5 Tips For Knowing When To Say No

I used to have a hard time saying no. This might resonate with most of you. I said yes a lot. Because I could help. Because I had the skill set and experience to do so. To help others is why I became a physician. But with that noble end goal, we are taught we are supposed to be of service, but we are not taught now to preserve ourselves in the process. Instead, we are told we are not supposed to be selfish with our time. We are supposed to give and give.

Part of the difficulty in learning to say no lays in the fact that for so many years I was hustling and building my private practice. When you're growing, you feel compelled to say yes to every opportunity that comes your way. You feel that you must say yes in order to continue the forward momentum.

So I said yes to every request for a lecture. I said yes to squeezing in and triple booking patients. I said yes to volunteer my time for non-profits and my community.

I tried to become more and more efficient with my time so that I could pile on more. I became a master of time management. I prided myself of being able to do it all.

And, though I loved every one of those opportunities, as was inevitable, I became burned out. I became resentful of these things I had said yes to. There was no longer any joy in doing them. They became commitments instead of opportunities. I felt unfocused and scattered.

So, I course corrected and here's what I have learned and the questions I now ask myself when presented with requests for my time.

1. Efficiency is not the answer

Getting faster at my tasks only to add on more was simply speeding up my feelings of overwhelm and burn out. I had the recognize the fact that I could not out manage time. We only have 1440 minutes a day and try as hard as I could, I could not add more minutes. If you're Type A like me, you think that it's a puzzle to be solved, that there's a Tetris type way to put all the commitments together so that you can achieve them all. And you can. It's possible. But not without sacrificing your mental well being.

2. Does the request align with your core values and goals?

I began carefully evaluating if the opportunity aligned with my core values. Community service is one of my core values, so that is high on my list. It might not be on yours. But, FAMILY is also one of my core values. And I must balance every opportunity with how it will affect my time with my family. The lecture that required me to fly 13 hours each way to speak for just 4 hours and fly back would mean 3 days away from my kids and truly only 1 day of networking. Whereas in the past, I would have said yes to that, now that I was checking in with my core values, I now said 'pass.'

3. Does the request allow you new opportunities?

It's not all about money. There are many requests that can lead to amazing opportunities. You have to know how to tell the difference. Sometimes it's about getting connected with the right people to advance your career in a different direction. I was asked to speak at a conference last minute. It was an academic conference, which meant of course, there was no speaker's fee. In addition, I actually had to pay to attend the conference, which required a 7 hour flight and 3 night hotel stay. But, I recognized it for the opportunity that it was - to be regarded as an expert in this field (this was a talk on using social media as a physician) and to get introduced to people who might be able to lead to those paid speaking gigs down the road. At the conclusion of my talk, many industry leaders sought me out after to tell me how much they enjoyed it and that it was something every physician should hear. I came away with many new contacts in a different sphere that I normally inhabited.

4. Does the request enable you to learn new skills?

Learning is fundamental to what we do in medicine. Some requests will allow you to stretch in a different way than you're used to. Learning new skills is ALWAYS a good thing, just make sure it's not the expense of your mental well being.

5. What will you need to give up in order to do what is requested of you?

This is the kicker. I think many of us disregard this very crucial question. Because we have to admit, that somehow we don't magically have more time in our day than everyone else. We like to pretend to ourselves that by saying yes, we can just absorb it in our already overflowing task list. And, we can, but again, not without consequence our emotional and mental health. So, be honest and consider how much time the task will take (remembering that we all underestimate the time tasks will take, a fallacy called planning fallacy) and then figure out what we will need to say no to to make this happen. For me to say yes to giving a lecture might mean I skip dinner with my kids which is an all important routine in our house. Once you uncover what it is you will have to say no to in your life currently to say yes to this request, you can then evaluate if it's worth it.

If you want my 'Saying No' Freebie, check it out below. A free, downloadable guide to figuring out which opportunities you should say yes to, and which ones deserve a hard pass.

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