Navigating Covey’s Circle of Control: A Guide for Senior Doctors

Understanding Covey’s Model

The concept of Covey’s Circle of Control has been the topic of a lively and engaging series of LinkedIn posts by Helen Bevan recently. I left a comment, but it also made me think about how doctors might navigate the circles of control, influence, and concern.

If you’re a senior doctor, you probably spend a lot of energy on problems you can’t fully fix. This can be exhausting and frustrating.

In Covey’s model, issues are organised into three circles. The outermost Circle of Concern includes things you care about but can’t directly change. The middle layer is the Circle of Influence, covering things you can’t control but can affect indirectly. At the core is the Circle of Control, containing the things you can directly "own" and act on. By noticing which circle an issue belongs to, you can focus your energy on things you can control, let go of what you can’t change, and act where you have influence.

The Complexity of the Healthcare System

So far, so good. Doctors need to know where to expend their precious time and energy. But doctors don’t operate as lone players; they are intricately woven into an inherently complex system, especially those in leadership positions. Even in failing, overburdened health systems, most doctors strive to provide the best possible care they can.

The personal and professional consequences of not doing so are great, particularly for senior doctors, who shoulder the greatest accountability. Yet many systemic and organisational issues are largely out of their control, very much in the Circle of Concern.

Senior doctors are often pushed toward things that are out of their control

Letting Go and Focusing on Control

The concept of the Circle of Control means letting go of things that we cannot change and focusing our energy on the things we can. This means choosing how you think and behave. However, for senior doctors, much of the day-to-day grind is out of their control, no matter how much hard work they put into their Circle of Control.

It also requires sufficient psychological safety to actually let go of things you cannot control. What does sit in our Circle of Control is our intrinsic motivation to do something and our choice about how much effort we put into it. This is inherently related to our beliefs, values, and sense of purpose.

The Power of Intrinsic Motivation

Senior doctors possess significant power of influence in healthcare (Oliver, 2022), but if their values and those of their organisation and system don't align, they are often left working to extrinsic motivators. Some, like financial rewards, are positive "pulls" towards something, but many are negative "pushes," such as the fear of sanction or punishment.

The evidence supporting the benefits of intrinsic over extrinsic motivators on employee performance is plentiful. Doctors are no exception (Tung et al., 2019; Zhou et al., 2025). We all do better when motivation comes from the Circle of Control outwards.

Aligning Values for Fulfillment

If you are a senior doctor operating in a system where there is a major values conflict, and it requires you to compromise your core values, it's time to consider your options. Reflect on what truly matters to you. Are you in a position that aligns with your beliefs?

Finding a role that resonates with your values can lead to a more fulfilling career. It may be time to explore new opportunities that allow you to work within your Circle of Control.

Conclusion: Embrace Your Circle of Control

In conclusion, understanding Covey’s Circle of Control can empower you as a senior doctor. Embrace the aspects of your work that you can influence. Let go of the things that drain your energy but are beyond your reach.

Remember, your intrinsic motivation is a powerful tool. Use it to guide your actions and decisions. By focusing on what you can control, you can create a more sustainable and fulfilling professional life.

As you navigate your career, ask yourself: What can I control today? How can I align my work with my core values? The answers may lead you to a more purposeful and satisfying path.