Our recent Alumni and fellowed friends online forum on boundaries reminded me that some topics continue to resonate no matter how long we've been practising. We can understand boundaries, attend the workshops, read the policies and live through countless interactions that test them, but boundaries are never really ‘solved’. They're something we keep returning to as our careers, communities and circumstances evolve.
As rural generalists, we're rarely afforded the luxury of anonymity. We're part of the communities we serve. We see patients at the supermarket, at school events, at the footy and in the coffee queue. Most of us wouldn't have it any other way. Yet the same connections that make rural medicine deeply rewarding can also leave us wondering where our professional role ends and our personal life begins.
The discussion highlighted that setting boundaries isn't about drawing hard lines or becoming less available to our communities. If anything, it is about recognising that sustainable practice requires intentionality.
Many of us have developed our own approaches over time. Some have clear rules around treating friends and colleagues. Some have learnt to gently redirect clinical conversations that start in public places. Some have become better at protecting leave, family time and personal space. Others, myself included, are still figuring it out.
What struck me during the conversation was the universality of these experiences and how beneficial it was to speak about them openly. That, regardless of age and stage, we all continue to grapple with the same questions. The context changes, but the tension remains.
- How do we stay connected without being constantly accessible?
- How do we preserve professional relationships without becoming overwhelmed by them?
- How do we care deeply without carrying everything home?
These aren't signs that we're doing something wrong. They're signs that we're working in a profession that asks a great deal of us.
Brené Brown’s idea that ‘clear is kind’ was a theme that resonated repeatedly during the forum. Attendees spoke about ‘calling out the elephant in the room’ when dealing with boundary challenges, tuning into your inner red or orange flags and that ‘no’ is a complete sentence. We also heard that boundaries aren't necessarily about saying no. Often they're about providing clarity; clarity for our patients, our colleagues, our communities and ourselves about what we need to be able to care for them and ourselves simultaneously. Perhaps that's why conversations about boundaries matter. They're not really about restriction. They're about sustainability.
The reality is that most rural generalists choose this work because we value relationships. We like knowing our communities. We like being part of something bigger than ourselves. Healthy boundaries don't diminish those relationships. They help preserve them. They allow us to remain engaged without becoming depleted, compassionate without becoming consumed, and committed without sacrificing our own wellbeing in the process.
Thank you to everyone who joined the forum and contributed so openly to the discussion. It was a timely reminder that boundaries aren't a destination. They're an ongoing, sometimes messy, lifelong negotiation and practice, one that deserves reflection, conversation and, occasionally, recalibration but that they are an essential part of creating the conditions that allow us to continue showing up, year after year, for the people and communities who rely on us.
For those interested in exploring the topic further here are some resources:
- Brené Brown – Daring Greatly, Rising Strong and Atlas of the Heart, particularly her work on vulnerability, courage and the idea that ‘clear is kind’.
- Dr Dominic Vachon – How Doctors Care – The science of compassion
- Kristin Neff – Research and resources on self-compassion (self-compassion.org).
- https://positivepsychology.com/great-self-care-setting-healthy-boundaries/