Ep. #3. How To Say No.Today I talked about saying no. I really believe this is one of the most important skills that every physician needs to learn to manage their burnout. I talk about some of the reasons it is so hard to say no and give you so easy examples to use when you are stumbling for words. So often we say no because of the fear we have about what the requester is going to think or feel. And most importantly, I remind you that we don't know what they are going to think and there is no way to control it anyway.
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Show Notes and Time Stamps
Today I talked about saying no. I really believe this is one of the most important skills that every physician needs to learn to manage their burnout. I talk about some of the reasons it is so hard to say no and give you so easy examples to use when you are stumbling for words. So often we say no because of the fear we have about what the requester is going to think or feel. And most importantly, I remind you that we don't know what they are going to think and there is no way to control it anyway.
(02:45) Is it wrong to say no?
(03:02) Saying no is one of the most important skills
(03:18) Why is saying no so hard?
(04:26) Patterns may begin in childhood
(06:16) The “pay-back-trap”
(07:24) NO should be your default answer
(07:44) Benefits of Saying NO
(08:26) Be Clear
(09:18) Show Gratitude
(09:38) Give an explanation or NOT
(11:10) Offer an alternative
(13:15) Decide to say NO in advance
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You are listening to the Beat Physician Burnout Podcast episode number 3
I want to talk about one of the most important skills you can learn. HOW TO SAY NO. Now notice how I phrased this. I didn't say something like "I'm not good at saying no" or "I feel bad letting people down." Our words matter, and this is where coaching, our thoughts, and language come into play. Those statements don't give you any motivation to improve or change. It makes it seem like that is "just the way you are." "I'm not good at saying no" seems like a fact, right? But notice what different feeling comes up with the pivot to "saying no is a skill that I can learn" or "I am committed to saying no more to others, so I can say yes to myself."
()The life of a physician is demanding - there's no way around it. Your professional skills and knowledge are highly valued and sought-after. Add to that the usual demands of life, family, finances, and one hundred and one other things, and you have a life that's prone to overwhelm. Fortunately, a complete life and successful medical practice don't have to leave you drowning in obligations and feeling like you're at the bottom of your own priority list.
()When life and career demands inundate you, it's tough to know what to do. When you can help, contribute, and even excel at a task, it may seem wrong not to. You can feel selfish, withholding, and even mean. Not to mention the worries over what people may think of you as you decline offers or invitations. But is it wrong? I think not. It takes courage and great insight regarding your priorities to know when and how to keep yourself from being overcome.
Of all the skills you can acquire over your career, one of the most important for self-preservation is the ability to say no. But it's not just the act of speaking the word; it's how you say it and then feeling good about your decision. Saying no may not always be easy, but it is vital.
()Why is saying no so hard? What if you're invited to participate on a physician committee in your area, but you're already feeling stressed with your current obligations? You don't know where you'll find the time to attend meetings, let alone the information that they'll expect you to research and contribute. And most likely, it is volunteer, meaning no pay included. You know you should say no, but what will they think of you? Or maybe you believe it is too great of a career opportunity to pass up? How can you admit that you're not capable of taking on more? At first, it can feel impossible to confront these feelings. And you might even feel tempted to continue to suffer rather than say anything.
()Studies reveal the surprising power of a simple request. Most people making the request think it's easy for others to say no to them, but this is incorrect. They fail to realize the awkwardness and guilt the person will feel saying no and our willingness to do what we don't want to do, just to avoid being uncomfortable.
()Sometimes our difficulties saying no even began in our childhood. Children easily connect their actions with the reactions of the adults in their life. Sometimes they start believing that they are responsible for other people's feelings. It is an inborn human trait to care what people think of us. It goes back to when we were cavemen and needed to be included in our tribe of people to live, get food, be safe, everything.
We are social beings, and as such, we want to be loved, accepted, and pleasing to the people around us. When you make a request, it's instinctive to want to say yes and make people happy, and saying yes comes far more easily and naturally than no does. ()But overdoing this at the expense of yourself is what we call people-pleasing. Maybe it isn't difficult for you when you're asked to take on more work or additional obligations. Perhaps you feel good about solving other people's problems, you enjoy being in demand, and you feel satisfied with a full schedule. But you have to ask if living this kind of life is good for you - physically or mentally. We should never base our decisions on whether or not they will make someone else happy. First of all, in coaching, we spend a lot of time learning that we can never really control someone else's thoughts and feelings. That's their job. If you find yourself thinking you can't say no because of what that person will think of you, this is where you need to catch your thought error. You can never control what other people think of you. And this is why sometimes we feel bad even after saying no. We believe this person might be disappointed or feel rejected. The true goal is learning to say no and feel good about it.
()Have you ever fallen into the trap where you say yes to helping someone out, thinking that in the end, they will pay you back, or the universe will pay you back for your good deeds? Well, I'm here to tell you, it very rarely works out that way. It seems to be the same people who give and give and give. So never say yes, expecting something in return. That will just lead you to feel resentful. Say yes because you want to. No strings attached. Of course, another option is to make it an exchange right upfront. Yes, I will do this call for you in exchange for doing this other call for me. So when you are trying to decide if the answer is yes or no, you want to check in with yourself. Why do you want to say yes? Do you have any hidden expectations on their future behavior regarding paying you back? Are you worried about what they are going to think or feel?
