How Physicians Can Overcome People-Pleasing and Set Better Boundaries with Megan Melo

October 28, 2026

EPISODE SUMMARY

Why is it so difficult for physicians to say no, even when their schedules are already full? In this episode of the Academic Medicine Strategy Podcast, Dr. Stacey Ishman speaks with Dr. Megan Melo, a board-certified family and obesity medicine physician, certified life coach, and the physician coach known as The Physician Whisperer. They discuss how perfectionism and people-pleasing develop during medical training, how physicians can make decisions based on their values, and why healthcare organizations need to treat physicians as people rather than endlessly expandable resources.

Megan shares how physicians can recognize the thoughts and emotions that make setting boundaries difficult. Stacey connects the conversation to physician time management, personal agency, and her book, The Physician's Guide to Owning Your Time. Together, they explore how individual decisions and organizational changes can help physicians build more sustainable careers and lives.

Key Points:

00:00 – Meet Dr. Megan Melo, The Physician Whisperer

Dr. Megan Melo introduces her work as a family and obesity medicine physician and coach. She helps women physicians recovering from employed practice create sustainable and profitable lives. Her coaching focuses on people-pleasing, perfectionism, boundaries, and connecting with personal values.

01:00 – Why Physicians Develop People-Pleasing Habits

Medical training rewards hard work, compliance, achievement, and recognition. Physicians may carry these patterns into their careers without learning when to stop trying to meet everyone's expectations.

02:00 – Learning to Decide What Is Enough

Physicians cannot do everything for everyone. Megan and Stacey discuss why defining what is enough is an important part of building a sustainable career and balancing professional and personal responsibilities.

03:00 – Why Physician Well-Being Matters to Patient Care

Physicians face pressure to provide care while managing limited time and increasing demands. When clinicians do not feel supported, it can affect their experience of delivering care and their ability to connect with patients.

04:00 – How to Decide What to Say Yes or No To

Megan explains why physicians need to understand what matters to them before accepting new responsibilities. Evaluating requests against personal priorities can help physicians make more deliberate decisions instead of automatically agreeing.

05:00 – Using Personal Values to Make Decisions

Megan describes using values-based reflection to help physicians identify what is important to them. Rather than requiring a formal list of values, she explores questions about goals, priorities, and what would make life feel better.

07:00 – Why Healthcare Systems Need to Treat Physicians as Humans

Megan discusses how organizations can increase physician workload and remove resources in the name of financial efficiency. Stacey highlights the importance of involving physicians in decisions that affect their work, rather than making them feel like cogs in a system.

10:00 – Why Wellness Programs Alone May Not Be Enough

The conversation turns to organizational responsibility for physician well-being. Individual wellness practices can have a role, but healthcare systems also need to examine working conditions, staffing, resources, and the demands placed on physicians.

11:00 – How to Start Saying No

Megan recommends identifying the emotion that arises when a physician considers saying no, then examining the thought behind that emotion. Fear, anxiety, and concern about disappointing others may require different approaches.

13:00 – Permission, Agency, and Owning Your Time

Stacey connects the conversation to her book, The Physician's Guide to Owning Your Time. She explains how recognizing personal agency can help physicians make decisions about their time, priorities, and responsibilities.

14:00 – Small Decisions Can Help Physicians Reclaim Agency

Megan shares an everyday example of giving herself permission to run the dishwasher before it is completely full. Small decisions can help people practice making choices that support their needs rather than following rigid internal rules.

FREQUENTLY ASKED QUESTIONS

Why do physicians struggle with people-pleasing?

Medical training often rewards achievement, compliance, hard work, and recognition. Physicians may develop habits of meeting others' expectations without learning how to decide when enough is enough. These patterns can continue into clinical practice, leadership, and family life.

How can physicians get better at saying no?

Start by identifying what matters most to you and where you want your career and life to go. When a request comes up, consider whether accepting it supports those priorities. It can also help to identify the feelings and thoughts that make saying no difficult.

How can physicians use their values to make decisions?

Reflect on what you want more of in your life, what feels meaningful, and which goals matter to you. These answers can help clarify your values and create a practical filter for deciding which commitments to accept.

What can healthcare organizations do to support physician well-being?

Organizations can examine workload, staffing, resources, and how decisions are made. Involving physicians in decisions that affect their work can help them feel like participants in the solution. Individual wellness practices are not a substitute for addressing workplace conditions.

What is physician coaching, and how can it help?

Physician coaching can help doctors examine their thoughts, understand the emotions influencing their decisions, clarify personal values, and develop new approaches to boundaries and career choices. In this episode, Megan discusses how coaching can help physicians recognize their agency and make more deliberate decisions.

