Joy in Family Medicine – Stories & Reflections
Lessons, lightbulb moments, and honest reflections from life inside and outside medicine - served with a side of perspective.
Tags: alignment
Showing 12 results:
Acting Out of Character
A common tension came up during a coaching conversation with a brilliant, deeply thoughtful coachee.
With a lot of diligent work, she has grown more comfortable being and showing her authentic self rather than holding back or becoming someone different for other people’s comfort.
Now she is facin...
by Dr. Tonya Caylor —
Sep 04, 2026
adaptability
adaptation
alignment
authentic leadership
authenticity
awareness
behavior
boundaries
coaching
communicaiton
communication style
confidence
congruence
connection
courage
development
emotional awareness
emotional intelligence
expression
extroversion
fulfillment
growth
identity
influence
integrity
interpersonal
introversion
leadership
motivation
performance
personal growth
personality
presence
psychology
purpose
purposefulness
reflection
relationships
renewal
resilience
restoration
self-abandonment
self-acceptance
self-awareness
self-expression
teaching
temperament
values
vulnerability
wellbeing
When an Unexpected Next Step is the Right One
When I began telling people I was considering becoming the Founding Program Director of a new family medicine residency in rural Eastern Washington, the responses were not exactly subtle.
“Are you nuts?”
“Do you need me to say WTF, Tonya?!”
And, perhaps most thoughtfully:
“This doesn’t seem align...
by Dr. Tonya Caylor —
Aug 19, 2026
access
accreditation
alignment
building
calling
career
change
coaching
collaboration
commitment
community
courage
culture
curriculum
decisions
development
discernment
education
faculty
family
gme
growth
healthcare
impact
innovation
intention
leadership
medicine
mentorship
mission
moses lake
opportunity
physicians
primary care
purpose
reflection
residency
residents
resilience
rural
samaritan
service
sustainability
systems
teaching
teams
throughline
training
transformation
transition
trust
washington
workforce
wsu
wwami
The Bump Nobody Warned You About
A webinar this week about the evolution of a rural residency program inspired this week's reflections. In addition to the successes and growing pains, the thing that caught my attention was the sheer number of changes they had both created and endured.
In just 11 years, the program had 4 Chief Me...
by Dr. Tonya Caylor —
Jul 10, 2026
acceptance
adaptability
adaptation
agility
alignment
awareness
change
change management
collaboration
commitment
communication
complexity
continuity
culture
endurance
evolution
expectations
flexibility
growth
healthcare
innovation
leadership
leadership development
medicine
mindset
mission
mission focus
navigation
organizational health
organizations
perseverance
perspective
preparedness
puprose
reflection
residency
resilience
rural
stability
stewarship
sustainability
systems
teamwork
transformation
transition
trust
turbulence
turnover
uncertainty
Building Impact Capacity
This week I did something new.
I asked Claude to forecast my workload after I entered in all the things from my calendar and everything that wasn’t. It included my coaching practice, presentations, faculty development, travel, writing, a new time-limited leadership role I'll share more about soon...
by Dr. Tonya Caylor —
Jul 10, 2026
agency
alignment
attention
awareness
boundaries
capacity
capacity building
change
clarity
collaboration
commitment
communication
compelxity
decision-making
delegation
design
efficiency
energy
expectations
focus
forecasting
foundation
growth
impact
intentionality
leadership
momentum
organization
planning
preparation
prevention
priorities
prioritization
proactivity
readiness
reflection
resources
simplification
stewardship
strategy
sustainability
sustems
time
tradeoffs
transformation
transition
workload
The Penstock Paradox
I've been catching up on Lisa Rosenbaum's Not Otherwise Specified podcast series on primary care. https://not-otherwise-specified-podcast.nejm.org/e/when-no-ones-watching/
The final episode is titled When No One's Watching.
Near the end, Jonathan Han, a family physician and residency director, ta...
by Dr. Tonya Caylor —
Jun 23, 2026
alignment
artistry
authenticity
balance
burnout
caring
community
compassion
connection
contribution
creativity
encouragement
energy
engagement
excellence
flourishing
fulfillment
generosity
gratidtude
humanity
impact
influence
inspiration
intentionality
joy
kindness
leadership
legacy
meaning
mentorship
motivation
presence
purpose
purpose driven
regognition
rejuvenation
relationships
relection
renewal
resilience
restoration
service
significance
stewardship
sustainability
values
wellbeing
John Changes the Question
A few weeks ago, I introduced you to John, a fictional physician whose story reflects common themes many physicians wrestle with. He’s a mid-career family physician facing a career dilemma I hear often:
“I’ve never stayed in one job more than x number of years. I feel I need to leave my current o...
by Dr. Tonya Caylor —
May 29, 2026
adaptation
agency
alignment
authenticity
awareness
burnout
career
change
clarity
coaching
compassion
connection
continuity
decision making
direction
discovery
engagement
fulfillment
growth
inquiry
insight
intention
leadership
listening
meaning
medicine
mindset
perspective
physicians
purpose
reflection
renewal
resilience
self-awareness
sustainability
teaching
transformation
transition
trust
values
Say It Again
Recently, something happened in a meeting that used to bother me, but now I find it fascinating.
