Chapter 1: Values, Externalization, Margin

Throughout my medical practice, countless patient encounters, and my experiences as a father, husband, and professional, I’ve identified a consistent theme in the lives of those who achieve sustainable control, engagement, joy, fulfillment, and growth. While the specifics vary between individuals, three foundational components are always present: Values, Externalization, and Margin.

These concepts didn’t emerge fully formed but grew out of my own life and experiences. The first concept, Margin, started as a simple “word of the year” for my wife and me, representing “free space” in our increasingly busy lives. Over time, Margin evolved into a more substantial framework, joined by Values and Externalization to create a positive feedback loop of growth, stability, and fulfillment. These principles became the foundation of my practice and a guide for helping patients achieve the lives they desire.

Let’s briefly explore these three concepts:

1. Values – What Is Important to You and Why?

Values are the guiding principles that define what matters most in your life. They answer the questions: What is important to you? Why is it important? Identifying your values helps align your actions with your beliefs, ensuring you live with intention rather than being influenced by external pressures.

When rooted in clear values, discipline follows naturally. Discipline is about doing what needs to be done, even when it’s difficult, because it aligns with what you value. This consistency builds results, and results build confidence and motivation.

Red Flags of Poor Values: Low motivation, lack of discipline, self-doubt, or a persistent feeling of being lost or unfulfilled.

Example: I value kindness. Treating others with compassion fosters strong connections and contributes to a more positive community. To live this value, I practice empathy in my daily interactions, whether with coworkers, family, or strangers.

2. Externalization – How Do You Measure Your Values?

Once you’ve established your values, the next step is to externalize them. This means setting measurable goals and defining actions that align with your values. Without specific metrics, it’s difficult to know if you’re making progress.

Metrics should be thoughtful and relevant, ensuring they genuinely reflect your values. Once established, they help you create a clear path and set actionable goals, such as using the SMART framework (Specific, Measurable, Attainable, Relevant, Time-Based).

Externalization is also practical—putting “what’s inside your brain, outside your brain.” Don’t rely on your precious mental capacity to keep up with arbitrary or short-term information (to-do lists, grocery orders, birthdays, appointments, assignments). Write that stuff down, put it in a calendar, or otherwise “externalize” it to a source not reliant on your active memory to maintain.

This also helps emotional processing—it’s easy to lie to yourself when it’s kept inside your head. Processing your emotions and thoughts in multiple ways often alleviates a significant portion of their burden and allows you to process them differently and more thoroughly with often better results and control.

Red Flags of Poor Externalization: A sense of underperformance, feeling that your efforts are unfulfilling, or lacking direction and purpose.

Example: If I value kindness, I define it as actively showing empathy and support to those around me. To externalize this, I might volunteer at my local food bank twice a month, check in on friends and family, and offer help when I see someone in need.

3. Margin – How Do You Set Yourself Up for Success?

Margin is about creating the space and flexibility to handle life’s challenges without becoming overwhelmed. It involves not overextending yourself and ensuring that your daily life leaves room for unexpected events. Margin also means diversifying your identity—finding fulfillment in multiple areas of your life—and prioritizing what truly matters.

Building Margin often requires setting boundaries, delegating tasks, and focusing on high-value activities that provide a meaningful return on investment.

Red Flags of Poor Margin: Stress, irritability, depression, or anxiety.

Example: If I value family time but feel consumed by work, I might delegate some work tasks and set stricter boundaries around my working hours to ensure I spend quality time with my family at least four nights a week.

Why These Concepts Matter

Values, Externalization, and Margin create a powerful framework for achieving a balanced and fulfilling life. They work together to guide your decisions, align your actions with your goals, and ensure you have the space to grow and adapt. In the coming blog posts, I’ll dive deeper into each concept to help you apply these principles in your life.

Stay tuned for:

• Understanding Values: Building the Foundation for Fulfillment

• The Power of Externalization: Measuring What Matters

• Creating Margin: The Key to Balance and Resilience