitude. When a low stakes decision comes up, practice making it quickly. For example, give yourself a time limit to choose the restaurant or decide on the travel itinerary. Every decision not made has a cost of inaction. Doing nothing feels like an impartial hold position, but doing nothing is actually something. Practice identifying the cost of inaction when you feel unable to commit to any decision, whether it be what to cook for dinner, or whether to leave a long-term job. Saying no. Saying yes to one thing means saying no to another, and that's the reality. We often don't consciously recognize the trade-offs yet. Trade-offs are an important part of practicing balance In my career, I have traded prestige and notoriety for a flexible, very part-time clinical schedule. I also trade late night TV time for more sleep and six pack abs for regular enjoyment of my favorite dark chocolate peanut butter cups. It's very easy in our lean in culture to assume that we must say yes to every opportunity, or there will be consequences. We'll disappoint important people. We'll miss out and our career will take an unintended turn. When contemplating an answer of yes to any work opportunity, consider the trade-offs to whatever is on the other side of your balance. Paolo Culo, author of The Alchemist, said, when you are saying yes to others, make sure you are not saying no to yourself. From another perspective, saying no to more things that don't immediately light you up. Things that don't align with your values will leave you open for more meaningful yeses. You are not the only one who will benefit from less yeses and more nos. Your family, friends, and loved ones will experience positive trade-offs too. If you're used to saying yes to everything scenarios where you need to say no, can invoke horrible feelings of guilt, worry, and dread. Look at saying no as an art that requires rehearsal and practice. Identify some low stakes commitments where you can work on saying no. The social engagement, this month's book club, the purchase of another online course you won't complete. Learn and practice some creative ways to say no. Here are my favorites. Inspired by ideas from Greg Mccuen's, essentialism, deferred. No. This is the easiest way to start placing boundaries, and it's the tactic I use most often. I simply say, I'm not sure. Let me check with my calendar husband, et cetera, and get back to you. Until I started doing this, I had no idea how many times I automatically said yes to things. Out of a mere inability to formulate a thoughtful response on the spot, delaying a no helps to strengthen your reason and resolve. In addition, if you have trouble with conflict like I do, it's often easier to say no to someone when you're not right in front of them. An email or text is perfectly acceptable. It gives space between the ask and response, so you can think of the best words to use when you decline. You can craft your best response by journaling on it first or by asking a trusted friend or coach Soft, no. Especially helpful when you must be face-to-face with the requester. A soft no is basically saying nothing. It's not saying yes, but it's not exactly saying no. Instead, you do one of two things. You either make an awkward silence and let the asker say the next thing, or you make a comment that is not an answer. It looks like that sounds like a unique opportunity. Silence if the need arises to give an answer on the spot. Use the deferral techniques above. Switcheroo. No particularly effective in work situations. There are a couple different flavors of the switcheroo. No. You can say, yes, I can make that a priority. What other role slash project would you like me to eliminate slash delegate? This forces the asker to also consider their priorities. Another way this can work is by passing the ask to another person. I'm unable to do that right now, but I'd highly suggest you check with blank because that sounds like something they'd be really interested in. They don't have to know. You suggested them, but if they find out it's okay because it's complimentary to them, you think they would do a good job at the task and yet not directly committing them to anything. The response now falls on them. Policy? No. This method works really well for small, generally impersonal social asks. Examples include, I have a policy of not volunteering for more than one advisory board, or I have a policy of not making donations over the telephone. While this no might seem curt, it's effective because it's universally understandable. Almost everyone has personal or family policies like this, whether they're aware of them or not. So people tend to respect the concept. There are entire books written about the why and how of boundaries. If you want more information on this topic, my recommendations are listed in the resources section. Get help from others. For many summer seasons, I spent two to three days a week working on a rock climbing project, a process of mastering a challenging climbing route in the pipe. Dream cave. The cave is a vast amphitheater sitting in the Aspen groves of central Utah. Made up of multicolored cobblestones that are somehow glued together with little bits of sand. The easiest route in the cave gets a sturdy five 10 grade, and the next route above that one is a tricky overhanging route in the mid five 11 range. Hard is an accurate word to describe most of the climbing there to, depending on your skill level, I'd set my eye on a climbing route that I thought contained a beautiful movement, but was just out of my current ability to climb cleanly with no mistakes or falls. Typically, a climber might try to climb a route on site for the first time without looking to others for help, but if a section seems tricky or daunting, they ask other climbers who've climbed it before for beta beta, a climbing term that refers to advice, strategies, or ideas from others who've been there before you. As a concept I've always loved, beta encourages you and opens your eyes to