Ep #77: Why Accountability is About You, Not Someone Else

Accountability is a major topic within my coaching groups, but I realized that there’s a way we tend to see accountability wrong. I’m going to share how I realized that true accountability doesn’t need to involve someone else. When we realize how accountability really works, it’s much easier to understand why certain methods may not have been working as well as you had hoped.

As physicians we seem to need approval and often confuse that with accountability. This can end up tripping us up and leading to an almost addictive relationship with approval rather than exercising our true power of accountability. Emotional childhood mode and self-sabotage happen when we rely only on the approval of others, so listen in on how to shift how you think about accountability.

Listen To The Episode Here:

In Today’s Episode, You’ll Learn:

  • The importance of outsourcing and getting help when you need it.
  • Why I now have two people helping around the house and how I found them.
  • Why having someone to keep you accountable with your finances is so valuable.
  • Defining accountability and why it doesn’t have to involve someone else.
  • How to become more accountable to yourself.
  • Questions you need to ask yourself about accountability.

Featured In This Episode:


Get The Full Episode Transcript

Read the Transcript Below:

Katrina Ubell:      You are listening to the Weight Loss for Busy Physicians podcast with Katrina Ubell, M.D., episode number 77.

Welcome to Weight Loss for Busy Physicians, the podcast where busy doctors, like you, get the practical solutions and support you need to permanently lose the weight, so you can feel better and have the life you want. If you’re looking to overcome your stress eating and exhaustion and move into freedom around food, you’re in the right place.

What’s up, my friend? Welcome to the podcast. So glad to have you here today with me. I want to tell you about something that I don’t think I’ve shared with you all on this podcast yet. It’s something that truly has changed my life. I know so many of you are so good about hiring things out and having help brought in. I totally used to be, too. I used to have the most incredible nanny, and she would help with so many things around the house, but when I left my practice, I somehow changed my thinking into, “I should be able to do all of this stuff and not need any help.”

Back in January, when I was at Miraval at that physician wellness retreat that I spoke at, I was having dinner with some of the other people there, and they said to me, “Well, you’re helping us all the time. What can we help you with? What do you struggle with?”

I said to them, “You guys, listen. I’m having so much trouble just getting the housework done, keeping up with the laundry. It’s just this ongoing issue, and I don’t know what to do.” For some reason, my thinking around hiring someone to come and do that was that that was totally indulgent and ridiculous. I guess that’s just the total Midwesterner in me, that I’m just too practical or something. I don’t know one person, who lives near me, who does that.

Of course, I have a cleaning lady, and I’ve had one since we were interns. That was the best decision we ever made, really great marriage advice that we got from another two-physician couple, to just get a cleaning lady, even when you think you can’t afford it. Of course, I had the house being cleaned every week, but it was all this other stuff that I just couldn’t keep up with.

The gals who were sitting there were wonderful and immediately gave me really great ideas of where to find someone who could come in and really help us with our laundry. I changed my thinking on this and decided that this totally made sense. It was going to change my ability to show up as the mom I want to be on the weekends and not always be so stressed out with the laundry.

I went on care.com, posted the job, found some really amazing people, and settled on this really, really lovely lady, who is coming in once a week. I just have to share with you, what was so funny about it was that I always felt so behind, in terms of … I mean, I could get the clothes done, but then with the towels and the sheets and all the bedding. It was like this is a full-time job, practically, doing all of this. I was always behind. Someone always had some sheets that needed changing or something, clothes that weren’t getting put away into the proper drawers, tons of laundry baskets full of clean, dry clothes, but it wasn’t folded, not put away, just constant, constant revolving door of issue here.

Anyway, she started coming in, and it was so interesting. It was taking her nine to 10 hours of constantly being on it, right? The minute the dryer was done, clothes out, new wash in, boom, it’s going again, to the point where I actually got a second washer and dryer for her to use, because it was taking her so long. She was staying at my house until 7:00 p.m. I was like, oh, my gosh, this is not okay, but it made me feel so much better, like no wonder I struggled so much with this!

This is the best money I’ve spent in years, to just have someone come in and handle it and take care of it. Every Thursday night we’re all sleeping in clean sheets. It is fantastic, and not nearly as expensive as I thought it was going to be, so just putting that out there for you if you have this immediate thought of, “That sounds great, but I can’t afford it.” Highly, highly recommend it. It is the best thing.