EPISODE TAKEAWAY

Physicians cannot meet every request or satisfy every expectation. Defining what matters most can help physicians make more deliberate decisions about their time, responsibilities, and careers. Healthcare organizations also have a responsibility to create working conditions that support the people delivering care.

YOUR NEXT STEP

Before accepting your next committee assignment, project, or additional responsibility, pause and ask: Does this support what matters most to me and where I want to go?

You can also reflect on what comes up when you consider saying no. Is it fear, anxiety, or a thought that you need to keep everyone happy? Identifying that response is a starting point for making a different decision.

ABOUT THE GUEST

Dr. Megan Melo, MD, is a board-certified family medicine and obesity medicine physician, menopause-certified by The Menopause Society, and a certified life coach through The Life Coach School. She is known as The Physician Whisperer.

She was named a “Top Doc” for Obesity Medicine in Seattle by Seattle Metropolitan Magazine in 2024, 2025, and 2026.

Connect with Dr. Megan Melo:

Coaching website: https://www.healthierforgood.com
Medical practice: https://www.phinneypcw.com
Email: [email protected]
Instagram: @MeganMeloMD
Facebook: Megan Melo
LinkedIn: Megan Melo, MD

Work With Us:

If you're interested in working with Academic Medicine Strategy Group, visit www.amedsg.com to learn about our programs that help academic physicians build a clear, strategic path to promotion, research, and career advancement.

Leaders can also explore the Faculty Excellence and Retention Initiative (FERI) to learn about faculty development and retention support at www.amedsg.com/feri.

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If you'd like to get in touch or suggest a topic:

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Episode Transcript

Stacey Ishman Megan Melo The PHyscian Whisperer
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[00:00:00] Hi, I'm Stacey Ishman, and welcome back to the Academic Medicine Strategy Podcast. I am joined today by Megan Mello, who is a fantastic physician who happens to be the physician whisperer, and she's gonna tell us a little bit more about that. But she is a coach who I have the privilege of working with and working next to in one of the mastermind groups that we work in together.

So Megan, can you tell everybody who you are and what you do? Yes. Thank you so much for having me, Stacey. It's great to sit down and talk to you here. But my name is Megan Mello. I'm a board-certified family and obesity medicine physician in Seattle, Washington, and I'm also the physician whisperer. I coach physicians recovering from employed practice, struggling with issues around people-pleasing, perfectionism, lack of boundaries, helping us to connect with what we really value so that we can have satisfying, fulfilling careers and lives.

And one, before we got on, one of the quick conversations we had was like, [00:01:00] "Hey, what do academic physicians deal with?" And I think you, it doesn't matter whether you're recovering from employed practice or you are actively employing people or being employed- ... perfectionism, people-pleasing, these are not exclusive to any one group of physicians.

These, in fact, are not exclusive to physicians. And so let's talk a little bit about what did people-pleasing look like for you in your own career before you really had a name for it? Like, how did you get to the point- Yeah ... where you even realized that was an issue? Yeah. And we are bred to be perfectionist people-pleasers in our journey into medicine, right?

We had to compete against a lot of other people. We had to be liked. We had to get letters of recognition. All of that created a very typically compliant, polite, hardworking, driven person, right? Who eventually gets into medical school and training and beyond. Nobody tells us that eventually we're gonna have to turn that off.

[00:02:00] Eventually we're gonna have to decide what is enough. That there are going to be things and people that we can't satisfy because the volume of work, the nature of the work that we do the limits of time are all going to be there. And so I think for me it was really this constant sense of I'm never gonna be enough.

I'm never doing enough. I'm never helping enough. Being able to see that as no, that's... It's not possible to take care of all the humans. It's not possible to do everything for everyone, have everybody like me. Yeah. And especially, when we get into the caree- we've got career and we've got family and there's just too much.

We could never do it all. So that's a really important piece of the puzzle, I think, for so many of us, is figuring out this sense of I get to decide what is enough. Absolutely. I get to decide what is the right size for me. Yeah. It's not gonna look the same for [00:03:00] all of us. Was there a moment or a day where it came to you?

No, it was much more messy than that. Me too, by the way. I don't have that like- As, as most things are. I can remember specific sort of crisis moments, right? Yeah. Where I was just like, "I'm not okay. I'm not okay." I... and thankfully, it never took me to a very dark place, right?

We know that we lose physicians to suicide every year, and there's probably more that we don't realize are constantly on the verge. That is a very real terrible statistic. I'm grateful that I never got there, but that should also not be the benchmark, right? Of at least I'm not feeling that bad.

