Saying No

It's OK to say no

Saying know on lined paper with red pencilAs physicians, we’re all familiar with the saying, “It takes 30 minutes to say no and 30 seconds to say yes.”  The unique demands of this profession – including the value of our time and patient satisfaction measures not always being what is best for the patient – sometimes cause us to fall into the trap of saying the easy yes when we should say the difficult no.

Although this saying typically comes to mind when talking about controlled substance prescriptions, I have tried to apply it to my personal time.  What I have learned (and I suspect most other physicians have too) is that when I say yes to patients, it can mean I am saying no to my personal life: family, friends, vacation time, and many of the other obligations I have in my life outside of patient care.  In no way do I mean to imply that we should not give our patients our best.  Indeed, we should give each patient 100% when we are engaged with them.  But every time we say yes to seeing just one more patient, we may be saying no to ourselves.

I try to look at my personal time and commitments as something I have said yes to.  Of course I want to see my child’s soccer game.  Who wouldn’t want to spend every minute of their vacation with their family?  Those are easy yeses.  The trick is to say yes to those things before we say yes to other things that make us say no to ourselves.  Instead of saying, “I have to pick up my kids at daycare when I am done working,” I now say, “I have to pick up my kids at daycare at 5:00.”  What I can give to my patients during that time, I do – completely.  But once 5:00 comes, I am saying yes to yes to my family and no to my patients.  That may seem a little heartless, but so is disappointing those that I love.  (My partners and I take turns providing phone coverage to our patients after hours.)

There is no doubt that being a physician is a lifestyle, not just a job.  None of us stop being a doctor at 5:00.  There will always be unexpected situations that arise and infringe on our non-patient care time.  We should always respond to those situations as appropriate.  But be sure to say yes with your time to what is important to you, and it will make it a little bit easier to say no when you need to.

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