new ways of solving the problem in front of you. Sometimes the information or insights you receive from others don't work well for you, but beta always feels comforting. It alerts you to the reality that what you are doing is indeed challenging. Yet others have figured out a way to do it for themselves. Continuing with your head down and blinders on persevering like a lone ranger, is a commonality of lean in culture. Asking for help can be seen as a sign of weakness. Throughout your professional training and early career, you might have felt unsure and wanted guidance. You might have asked yourself, is what I'm needing obvious or stupid to other people? Sometimes you need to do the hard thing of seeking help. There is no shame in admitting when you could use a little beta. Many conferences and retreats now cater to professional women promising inspiration, empowerment, and camaraderie. Meeting other women who are going through similar career challenges can open your eyes to new possibilities for leaning out in your field. But you must do the hard thing of being open and vulnerable one-on-one. Mentorship can also be helpful for a specific problem solving, but you must do the hard thing of finding the right mentor. Coaching is another type of help like beta with a little magic thrown in. Coaching, promotes self-discovery, self-reflection, and openness to possibilities so that you can become the best version of yourself. The relationship between coach and client is particularly non-hierarchical. Unlike therapy, counseling or mentorship, coaching sessions are focused not on diagnoses or advice, but instead on thoughts, goals, and feelings. Coaches offer support tools, structure, accountability, and an objective sounding board for personal growth in physician workplaces. Coaching has also been proven to effectively increase quality of life, decreased burnout, improved job satisfaction, and foster resilience and engagement and careers. There are a couple of hard things about coaching. First, it requires a monetary investment you must make in yourself. One-on-one sessions while more expensive will give you the most bang for your buck. In terms of personal insight and growth, they can range in price at the time of publication from$100 to$500 per session. Group coaching programs can be more economical, but they are less personal. If you choose to try coaching, make sure to research your prospective coaches. While certifications and fancy trainings don't necessarily make a great coach, the key to a good coaching relationship is finding a reputable coach who has personal experience and or experience coaching other professionals with the specific problem you're having. Also, coaching requires you to do work. Unlike a mentor, a coach's role is not to give you advice, but instead to ask provocative questions and bring up different points of view to draw out your own personal insights. Much like when one rock climber gives beta to another, she's providing ideas from her personal training and experience without offering an exact solution. Each climber is different and must figure out how to solve the riddle of climbing sequences to reach the pinnacle of the root in a way that works for her body, constitution and strengths. Coaching can seem like opening a Pandora's box filled with highly personal items from moments of your life. But for many women, including me. It has proven to be a worthwhile investment of time, money, and vulnerability. I might be biased, but I highly recommend it. If you're having conflicting feelings about leaning out, live on less. There will be people who, despite a deep desire to lean out, will dismiss it as something reserved. For those who have privilege and money, they will say they don't have choices because they need their entire full-time salary. They are breadwinners. They have unique expenses like a special needs child, et cetera. While these situations require consideration, you are not trapped where you are. You always have choices, even if you don't currently see them. My lean out might have commenced with a health crisis, but the journey to where I am now to time, sacrifice and courage, consistently living below my means is the thread that wove it all together. Having money saved and knowing that I could consistently live on less gave me added confidence to ask for a reduced schedule at work after I had a baby. It later enabled me to leave a steady job and collect the less stable income of locum tenant's work, a worthy sacrifice for the location freedom I desired. It also helped me pursue my nonclinical business interests without worry about sunk costs or profit margins. I've been asked, how do you afford your life? You must have fill in the blank with real estate investments and inheritance. Or a husband who makes a lot of money in truth. My husband defected from the traditional law work environment to be a counterculture professional years before I did. He now works the amount he wants when he wants. There is no secret formula to financial freedom, as mundane as it sounds. The secret is living simply and flexibly. It's about maximizing savings so that you can have what JL Collins calls fuck you. Money. Saving more and spending less is simple, but by no means easy. If you know your core values, you can figure out ways to save. Take a non-judgmental look at all your expenses. Are they aligned with your core values? If not eliminate, you can do this swiftly or gradually, but no matter how you adjust. You'll feel more confident in your ability to live on less professionals often finish their training with a high debt burden and years of loan repayments ahead of them. This does not preclude you from finding ways to live simply and live on less when you lean out. There is likely to be some financial uncertainty, but that won't always be the case. For now, keep your why for leaning out firmly planted in the forefront of your brain. Use it as your North star. Do the thing. Years ago, I found the idea of meditation and stillness to be daunting. So I conducted my own 30 day challenge where I spent at least 10 minutes every day in silent meditation. 