The Power of Saying “No” — And Knowing When to Say “Yes”

Learning when and how to say “no” can help set patients’ expectations and prevent physician burnout.

In the medical profession, the ability to say “no” is often undervalued, yet it is a crucial skill for maintaining balance and achieving personal goals. Physicians, by nature, are inclined to help others, which can lead to an overwhelming sense of obligation to meet every demand placed on them. However, constantly saying “yes” can detract from focusing on what truly matters professionally and personally.

Why Say “No”?

We live in a world where expectations are ever-increasing, and around-the-clock availability is often assumed. This is particularly true in medicine, where the pressure to be perpetually accessible can be immense. Yet, learning to say “no” is about setting boundaries to protect your time and energy. It is not about rejecting every request but rather about discerning which tasks align with your goals and which do not. By doing so, you prioritize your own agenda, ensuring that your aspirations are not sidelined by the demands of others.

Saying “no” can help you reach your goals by freeing up time to focus on your own responsibilities. If you are constantly tending to the needs of colleagues, administrators, or even patients beyond reasonable expectations, you risk neglecting your own career advancements and personal development. For instance, a physician who is always volunteering for extra shifts or administrative tasks may find little time left for continuing education or research projects that could enhance their expertise and career trajectory.

Moreover, saying “no” can increase your effectiveness. Multitasking, especially in an error-prone environment like healthcare, often leads to decreased quality and efficiency. By concentrating on fewer tasks, you can devote more attention to each, improving both your performance and the outcomes for your patients. This focused approach enhances your ability to enter a “flow state” where you can work with maximum concentration and effectiveness.

Additionally, the power of saying “no” can increase your value. When you are constantly available, your contributions can become undervalued. You may be taken for granted. The “Yes Man” principle or the “Yes Person” phenomenon suggests that individuals who are inclined to agree or say “yes” to requests are often given more responsibilities and tasks. This tendency occurs because they are perceived as reliable and willing to take on additional work, which can sometimes lead to an imbalance in workload distribution.

By saying “no” and establishing boundaries, you communicate that your time and expertise are precious. This can lead to greater respect from colleagues and patients alike, making your assistance more meaningful when you do choose to offer it.

Reducing stress is another significant benefit of learning to say “no.” The constant pressure to fulfill every request can easily lead to burnout. By limiting the number of tasks you agree to, you reduce the stress associated with over-commitment and ensure that you can deal with your own responsibilities effectively. This preserves your mental health and increases your ability to provide quality care.

Why Say “Yes”?

While saying “no” can be a superpower for physicians, it is equally important to be supportive and collaborative and understand the critical incidents and events that doctors must say “yes” to. One of the most critical instances is in the direct care of patients. This includes responding to urgent medical needs, providing necessary treatments, and ensuring that patients receive timely and appropriate care.

In situations where a patient’s health is at risk, a physician’s commitment to their well-being takes precedence, and saying “yes” to these responsibilities is essential to uphold sworn oaths and maintain the trust placed in them by patients and their families.

Doctors must also say “yes” to opportunities for continuing education and professional development. The medical field is constantly evolving, with new research, technologies, and treatment guidelines emerging regularly. By agreeing to participate in seminars, workshops, and courses, physicians ensure they remain knowledgeable and skilled in the latest advancements, which is crucial for providing high-quality care. This commitment to lifelong learning is vital for personal growth and the advancement of medical practice.

Effective healthcare delivery often requires collaboration with other healthcare professionals. Physicians must say “yes” to working as part of a multidisciplinary team, which can include nurses, specialists, therapists, and administrative staff. This collaboration is essential for comprehensive patient care, ensuring that all aspects of a patient’s health are addressed. By embracing teamwork, doctors can contribute to more cohesive and effective treatment, ultimately improving patient outcomes.

Finally, physicians should say “yes” to roles that involve advocacy and leadership within the healthcare system. Whether the roles involve advocating for patient rights, participating in policy development, or leading quality improvement initiatives, they are crucial for driving positive change in healthcare. By stepping into leadership positions, doctors can influence the direction of healthcare practices and policies, ensuring they align with ethical standards and best serve patient interests.

Conclusion

When I accepted a position at a healthcare organization that prided itself on customer service, I was told: “Never say no without saying yes.” This expression is often used to encourage a positive approach to communication, particularly in healthcare and other professional settings. The idea is to frame responses in a way that maintains a constructive and cooperative tone. Instead of outright declining a request or opportunity, one might offer an alternative solution or suggest a compromise. This approach helps maintain relationships and encourages problem-solving while still setting boundaries or addressing limitations.

Excerpted from How to Jumpstart Your Medical Career and Thrive in Practice: Practical Advice and Insight from a Battle-Tested Physician by Arthur Lazarus, MD, MBA, CPE, DFAAPL.