Now, I know many of you have nannies, and you have your nannies do this. Our nanny used to do all the kids’ bedding, towels, clothes, our clothes. She didn’t do our bedding and towels, but then I would just do that on the weekend, and it was no problem, but yeah, I don’t have anybody like that anymore. Now, I have my gals who come in, one who cleans the house and one who does all our laundry, and she helps with some other additional cleaning tasks, just things that are not weekly things, but need to be done every now and then, and it has changed my life for the better. Think about it, and care.com … I was a little nervous about that, but that was a great experience, too. It was totally great, totally excellent experience, highly recommend.

Okay, so I, a couple weeks ago, went to Salt Lake City with my husband for a financial seminar for two and a half days. As these things go, I hear different things, think about different things, and then I get podcast ideas. This podcast idea was born at this financial seminar.

What ended up happening was that this program that you can sign up with, they have all kinds of different coaches and all kinds of different people who can help you to get your whole financial game completely set up. They talked about having a financial coach to help keep you accountable to implement your financial plans, because you know how it is, right? We’re like, “Oh, yeah, I totally need to set that up and set this up,” and we just never get around to doing it. It’s not the most fun thing we can think of to do. It’s on that to-do list, and it never gets done.

One specific person that we were talking to told me that he gave somebody else in their organization $100 to hold him accountable to completing this one form that they like you to fill out, this one document, and that a year later he still hadn’t done it. This really got me thinking about accountability, because it comes up in my coaching groups quite a bit. We talk about it a lot. Some of my clients will fall off the wagon, as they say, which doesn’t even exist by the way. There is no wagon. It’s always just choices you make. They say, “Well, I fell off the wagon,” and then they say that they need more accountability, so that they will stay on track.

I was really thinking, what is accountability actually? What does that mean? The Merriam-Webster definition for accountability is “an obligation or willingness to accept responsibility or to account for one’s actions.” Let me read that again: “an obligation or willingness to accept responsibility or to account for one’s actions.” I found this so interesting, because it doesn’t talk about someone else being involved at all. Did you notice that? But we often think about accountability in that way.

Sometimes my clients think that if they had more contact with me, then they’d be held more accountable, which would mean that they’d follow their plan all the time, and they’d stay totally engaged in the weight loss process, or their dream come true with the weight loss process would be a personal chef and a personal trainer, right? We think like, “If someone just cooked all my food for me, and someone just came to my house and made me work out, and if Katrina just moved in with me and coached me all the time, then I would have success.” What we don’t always realize when we think that way is we could still eat off plan anytime we want to, right? It’s not like your personal chef is following you around and putting the food in your mouth, and your personal trainer isn’t doing that either, right? You can cancel the personal trainer.

Let’s just say I did move in with you. You might just be like, “Screw it. I’m going to go get some gas,” and then you go get some candy bars while you’re at it, at the gas station. True accountability is when you are willing to accept responsibility and to account for your actions. This is something that we have to develop within ourselves. Nobody else can do this for you. You cannot hire this out. Now I am a huge fan of hiring things out, so trust me, if this worked, I’d be all in. It’s just not how it works.

Sometimes we think that it’s someone else’s job to hold us accountable, but even if you hire me as your coach, I’d argue that it’s not my role at all to hold you accountable. If I could somehow hold you accountable, and your accountability is my job, then what happens when our time together ends? You go right back to doing what you always did, because you were outsourcing to someone else, me, what you actually needed to cultivate within yourself. If your coach is always there to give you the gold stars and the pat on the back and all the approval, that really doesn’t help you in the long run at all. In fact, it turns you into what we lovingly call an approval whore.

So many of us women physicians have this issue, because we developed it a long time ago in our educational journey and our training. We really are high achievers. I don’t think there’s one doctor who’s not a high achiever. We worked really hard, and just having the teacher give us an A was often the approval that we were seeking, that we needed and wanted. It’s like we’re thinking, “If I just work hard enough, I’ll get the A, and then I can feel good.” Then, with weight loss, sometimes we’re working really hard, and we’re still not getting the results we want, and then we’re pissed. We’re like, “Where’s my gold star?” The scale is supposed to be dropping, and if it’s not, then I’m not getting the pat on the back that I want so much, and we go into emotional childhood, and then we often self-sabotage or rebel. We’re like, “Screw this. This doesn’t even work anyway. I’m just going to eat whatever I want,” which is always so fascinating, because then what does the scale do? It actually goes up, which is the opposite of what we wanted.

We’re looking for someone or something else to give us approval, instead of learning to rely on our own approval of ourselves. Can you have your own approval, even when you’re not losing weight, even when you’re making mistakes and eating off your plan, or planning something and it not working out, but then you’re learning from it and making changes and doing better next time? So many of my clients don’t think they deserve their own approval unless they’re doing everything perfectly, which just sets them up for that self-sabotage and never making any progress.