30 days feels feasible to complete, and if you don't like the thing you're trying, you aren't committed for too long at the same time. 30 days is long enough for a habit to become incorporated into your typical routine. Choose a thing from the ideas presented in this chapter that seems hard for you from what you choose. Identify a single item, achievable habit, and set up a 30 day challenge. After the 30 days reflect on how you felt, what you learned, and how you want to go forward with the habit to get back to Willa, she and her family ended up making the move. They gave up a rental property in their former city and compromised slightly on the size of their new home to live near a beautiful canyon on the edge of the small town. Her teenager is excited to find a local job, and they are all relishing their outdoor playtime. More importantly, by leveraging her successful past projects and unique skills with a particular software program, will then negotiated a temporary yet indefinite remote arrangement with her employer. In addition, the shakeup of her old situation expanded her ideas about working in design, and she is now investigating other remote opportunities. Exercise, make your own priorities chart. I discussed this idea in the previous chapter, but it also qualifies as a hard thing because be honest, have you ever in your life, let anything slide. Well, now's the time to figure out what you can let slide. Make your own chart, as I described in chapter eight. Keep your focus on the present timeframe and your current priorities. Imagine the future without judgment to fill in the other parts. Here are the three columns. Again, focus. Let's slide. Ignore altogether, Kara's journey. Once I made the decision, there was no turning back. Kara is an ex ballet dancer and internist in Atlanta. She spent 10 years working for a large private practice group before the moment came that she knew she needed to lean out. She initially went through a serious bout of burnout, born of her own perfectionist and people pleasing tendencies through therapy and coaching. She was able to find solutions that helped this, in her words, basically looked like an outsourcing of everything. Though Kara was in a better place and had started coaching other physicians in burnout, the pandemic brought a new set of stressors. Her entire practice group needed to shift to telemedicine for their outpatient services, and she spearheaded the system. Telemedicine became something she enjoyed, something she was proud to build. At the same time, the volume of work she was doing for her group and her patients left her treading with her head barely above water. I was surviving, but I just didn't feel good. She said The moment when Karen knew she had to make a drastic change came during one of countless virtual group meetings held outside of work hours. The meeting was about banal subjects such as how to talk to your patients about smoking, and that's when she realized she couldn't do it anymore. I needed a new garden. She said one of Kara's core values is autonomy. She brainstormed ways that she could incorporate her new love of telemedicine and her passion for coaching in a way that was completely her own. She also saw a need for improved care of patients with eating disorders. Another passion of hers, given her ballet background, what she created is a solo telemedicine practice with an emphasis on eating disorder care, something no one else is doing in her geographical area. Her business also includes a coaching arm for both patients and other physicians. Kara is now manifesting autonomy, which for her looks like a mixture of telemedicine and coaching between the hours of 9:00 AM and 2:00 PM Monday through Friday, she has complete control over her schedule and her billing, no insurance hassles. She moved her children to a private school for educational reasons, and she is now active in some of their after school activities. While her husband has a job that comes with some geographical constraints, he has always wanted to travel more. They're finally making that happen. Most recently, she took a three month sabbatical that involved both travel and home time through deep introspection. During her sabbatical, Kara realized that she needs more quiet alone time than she's used to giving herself more white space, as she likes to call it. I've never been this happy she said. The hardest part about Cara's journey of leaning out has been giving herself permission to do things differently. There's a lot of tribalism in medicine. She said she's had to let go of beliefs she had about what women should be doing and what doctors should be doing. I realized there's no right way to do life. What would Cara tell other women who are contemplating a change like hers? Look internally for the answers. Have a clear, compelling why to guide you. She also advocates cultivating a nest egg to navigate any financial uncertainty. Revenue from her side gig of physician coaching helped to bridge her startup time and give her the confidence to keep going. It's not that hard. She said, if you can take care of patients, you are perfectly capable of starting your own business and learning a new technology. Thanks for listening to the lean out podcast. If you find these conversations inspiring and useful, please forward them to a friend and also leave a review on iTunes or Spotify so that other people can find them easier. If you want to get in touch with me, you can find me at my website, practice balanced.com, where you can subscribe to my newsletter and get updates regularly about new podcast episodes, blog posts, speaking, engagements, and coaching services. You can also support my work by buying my book, lean out a professional woman's guide to finding authentic work-life balance for yourself, a friend, family member, or coworker. Have a great day and we'll see you next time