Your time and energy are not unlimited supplies. Sometimes your constant availability is draining you, although the signs may be subtle at first. Setting healthy boundaries is a good practice whether or not you feel overwhelmed.
()Maybe NO should be our default. If you are experiencing any burnout symptoms, you should NOT agree to anything more, primarily work-related. Burnout is currently being described as radiation toxicity. If you can minimize your exposure, your symptoms improve.
() Let's talk about the benefits of saying no. The excellent news about saying no and setting boundaries is that you'll get better at it over time with practice and guidance.
Here are a few of the benefits of saying no sometimes:
- It will open time in your life for rest and recreation.
- You'll have more energy for the ones you love.
- You'll feel more confident. Saying no to others can feel equal to saying yes to yourself.
- You will have more control over your life.
- You will feel greater self-respect.
- Your life will be more fun and enjoyable.
So how do we do it? Here are some tips for how to say no and mean it.
()1 Be Clear
Nothing is more confusing and more disempowering than an unclear no. Do the requester and yourself the excellent service of saying no to them clearly, so you BOTH completely understand the situation.
A few examples of how to be clear:
- "Sadly, I can't…."
- "No, I'm not able to do that."
- "Thank you, but that's not going to work for me."
- "I love you but no." I use this all the time in coaching.
Obviously, this last one, is not when you are talking with your boss, but let's give an example of a family member who wants to borrow some money. The giving or loaning of money between family members almost always ends up being a bad idea in the end. But these are also some of the most complicated people to say no to. So try this one out…. "I love you, but no."
()2 Show Gratitude for the request
Showing sincere gratitude can soften the blow and make you and the requester feel better.
A few examples of how to show sincere gratitude:
- "I'm honored!"
- "I am so grateful."
- "Thank you for thinking of me."
- "I really appreciate you asking me."
()3. Add a Brief Explanation or NOT
Don't feel you have to over-share or make a case for your denial, but a short explanation may be in order. *Remember, no is a complete sentence, and this is optional. Don't beat around the bush or offer weak excuses or hem and haw.
- I am really sorry, but I am unable to do it.
- Unfortunately, that's not something I can do (at this time).
- Understand people's tactics so BE CAREFUL. Don't allow them to still "make it work" unless you want to. Like with the example above, I said, "unfortunately that's not something I can do." But if you change it slightly to "unfortunately, that's not something I can do this month." Just adding in "this month" may allow them to say, "that's great will just do it next month." If you genuinely don't want to do something, don't give any wiggle room.
- "I appreciate this opportunity. Unfortunately, I'm fully booked (all month long). Thank you again for asking."
- "Thank you so much for asking. But I won't be able to be there.
- And here is one of my favorites because most in healthcare are aware of the amount of burnout. "I'd like to, but I'd regret it because I am trying to balance my life and take better care of myself and get more rest."
()4. Offer an Alternative
This isn't something you should feel obligated to do. But if the request was something you wish you could do or there's another reason you had to say no - you might offer an alternative.
Now, if this is something you think you might actually want to do, it's all right to ask for some time to think about it. "I need to check, can I get back to you?". Now, remember, this is only if it is something you think you might actually want to do. If you know it's a NO, then do it right away. Don't postpone the decision. Don't say maybe, planning to say no later. The longer we take to say no, the harder it usually gets. To someone desperately trying to fill a position or task, your "maybe" will sound a lot like a "yes" to them. They will stop looking for someone else.
With your own needs in mind, here are some examples of compromises you can use:
- "Unfortunately, I can't bake my famous brownies for the bake sale because of my work schedule, but I'd be happy to bring by some store-bought ones."
- "I'm sorry you're having a hard time right now. I can't come over at the moment, but we can talk on the phone if you like."
- "I'm honored you want me to be a part of this program. Unfortunately, my schedule won't allow me to participate at this time. If the dates can be pushed back a few weeks, I'd be happy to be a part."
Additionally, you might offer the requester another suitable person if you know of one. Now, this doesn't mean throwing another person 'under the bus' and passing on the guilt of saying no to somebody else. But if you genuinely know of someone who might be interested in the opportunity, you could be doing a big favor for all parties. So many times, the requester wants to "fill the spot" and may just be tired of asking. Give them a solution, and maybe you can "hold another physician up" who is less experienced than you.
()Sometimes you may want to decide in advance. When I work with very burned-out clients, sometimes they just decide that "for the next six months I've promised myself I won't take on any more optional tasks." PERIOD. The end. Just set this rule for yourself, and then you just stick by it. This really helps when you are put on the spot and prevents you from decision fatigue and the need to continually think about the options over and over again. You've already decided. "I've promised myself I won't take on any more optional tasks for the next six months."
At first, it may not feel right to say no and decline requests for your time and energy, but remember those are in limited supply. Saying no may be done confidently and courteously, leaving you feeling in control of your life. After saying no, your brain may offer up multiple different thoughts such as "they're going to hate me. They're going to say I'm a bad partner. It's going to ruin our relationship". And these may feel so true at the time but just remember, you are never in charge of someone else's feelings. Sometimes we feel like we can see the future and somehow predict what they are going to feel. Maybe they will be upset. Perhaps they won't. Regardless, saying no should be accompanied by a positive feeling towards yourself. How people react to your no, it's not your responsibility. You can't control it. You can't predict it. You can only do what's best for you.
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