In the fast-evolving world of medicine, autonomy isn’t just a luxury—it’s a way to access greater fulfillment and sustainability in your career. For seasoned physicians, whether in leadership roles, working within large groups, or as practice owners, cultivating agency over one’s work is both an aspiration and an ongoing process.
We've drawn on lessons from Netflix’s revolutionary approach to autonomy, offering unexpected insights that can help physicians rethink how they approach their careers and work environments.
The Science of Autonomy: Why It Matters
Daniel Pink’s book Drive identifies autonomy as one of the core drivers of human motivation, alongside mastery and purpose. Autonomy—the desire to direct our own lives—plays a significant role in fostering creativity, engagement, and satisfaction. Pink highlights that individuals thrive when they are given the freedom to decide what to work on, how to do it, when to do it, and with whom.
For physicians, this can mean having the ability to shape your work in ways that reflect personal values and goals, whether that involves how you lead a team, contribute to patient care, or develop new initiatives. Autonomy isn’t a “one-size-fits-all” concept—it’s about finding ways to incorporate more agency into the areas of work that matter most to you.
Lessons in Autonomy: The Netflix Model
Netflix’s culture of freedom and responsibility, as described in Patty McCord’s book How Netflix Reinvented HR, provides a compelling example of how autonomy can empower individuals and teams. Here are some lessons physicians can draw from their approach.
1. Eliminate Unnecessary Bureaucracy
Netflix replaced traditional vacation policies with an unlimited vacation approach, giving employees the freedom to manage their time while aligning with their responsibilities. By emphasizing trust, the company removed administrative hurdles and focused on results.
While medicine often requires strict schedules, some bureaucratic processes may still be worth reevaluating. Whether it’s how administrative approvals are handled or how resources are allocated, exploring more flexible solutions could open up new efficiencies.
- Actionable Step: Identify one administrative process in your workplace that feels unnecessarily rigid. Could it be simplified or delegated to reduce friction?
2. Rely on Trust-Based Systems
Netflix operates on the principle, “Act in Netflix’s best interests.” Employees are trusted to make decisions without relying on rigid rules. This fosters accountability and creativity while aligning actions with organizational goals.
For physicians, fostering trust might mean encouraging team members to take ownership of decisions—such as how to prioritize daily tasks—while providing a clear vision for outcomes. Trust can be reciprocal: advocating for autonomy in your role might encourage leadership to provide the same flexibility.
- Prompt: Reflect on an area of your work where micromanagement or over-structured processes create bottlenecks. How could trust and clear guidelines improve outcomes for your team?
3. Hire and Align for Excellence
Netflix emphasizes hiring individuals who align with its values and excel in their roles. This ensures that autonomy thrives within a capable and motivated team. In healthcare, alignment can go beyond hiring—it’s about fostering shared purpose among existing teams.
Consider the value of clearly communicating your team’s shared mission. When individuals understand their role in achieving larger goals, they feel more empowered to act autonomously within their scope.
- Prompt: Are your team members aligned with the larger mission of your organization? What steps could you take to strengthen collaboration or clarity around shared goals?
4. Open Conversations Instead of Formal Reviews
Netflix eliminated traditional performance reviews in favor of continuous, informal feedback. This encourages growth without the rigidity of annual evaluations. Physicians, whether leaders or contributors, can benefit from this approach by incorporating more frequent, low-pressure discussions into their routines.
Instead of treating feedback as a formalized process, think of it as a natural part of collaboration. For instance, a quick debrief after a challenging case or a spontaneous acknowledgment of a job well done can strengthen team dynamics and foster trust.
- Actionable Experiment: Start with a five-minute informal check-in with a colleague or team member. Discuss what’s working well and what could improve—keeping the tone collaborative rather than evaluative.
How to Cultivate Autonomy in Your Career
1. Clarify Your Priorities Autonomy begins with understanding what matters most to you. Reflect on which aspects of your work bring you the most satisfaction and where you feel limited.
Reflection Prompt: What three priorities in your career feel essential to your fulfillment? How closely does your current role reflect these priorities?
2. Delegate Strategically Autonomy isn’t about doing everything yourself—it’s about focusing on where you add the most value. Delegating tasks or seeking support for non-essential responsibilities can free you to focus on work that aligns more closely with your strengths and goals.
Actionable Step: Identify one task you can delegate or streamline this week. Assess how this impacts your focus and satisfaction.
3. Encourage Responsibility Across Your Team As Netflix’s model shows, autonomy works best in cultures where everyone takes responsibility for their role. This can involve creating clearer expectations, fostering accountability, or advocating for greater trust within your organization.
Actionable Step: Propose a team discussion to align on shared goals and explore ways to improve autonomy and responsibility in day-to-day operations.
A New Perspective on Autonomy
Netflix’s example demonstrates that autonomy and responsibility can complement one another to create an environment where individuals thrive. For physicians, these principles offer a way to rethink how you approach your work, lead teams, or contribute within a larger organization.
By incorporating small shifts toward autonomy in your day-to-day work, you can create opportunities for greater fulfillment and impact—one thoughtful step at a time.
How are you redefining autonomy in your career? Join the community and connect with peers shaping the future of medicine.