It really is incredibly fascinating to watch it play out, as the observer, because I’m the observer. They’re in the drama, and I’m like, “Look at what they’re doing. That’s so interesting.” My job is then to help them to see what they’re doing, because I can’t make them change. Only they can do that.

Ultimately, I believe my role as your coach is to teach you and help you through the process of learning to become accountable to yourself, which is what true accountability is. I don’t have a coach anymore, who’s looking at my food journals, who’s telling me what to do. I’m completely on my own, because I learned to develop that accountability to myself through the process of being coached.

As I’ve coached hundreds of women physicians, I’ve noticed that it’s the clients that are willing to go through this process that get the best results that are also permanent, because they leave our coaching time together fully accountable to themselves. They’ve taken ownership of the job of keeping themselves accountable to themselves. What’s interesting is that I’ve seen time and time again that clients, who would want to continue our coaching relationship ongoing, like they didn’t want to let me go, they would get worse and worse results as they went along.

Early on, when I first started coaching, I was like, “Sure, you want to keep working together? Great. Let’s do it,” but what they were doing was outsourcing that accountability to me, thinking that if they hired me, then I would somehow make them do what they needed to do, like, “Let me just pay her more money. Then I’ll do what I’m supposed to be doing. Then she’ll make sure that I’m doing what I need to do,” except that’s not possible, right? I can’t make you do anything. If I tried, I’d be trying to control you, which we know never works, right?

I think this is one reason that people diet shop and hop so much, right? They’re like, “I did Whole30, and I white-knuckled my way through the 30 days. Sure, I got great results, but then I didn’t keep it up,” or, “I followed Weight Watchers for a few months, and I lost some weight, but then I stopped going to the meetings, and I gained it all back.” I mean, that was literally the story of my life for let’s just say maybe 17 years-ish. We really feel more accountable when there’s novelty to what we’re doing, or there’s a meeting leader weighing us in every week, but that’s only motivating for so long, and then we’re right back to doing what we always did, no more accountable to ourselves than we were when we first started.

How do you become accountable to yourself? We understand the problem. What do we do now? If you’re anything like how I was, then you’re super accountable to others, to a fault, a massive fault, over-delivering like crazy to everyone at work, with phone calls, seeing patients, seeing extra patients, answering questions. You name it. If I was responsible for doing something at the kids’ school, I definitely would do it, no matter what. I made sure I got everything done that my husband and the kids needed, but when it came down to me and what my needs were, it was basically a total crap shoot, as to whether I’d do it or not. I didn’t trust myself. That’s that relationship with yourself that’s so important. Mine was completely broken down, and I would guess that many of you who are listening are in the same position.

I see this with my clients, who struggle so much to keep up with their charts in their electronic medical record. They’re pretty much the only one who suffers if they don’t complete their charts on time, right? The Records Department might sanction them or something, but really they are the only ones who suffer, right? They let them back up like crazy and create so much drama around getting caught up and staying caught up, and if it’s not the EMR for them, then it’s often keeping up with household chores or some other responsibilities.

I personally just kept thinking that I needed better systems in place in the house. It was definitely a lack of systems in my mind, or that I needed to lower my expectations of myself, which is hard when you’re a high achiever. I just kept thinking, if I could just figure that out, then I’d really be set up to not overeat anymore, but I was totally mistaken.

Of course, systems can be helpful, and having realistic expectations is a good idea for sure, definitely, but all the systems in the world weren’t going to make me not eat a snack at 10:00 p.m., when I said I wouldn’t eat after dinner at 10:00 a.m. that day, right? What I needed was to learn to be accountable to myself.

What’s so interesting is that accountability is 100% just a mental construct, like the financial coach, who gave someone else the hundred dollar bill to hold him accountable to doing something. Giving the hundred dollars only means what he decides to make it mean. I bet that if he’d given his friend $100,000, he would’ve gotten that work done immediately, like he wanted to do, right? The only thing that would be different would be his thinking about it. The other guy would just have more pieces of paper, right? His thoughts about the value of $100 versus $100,000 are different, and his thoughts about what it would mean to lose $100 versus $100,000 are different, right?

Think about the diet bets that people do. You have a certain amount of money on the line, and that really can motivate people a lot, to the point of sometimes doing some pretty extreme things. I’ve seen a lot of diet mentality stuff happen with diet bets, but as soon as the bet is over, then what? I’ve seen so many people then immediately soften up their plan right away, as soon as it’s over, because they don’t have that external accountability anymore.

