Join the October #AASchat on Tuesday, October 30th beginning at 8:00pm Eastern
I probably should have said “No” to writing this blog post. I said yes, because I thought it would be easy. I’ll cut to the chase. My main failing at saying “No” is that, like most surgeons, I think I can just squeeze in one more thing. It will be easy, right? It’s just a blog post. I can churn that out on a Saturday morning before anyone else wakes up. Of course, all these seemingly easy tasks we agree to do add up. Suddenly, you have six such tasks that you’ve saved for your Saturday. Now you’ve got a half day’s work on a bunch of “little” things that are not really moving your main career goals forward. The curse of doing a good job on these “yes” tasks is that they’ll ask you to do it again. Worse, they’ll want you to chair the committee!
Why did I think this blog post would be easy? First, I remembered reading an article about saying “No.” I pulled up my Pocket feed and searched the archive for “Saying No.” That search returned 51 articles. OK, so I guess I was wrong; apparently, I needed help saying “No.” There’s a zillion of these listicle type articles – see here and here in case you are not familiar. This leads me to the second reason I just said “Yes” to writing this blog post. All of these articles are geared toward the business person and not the junior faculty member in a surgery department. I’m in my sixth year on faculty. While I clearly still need help saying “No,” I can share some real-world, surgery-specific tips.
Let’s start by reviewing the listicles, and where they go wrong for an academic surgeon. Don’t these articles feel so good to read? The quick tips and sample lines. Such a quick read that makes you feel accomplished. Here, I’ll give you a quick hit:
The Deferral: “I’m swamped right now, but feel free to follow up.”
The Referral: “I’m not the best person for this. Why don’t you ask ______________?”
The Introduction: “This isn’t in my wheelhouse, but I know someone who might be helpful.”
The deferral is probably the weakest of the three for an academic surgeon. Everyone is swamped right now. Cry me a river, right? What I’ve learned is that if you’re going to say “No” and you don’t have any more creative way to get out of saying “Yes,” then the “No” has to be solid, definitive, and final. I will often start asking questions trying to get a reason for saying “No.” Leave no room for a savvy Division Chief to work around your other competing commitments or excuses. Try this:
The Definitive No #1: “I’m sorry, it’s just impossible for me to __________ right now.”
It’s polite, but the word “impossible” leaves no wiggle room. Providing reasons why it’s impossible will just lead to a discussion about time management or other advice on how to approach your competing task(s). Resist the temptation to provide a reason right away. A slightly bolder version of this is even more succinct:
The Definitive No #2: “No.” Look the asker in the eye and let the silence do the work.
Inevitably, the asker will ask why, and I would follow that up with The Definitive No #1. This method is especially useful for those of us who are quieter. It’s unexpected and will catch the asker off guard. It also displays your confidence and determination and garners a certain level of respect for not acquiescing. If just giving a flat out “No” is too bold, then try blaming it on a rule. Here’s an example:
Don’t make me break my rule: “When I joined faculty, I made a rule for myself that I would not join more than three committees during my first three years. Unfortunately, I’m already on three committees, so I cannot join another.”
Rules are definitive, and nobody likes to break them. Worse, nobody wants to force another person to break a rule. Use this psychology to your advantage. (By the way, it helps if these rules are real, and creating rules for yourself truly is a useful way to achieve your goals. Check out the work of Behavioral Economist Dan Ariely).
Most junior faculty still maintain the “yes sir/ma’am” type mentality that was cultivated during residency. We want to please our superiors. You cannot say “No” to everything as a junior faculty member, but selectively saying “No” firmly and confidently carries a certain gravitas that others respect. While you may feel powerless, remember that if you’re being asked and not told, then a “No” is a reasonable response.
Now, let’s consider The Referral and The Introduction. These do not hold up in an academic department of surgery because you’re offering up one of your colleagues or partners so that you can get out of an undesirable task. Even though a direct or named referral might not be the best idea, I think there are ways to do this successfully in academic surgery. You can refer to others without giving up a specific name. I have found that appealing to the asker’s sense of fairness usually helps. For example:
Let’s be fair: “I’ve served on the review committee for the last 2 years, I know there are others who have not done any type of committee work at all. Shouldn’t we all share the burden for this type of committee work?”
A related tactic is to offer a rotating or shared work load. Although this is not quite saying “No” it might make the “Yes” a bit more tolerable. Most leaders want to appear fair, and they will gravitate toward solutions that reflect fairness and equality. A creative solution is usually worth consideration. One useful piece of advice common in the listicle articles is to hold off on responding to an “ask” until you have done your research. While the articles stress the importance of evaluating the task, how it fits with your goals, expected time commitment, etc., I would argue that you can use this time to do a bit of reconnaissance. Who has done this task in the past? Who has not? Maybe there’s someone whose interests are truly aligned with the ask. You could even talk to that person yourself thereby turning The Referral into a genuine assist rather than a stab in the back.
Go ahead, read a few listicle articles on “Saying No.” Adapt these techniques to the surgical world. My own adaptation has included being definitive, appealing to fairness, and doing some research before answering. I still struggle with “Saying No.” Let me know how you handle it – @dfs_77.
The October #AASchat will explore these issues through facilitated questions led by our distinguished moderator, Dr. Lillian Kao, MD FACS, UTHealth, University of Texas
In the chat, scheduled on Tuesday, October 30 @ 8PM EST we will explore the following questions:
Questions for Discussion
- How do you know when a seemingly undesirable ask is really an opportunity?
- Is it possible to say no and remain a team player in the good graces of your superiors?
- Leaders need to fill various positions. They might sell or spin a certain task to make it seem like it fits with your interests or goals. How can you distinguish spin from reality?
- How can you refer an ask to someone else without betraying the other person?
- Can you really say “No” by saying “Yes”?
- Research shows that both men and women expect women to say “Yes” to tasks that do not lead to promotion. How can we overcome this implicit bias (of both others and ourselves) to level the playing field?