Team Culture: Boundaries, Generosity, and Trust

For me, Fall is closely associated with sports. College football, one of the primary ones, but also volleyball after years of being a volleyball mom.

I have a few friends who find sports a bit pedestrian, too focused on competition, and something they’ve never really understood the appeal of. I sometimes wonder if they miss what I love about them.

To me, sports are this remarkable microenvironment for learning about ourselves, others, and life: leadership, teaming, resilience, communication, confidence, recovery, belonging, coaching, growth mindset, and sustainable generosity.

The year my daughter’s volleyball team won state, they were just plain fun to watch.

She was a middle hitter, and by that point those girls knew each other well. They knew how each other thought. They anticipated where someone would be. When a play went south, they adjusted. Someone covered. Someone dove. Someone made something out of a ball that absolutely did not go where it was supposed to go.

And when things started unraveling and they were down, they united. They encouraged each other, huddled, reset, and went back out there remembering to have fun while focusing.

Their coach, Connie, who is also a good friend of mine and has provided me with more than a few lessons of my own over the years (including one involving my daughter, a bench, and the surprise appearance of my inner mama bear - another story for another time 😉), had expectations that went well beyond winning. Her lessons focused on teaching life lessons through sports.

One of them was simple: If a ball landed inside the lines, someone or two better have dove for it.

In other words, you might not be able to save every ball. But she’d better not watch one hit the floor because everyone decided it belonged to somebody else or because there was a lack of communication.

I’ve thought about that a lot in medicine.

My husband spent most of his career in small orthopedic practices, and I watched a similar kind of teamwork happen routinely. A partner would call and say, “Hey, you don’t need to come in. I’m already here, I’ll run down to the ED and see your patient." Or he'd offer to help someone round or cover weekends for their kids' birthday parties.  They scrubbed in for one another when another set of hands would help, and rearranged plans when life happened.

It wasn't that they didn't have boundaries. It was that they loved being good partners and had built trust. The generosity moved in all directions.

I’ve seen the same thing happen in residency programs. In the healthiest ones, residents cover for each other because they care about each other and it’s simply what teammates do. Someone gets sick, a child needs them, etc. There’s an “I’ve got you” feeling to it that doesn’t feel transactional.

And I’ve also seen the opposite in a program's team culture.

When people begin to feel that others call out easily or that they are repeatedly left holding the bag, they start thinking, “Well, if everyone else is going to look out for themselves, why wouldn’t I?” they call out, and the cycle continues.  There’s much less assumption of positive intent and much less generosity about pitching in. The overall sense is closer to “I’d better look out for me.”

A few years ago, during a coaching conversation about career planning, a third-year resident was considering a full-spectrum job with a physician-owned group he said he was excited about. As we talked about the offer, he said he wanted to make sure his contract put a cap on his call responsibilities. Because in his words, he wasn’t going to be taken advantage of as “the new guy” when someone had to go out on leave.

I totally understood where he was coming from.

There are very real examples of physicians being asked to absorb unsustainable workloads, cover chronic staffing problems, or continually give more than they agreed to give. Learning to recognize those situations and set boundaries is important.

But the contrast to my husband's practice really stood out.

Before he had even joined this group, one he was expressing excitement to work with, he was preparing to protect himself from them.

It made me a little sad that our culture has brought us to a place where self-preservation feels like the safest position from which to enter a new group or team.

Because there is real vulnerability in being the person who says, “I’m already here. I’ll see your patient.” You are trusting that your generosity won’t become an expectation. That when you need help, someone else will dive for the ball. That the organization will have built in the redundancy needed to make that sustainable. And that the organization won't discover your willingness to help and simply keep handing you more until you've become like the Giving Tree with nothing left to give.

Healthy teams require boundaries. But they also require generosity, flexibility, extension of positive intent, and a willingness to occasionally be inconvenienced for one another.

Healthy boundaries protect us from exploitation. Trust and reciprocity are what allow us to be good teammates.

A team where one person is expected to dive for every ball while everyone else watches isn't a healthy team.

But neither is one where the ball hits the floor because everyone decided, “That wasn't mine.”

Reflection:

Where on your team do you see trust and reciprocity working well?

When do you assume positive intent and when does it feel unsafe?

What helps you stay open and generous with teammates while still honoring healthy boundaries?

Speaking of sports, former NBA player Shane Battier was known for something that didn’t always show up in the stats: being the kind of teammate who makes everyone around them better. Watch: Being a top teammate

Challenge for the week:

Let's think about one team we work on regularly. For the next week, let's notice the “invisible assists” the small things people do that make someone else’s job easier or help the team succeed. Then intentionally make one ourselves.