I was catching a colleague up who had missed the previous meeting. We had left one decision unresolved: where to place a particular talk. I mentioned the option we had discussed and asked for her take...
by Dr. Tonya Caylor —
Mar 13, 2026
alignment
attention
awareness
behavior
clarity
cognition
collaboration
communication
complexity
culture
curiosity
decision making
distration
dynamics
focus
grace
group
hearing
inattention
information
insight
integration
leaders
leadership
learning
listening
management
meetings
message
messaging
miscommunication
neuroscience
patience
patterns
perception
processing
psychology
reflection
reinforcement
reminders
repetition
signals
strategy
teamwork
understanding
workplace
What Renovation Taught Me About Teams
My husband and I are back in the messy middle of building.
We are not a strangers to it. We completely renovated a historic home over seven years and our Alaskan home over ten, with my husband acting as contractor, doing the work he enjoyed and subbing the rest out.
And now, we’re building remote...
by Dr. Tonya Caylor —
Mar 13, 2026
adaptation
alignment
behavior
building
change
clarity
co-creation
collaboration
communication
conflict
construction
creativity
decision making
development
dynamics
expectations
forming
friction
group
growth
homebuilding
innovation
leadership
learning
marriage
mindset
organization
partnership
patience
performing
problem solving
process
progress
reflection
remodel
renovation
resilience
satisfaction
storming
structure
teams
teamwork
transformation
uncertainty
vision
Tools and Strategies
Mindset
I always spend a lot of time on mindset. It is foundational and under-discussed. However, if we only change mindset without also learning strategies and new tools, many things will stay the same.
For instance, you may have a whole new outlook on your inbox. But if you want to improve comm...
by Dr. Tonya Caylor —
Feb 27, 2026
accountability
alignment
assertiveness
awareness
boundaries
burnout
clarity
cognitive load
communication
compassion
conflict
decision making
development
efficiency
emotional intelligence
empowerment
energy management
execution
feedback
focus
growth
intentionality
kindness
leadership
mindset
ownership
perspective
prevention
prioritization
proactivity
processes
productivity
professionalism
psychological safety
reactivity
reflection
relationships
repair
resilience
respect
response
sbar
self-efficacy
self-leadership
self-regulation
strategy
structure
systems
triage
What’s Your Fuel Level?
It’s the start of a new year, and for many of us, change is on the horizon.
Sometimes that change is self-initiated. Sometimes it’s suggested by others. Sometimes it’s formally required. In medicine and academic life, change often shows up wrapped in goals, milestones, improvement plans, or feedb...
by Dr. Tonya Caylor —
Jan 09, 2026
academia
agency
alignment
autonomy
behavior
beliefs
change
coaching
compliance
confidence
defensiveness
discipline
education
emotions
feedback
fuel
goals
growth
identity
importance
integrity
leadership
learning
meaning
medicine
motivation
needs
ownership
process
purpose
readiness
reflection
reframing
resistance
sustainability
thinking
transformation
values
The Emerging Choice: Staying for the Long Game or Moving On Gracefully
And just like that, it’s 2026!
The perfect time for the final piece in a five-part series exploring what helps when you care deeply about something, your influence no longer influences, and meaningful change seems unlikely.
Over the past several weeks, I’ve shared a few different approaches to ha...
by Dr. Tonya Caylor —
Jan 09, 2026
abundance
academia
agency
alignment
calling
choice
clarity
coaching
commitment
completion
culture
departure
discernment
equanimity
fulfillment
hope
identity
influence
integrity
leadership
legacy
maturity
meaning
medicine
ownership
patience
physicians
purpose
renewal
resilience
scarcity
stewardship
sustainability
systems
timing
transition
values
wellbeing
wisdom
Holding Pattern
This is Week 4 of a 5-part series exploring those moments when you care deeply about an issue, and nothing you do seems to move the needle.
So far, we’ve looked at three different approaches to that situation: • Week 1: Redefining success when outcomes aren’t changing • Week 2: Navigating real co...
by Dr. Tonya Caylor —
Jan 09, 2026
academia
agency
alignment
ambiguity
becoming
belonging
calling
choice
clarity
coaching
dignity
discernment
endurance
engagement
equilibrium
fulfillment
holding
identity
leadership
liminality
maturity
meaning
medicine
middle
patience
physicians
presence
process
purpose
resilience
restraint
steadiness
tension
threshold
timing
transition
uncertainty
urgency
values
wisdom
worth
Joy in Family Medicine – Stories & Reflections