Is the answer to just do another bet, be accountable, lose some, then gain some when you go back off again? No, of course not, right? Here’s the good news, though. You already know how to be accountable. You show up at work every day, even when it’s the very last thing you feel like doing. You focus and show up for your patients and provide them with excellent care, even when you have zero desire to do so. You get up in the middle of the night and you help your kids if they’re sick, even though you really, really, really would rather just keep sleeping.

If you know how to be accountable to someone else, you just have to extrapolate that same skill to yourself. You’re already a total A player in the field of accountability. You just have this one final area to apply it to, yourself.

In order to do this, you have to get really clear on why you want to be accountable to yourself. Why do you want to develop this skill? Basically, you have to ask yourself what’s in it for you? How will it make your life better over the long haul? Are you willing to do the immediate hard thing, so that it’s easy for you later?

With your job, the immediate hard thing is getting your butt out of bed and getting ready and going there, and then showing up as the world-class doctor who cares about her patients that you are. The ease you get later is the pride you have, knowing that you produce incredible value for your patients, as well as the paycheck you get. With eating, the immediate hard thing is planning your food in advance and then only eating that, because you honor your plans. The later ease is getting the results on the scale that you want, plus knowing that you’re in integrity with yourself, plus massively reducing the brain chatter and negotiations about what food to have, which ends up lowering your desire, too.

Then you have to set yourself up for success. As you know, if you allow yourself to make decisions in the moment, then you’ll be relying on your primitive brain to have your best interests in mind when making those decisions, and that is just not how the primitive brain rolls, right? It’s all about comfort and ease. It’s all about less pain and less effort. What that results in, though, is an overweight body. Primitive brain in control equals overweight body.

When you’re accountable to yourself, you’re willing to accept responsibility and to account for your actions. That means creating a plan and doing what you said you would do, no matter how uncomfortable it is in the moment. It means recognizing that it’s only your responsibility to do this. This is the epitome of emotional adulthood.

Plan to mess up, and decide right now that you won’t make this mean you’re a failure. Instead, make it mean that you are still learning how to be accountable to yourself. You’re not going to get this immediately. Then make sure that you spend the time required to figure out what the lesson actually is and implement the solution in your life. Then rinse and repeat, and keep going and going and going, and repeat it and repeat it and repeat it. Apply massive action to this skill.

Over time, you will find that your ability to be accountable to yourself is amazing, unlike it’s ever been before. You’re going to look back and be like, “I can’t even recognize myself, basically, at this point.” That is the ease that you get at the end. I promise, you’ve got this, my friend. This is some of the best work that you can do for yourself. Have a wonderful week. I will talk to you soon. Take care. Bye-bye.

Thanks for joining me today. If you like what you heard here, be sure to hit subscribe in your podcast app, so you never miss an episode. You can also get my Busy Doctor’s Quick-Start Guide to Effective Weight Loss for free by visiting me over at katrinaubellmd.com.

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Showing 2 comments
  • Krista

    Hi, Katrina…love the podcast!! Have you ever read any of Gretchen Rubin’s books? Specifically, the Four Tendencies. I was thinking about her book listening to your podcast. She divides people into four tendencies, and one of them is an Obliger (which is mine). The key for Obligers to be successful is to have external accountability according to Rubin. A personal example: I pay a high monthly fee at my bar method studio in Chicago. So, I go 4-5 times a week because of both the cost, as well as the fact that I see the same teachers week to week who expect to see me. When I used to pay a monthly fee for a gym without classes, I didn’t go.

    I found her book to be extremely helpful, and it helped me to understand my past behavior (I was most successful in optometry school when I studied in groups vs alone, etc.). You seem to be to be an Upholder (just a guess!), so you can motivate yourself without external accountability. I wonder if you find with your clients that different types of people do better with more/less accountability. I thought you may find this interesting! I’ve found the Four Tendencies to be really helpful at work when treating those with chronic disease and keeping them motivated to stay on the treatment plan. I would be really curious if you find the book applicable to coaching.

    This is a link to the quiz to find your tendency:


  • Brenda

    Hi Katrina,
    This was the most powerful podcast yet for me. I have listened to it three times in the past 2 days. It really is empowering to know that I deserve to be in the highest category of accountability with myself. Oddly I have always put everyone elses needs first and believed that I needed to sacrifice accountability to myself to make everything perfect. However, since my journey began in October I have prioritized accountability to myself and made great strides. Your podcast came at a perfect time where I found my primitive brain wanted to be in control and is perfect for reminding me of my obligation to own accountability to myself. Powerful

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