We've got widespread crisis in terms of how physicians walk around feeling. And of course, it's not all of us, right? And it's not all of us all day all the time. But when we're in this place where patients are complaining they don't feel heard, they feel rushed, they feel like [00:04:00] nobody's taking them seriously, we've got doctors and other healthcare professionals who are so watched in terms of the time that they spend with people.

It's just a terrible setup for delivering care. We still call it delivering care, right? We provide medical care for people. You can't care about it when you don't feel cared for. Yeah. So you've defined the problem, like and many of us, I think, can relate to this, this feeling you're talking about, even if it's not to that degree.

Yeah. We get asked all the time to say yes to things. Committees, mentors- I'm more patient. Teaching Can I ask you a question? Can we, you know- Can we put one more patient on your schedule? All of it, right? So how do you decide what to say yes to and what to say no to? How you make the decision on what to accept?

Yeah. I think the real work comes down to understanding what's important to you and where you wanna be going. There are a lot of people [00:05:00] who will try and put their opinions, their values, their goals on top of you. We are excellent problem-solvers, we are excellent doers, and people want those things from you.

But if people are constantly asking you to do things that really aren't in service of you and what you're trying to do we need to recognize that and say, "This is actually not something I'm gonna take on." So one- And it's hard. I think it, it takes reflection, right? Yeah. It takes really understanding that "Ah, I can't just be doing for everybody else.

I need to know what's important to me." One of the things I do with the t- groups that I work with and in the course that I have, is we go through a les- list of values- ... and we figure out what our values are, and then we create a filter so that we can have- ... an easier, less guilt- Yeah, easier

ridden yes or no. Is there an exercise or something that you take people through in order for them to get to that? 'Cause I find when I ask people what their values are, unless they've been in coaching, almost nobody [00:06:00] can say "Here's my list of values," and I couldn't before I did some coaching.

So how do you- Yeah ... approach that? Yeah. Yeah, I don't usually ask that direct question of "Oh, what are your values," right? 'Cause yeah I think any of us would- Yeah ... rightfully sort of- I don't know ... struggle with that. Yeah. But I think for me it's often coming to it from different questions of- Trying to help that person sit and connect with what is really important to me?

Like, where do I want to go? What would feel good? Because the values come out of that, right? Somebody who wants to build up more of their personal time, right? That will trickle out. Somebody who has it on their goals to, get I don't know, get some research grant, something, some specific goal, their values will unfold from there, and then we're gonna talk about it and connect it through.

So I don't need them to leave with a list of "Here's my values that would go on my CV." It's like, no, but I want them to leave with a very clear sense of [00:07:00] who they are and what is important to them. And then I think the filter tool becomes that much more useful, right? 'Cause it's- Yeah ... okay that's not getting me closer.

The, yeah, it's, it's not improving the relationship, so we're not doing it. Okay, so if you're thinking about that at a systems level, and I oftentimes try and bring it back, 'cause I think a lot of this is infrastructure that needs to be built for physicians, what could a health system or an employed practice or an academic department do that might have either kept you or you think would support physicians who are struggling with perfectionism and this kind of filter and values?

Yeah. I think We have to bring it back to treating physicians as humans You and I know because we have been in business coaching how the flow of money works through medicine, right? Physician sees a patient, writes a note, drops a bill, eventually the insurance pays, right?

There might be some patient responsibility. [00:08:00] Most of us are very disconnected from knowing how the money flows through, but the businesses that employ us, whether they're for-profit or not, right? Universities, whatever, they know how they get paid. Yeah. They know how they get paid, and they know the levers that they have in order to get more payment or pay less, right?

Drop their expenses. And so often it's we're gonna make the physician see more patients," right? "So we get more bills out, and, these nurses or this resource costs us more money, so we're just gonna, we're just gonna take that out." So we're cranking the machine of, physician capacity way up, whether we call it RVUs or whatever.

We're cranking that way up at the expense of the human, right? We are making them exhausted, overwhelmed, compassion fatigue, [00:09:00] burnout, like the whole spectrum. We're taking away resources and supports for them, and just, shrugging our shoulders and saying that's just what we have to do.

We're in a bad business position." It is a terrible feeling that physicians have who come to this work wanting to be compassionate, wanting to take care of, people, their disease states that they're in love with. The things that they really wanna be doing, and it is soul-crushing when you're just treated like a machine.

Yeah, I think- a machine that they can just ratchet up the capacity. So bringing human care and concern back to the people providing the care- Yeah ... needs to happen. I think it's a really great point. I think some of it might be the conversation, because it is a tough time in medicine in terms of the economics.

