Overwork is normalised in medicine and public health. Long hours, relentless responsibility, and personal sacrifice are often equated with professionalism. Yet in my coaching work, overwork frequently emerges as something else entirely: a way of managing self-belief. This is the second in a series of linked blogs, on the subject of challenges faced by medical and public health leaders.
Conditional Self-Worth
Many medical leaders, public health leaders, and global health leaders don’t describe themselves as lacking confidence. Instead, they say things like, “I just need to stay on top of everything,” or “If I don’t do it, it won’t be done properly.” Psychological research suggests these patterns are often driven by conditional self-worth, where value is tied to performance, productivity, or being indispensable.
In senior health leadership roles, this becomes problematic. Chronic overwork reduces cognitive flexibility, narrows strategic thinking, and impairs ethical decision-making. Medical, public health and global health leaders may be, and appear to be committed, but without proper recovery from work, the cost is often reduced capacity for reflection, delegation, and long-term vision: these are precisely the capabilities that modern complex health systems require.
We overwork to try to gain control in the face of uncertainty
From a coaching psychology perspective, overworking often acts as a coping strategy for uncertainty. When leaders feel unsure about legitimacy, influence, or role boundaries, effort becomes a form of control. Yet research on leadership effectiveness consistently shows that sustainable authority is built through judgment, relationships, and adaptability, not exhaustion.
Developing an internal, unconditional sense of self-belief does not mean caring less. It means grounding confidence in competence, values, and learning, rather than in relentless output. Self-determination theory highlights that autonomy, mastery, and purpose – not overwork – are the foundations of motivation and wellbeing. Leaders who internalise this demonstrate greater resilience and inspire healthier team cultures.
In coaching, this work involves making internal thought rules visible: ‘I must always be available’, ‘I can’t slow down’, ‘Rest equals weakness’. These beliefs were often adaptive earlier in medical and public health careers, but become maladaptive in leadership. Challenging them requires psychological safety and permission to experiment with different, effective ways of leading: something that my psychologically-informed coaching explicitly supports through my use of cognitive-behavioural approaches grounded in adult development theory.
Leaders set cultures
Overwork is not just an individual issue. Leaders model norms and set culture consciously and unconsciously. When senior clinicians and public health leaders operate from depletion, it legitimises burnout cultures. Conversely, leaders who set boundaries and lead sustainably create conditions for the wellbeing of their wider workforce: this is now an essential leadership behaviour across health systems.
These dynamics are amplified when health leaders move into unfamiliar contexts, we feel we need to prove ourselves in the early weeks and months of new roles. In my final blog, I explore what happens psychologically when doctors and public health leaders transition into global health roles, where identity, power, and assumptions are tested in new ways.
As the world’s only Chartered Coaching Psychologist with a medical and public health leadership background, I provide evidence-based coaching proven to increase senior leader wellbeing scores by an average of 17.4%. To transform your leadership, career, and wellbeing alongside a genuine peer who understands your reality, book a free Confidential Consultation.