There's a reason we have more conversations about RVUs than the academics, even in the academic world. Yeah. But if you're part of the decision-making or at least informed of the reason why, and you can feel like you [00:10:00] are part of the solution, it's very different than it feels like if it's coming down to you than if you're helping co-create the solution.

And I don't have the perfect solution for everybody out there, but I think your point about treating everybody as a human, helping them feel like they're part of the process instead of just a cog in the wheel, is really important. Yeah. Yeah. I don't know. I don't have a perfect answer for that either, it's just there's a real, there's a real opportunity there for- Systems to see, physicians and the people who provide care as an important resource and asset, and to try and help take care of them.

And not just telling them we've got yoga before work," or, at lunch that nobody can make it to, right? Yeah. Because nobody has the resources they need. It's like no. We need to figure out, how do we take care of people better so that those people can then take excellent care of all the patients that we serve?

And that's the reason that there's such good data showing there's lots of interventions that actually help with [00:11:00] burnout and other things. Yoga's not necessarily on the top of the list, although I do love yoga, for anybody out there who likes yoga. Yoga's great. Yeah. But- It's great, but it's not gonna fix all the things, right?

Yeah. Mindfulness is 64% effective. You start getting to system level solutions, we're in the 70s. Coaching's actually the most effective, and you can integrate it with all of those. And so there's lots- Yeah ... of ways to address it, but I think they all start with focusing on the human in front of you.

So I love that point. I know we only have a couple minutes left, so I wanna know, if you were gonna try and help a physician who can't say no- ... how would you approach it? What skill or tool would you give them to try and work on it this week? Yeah. I would... in my sort of branch of coaching I would dive into what is the feeling that comes up when you think about saying no?

It might be fear. It might be anxiety. It might be something else, right? But tapping into what is that actual emotion, and what is the thought that's [00:12:00] behind it? Because somebody might be having a true trauma response to the idea of saying no, they really feel it's unsafe to say no, and somebody else might just not be aware that they have permission, right?

They might think "Oh, I really want this person to like me," or "I don't wanna be difficult." Yeah. Those are very different, and I don't think that we can, just sit and pretend like people don't have more, traumatic responses to that because, that's just the reality.

So that is how I start to approach that. I was like, "Yeah, what actually comes up?" Because we can talk about it all day, but if we don't know the actual feeling that stops you from saying no, then we're probably just gonna keep circling it. Yeah, and I loved your point about the thought behind it too, because I think many of us are able to identify the feeling- but don't necessarily take one more step back to figure out, what thought am I having that's making me feel that way? Yeah. And I [00:13:00] love your permission comment. I... my book just came out, called The Physician's Guide to Owning Your Time. And it is, it sounds like a time management book, and there are definitely strategies to help with time management, but it is really about permission and recognizing- how important we are, and that we do have the agency to make those decisions. But we forget that we do or we're told that we don't until we actually poke that bear and give it a shot. Yeah. And it turns out we, we have far more agency than we realized. Yeah. Yes. And reclaiming agency I was just coaching somebody minutes ago, and that's what we were talking about.

And it shows up in big ways and small. She was giving the example, she was like, "Oh, it's so silly, but me deciding to run the dishwasher not, completely full because it was gonna make it easier." And it's yeah. Yeah. You decided to make things easier and you gave yourself permission to do it.

Yeah. It's not silly at all. It makes a difference, right? And we keep stacking up "Oh, I have agency here and here. Oh, okay. Great. [00:14:00] I get to make my own decisions." It is so conditioned out of us, so remembering that we have agency, that we always did to some extent, right? Maybe not as much during training, but- Definitely not

now we're grown adults, right? We get to- Yeah ... we get to step into the big girl big boy pants and say, "I have agency. I'm gonna make decisions." When we allow physicians to do that, I think great things happen. No, I love that, and the dishwasher analogy actually totally resonates with me.

I think I literally got goosebumps- ... 'cause I was like, "Oh, I think I've had that one," where I was like, "Can't run it unless it's full." It's like you have to finish everything on your plate, right? Yeah. Like you're in obesity medicine. Yeah. There's so many of these things, these thoughts in our head that we are...

They're giving us feelings about what we're doing, and we aren't even examining them. So I love that, that example. Yeah. Thank you so much for taking the time with us today. How do people work with you? How do they find you? Yeah you can find me at my website, which is www.healthierforgood.com. I am Megan Melow.

I'm the physician whisperer. I'm also on [00:15:00] Instagram and Facebook and all the places, and always happy to connect. Sounds good, and all that will be in the show notes if anybody wants to follow up with Megan. In the meantime, thank you all so much for joining us. We would really appreciate if you share this with somebody where it r- might resonate or be useful.

And in the meantime, I look forward to talking to you next week And out