Why you should say "no."

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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I'm your host, Toyosi Onwuemene, and it is an absolute privilege to be here talking with

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you.

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Thank you for listening.

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The only reason I'm able to talk is because you keep listening to me.

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So I just want to say thank you for being here.

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And I want to invite you, if you are looking for an opportunity to coach with somebody

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in academic medicine who can help you as you transition from clinician to clinician scientist,

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I would love to be your coach.

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Reach out to me by DM on Facebook or Instagram.

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I'm Tiosi Unwemona.

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I'm on LinkedIn as well.

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And I would love to talk with you about some of our offerings to help you succeed as a

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clinician who is transitioning to becoming a physician scientist.

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Okay.

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So today I am talking about why you should say no.

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Okay.

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I said the word.

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It's the N-O word.

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And I want to tell you that the problem with this word, N-O, N-O, no, it is such a hard

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word to say for me today.

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But I look at my children, or at least more when they were two, right?

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They're two years old.

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We call it the terrible twos.

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And the reason we call it the terrible twos is because of this word, no.

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Like suddenly children discover this word called no and they use it all the time.

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And we try to discourage them from saying no.

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But now as an academic physician, I envy young children who can say no so easily.

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And they don't say no just to be difficult.

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They say no because they genuinely don't want it.

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They just don't want broccoli.

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Of course they don't want broccoli.

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No.

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You know, they say no.

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So why do we struggle as academics to say no?

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And I blame my mother.

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I blame every time she dissuaded me from saying no and tried to teach me to always say yes.

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Okay, okay, so I don't blame my mother.

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But I think what I'm saying is that it actually is an absolute gift that children have that

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I think we had as children where we could so easily say no to anything we didn't want

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to do that is so much harder right now.

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But I'm here to talk to you about why we should say no, why it's so important to our academic

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careers, why it's so important to our health and well-being to learn to go back to our

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two-year-old self and say no.

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Okay, so I'm talking today about five reasons why you should say no.

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And it is so important to be able to learn to say no and to be able to learn how to say

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no.

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And in a future episode, I'll talk about how to say no.

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But today I really just want to sell you on the idea of saying no.

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And before I give you these five things, the first thing I really want to share with you

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is that no is only half of the equation.

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No is only half of the equation.

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In reality, every time we say no, we're actually saying yes.

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Like no and yes are two sides of the same coin.

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And so in academic medicine, many times we feel pressure to say yes.

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And what's not obvious when we say yes is that we're really saying no at the same time.

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You might say yes to the thing that's right in front of you, but what are you saying no

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to?

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And the reason it's challenging for us in academic medicine is that the thing to which

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we are saying no is often hidden in the background, out of sight, out of mind.

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And the thing to which we're saying yes is the thing that's most front and center, usually

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the urgent, not important things.

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You've heard about that matrix that goes from things that are urgent and not important to

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not urgent, but important.

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And it talks about a matrix of four, and I can't recall it all right now.

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But the things that are most important in that matrix are the things that are not urgent,

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but important.

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But they tend to be the things that are most silent.

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And when we say yes, what we forget is that there's a list of things that are not urgent,

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but very important that we're probably saying no to.

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And so no and yes are actually two sides of the same coin.

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And the reason we need to understand the saying of no is that every time we say no, we're

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saying yes to something more important than the thing in front of us right now.

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But if we say yes, then we're saying no to something else that we're saying is less important.

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And so whenever we say no, we need to understand what we're saying.

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Whenever we say yes, we need to understand what we're saying no to.

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Whenever we say no, we should understand what we're saying yes to.

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Okay.

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So having understood that, no and yes always travel together.

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Every time you say no, you are also saying yes.

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And every time you say yes, you are always saying no.

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And you know, I want to double down on that a little bit more to say that one of the things

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that is really easy for us to do is to forget everything else that happens when we're not

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at work.

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For example, many times when we say yes to the extra three patients tacked onto our schedule

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at the end of the day, then what we're really saying no to is our son's basketball game

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that starts at 6 p.m.

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We're going to be late to that.

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But now it's important, but it's not urgent.

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You know, if you don't show up to the game, it'll be okay.

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I mean, or will it?

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But those are the things that sometimes we miss.

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We miss out on because we're so, so unaware in the moment of what it costs us to actually

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say yes.

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So I want to just make that a little bit more explicit if it wasn't already.

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Okay.

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So the number one reason to say no is because you are saying yes to something.

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And so what are you saying yes to?

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Number one, you're saying yes to allocating your time efficiently.

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Okay, there are 24 hours in a day.

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And if we could, if we could rub a lamp and a genie could come out, I bet that we, if

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we could, could expand our day to have more than 24 hours, but we can't.

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We really do have 24 hours in the day because we've decided that 24 hours are what mark

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the day.

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And so we don't have more time.

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So here's the thing.

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There are so many things that we have to do.

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The list is endless.

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I don't have to tell you.

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You have an endless list of to-dos.

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And there is not enough time in the day for all of it.

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And I heard a quote and I can't remember who said it.

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I will put it in the show notes as soon as I find it.

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It says, there is never enough time in the day to do the things you don't want to do.

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In reality, you will never have enough time to do the things you don't want to do.

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And so you want to be clear about the things you want to do so that you can make sure you're

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saying yes to them.

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The reason you say no is so that you can manage your time effectively.

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You say no because you already have things that need to be done.

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And by saying no, you give yourself time and space and permission to do those things to

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which you've already committed.

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And so if you're going to be successful as a clinician scientist, saying no helps you

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manage your time.

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If you say no, number two, you have more time to focus on your research.

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Okay, so let me tell you that most of the time when people are asking you to do things,

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they're not asking you to do things that enhance your specific research project or your specific

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goal.

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They might be asking you to say yes to something that helps advance their project that you're

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also contributing to.

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But who is leading your research program?

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And the answer is that you are.

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You're the one leading your own program.

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And to be honest, you're the leader of it because if you don't lead it, nobody else

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is going to do it.

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And so it is so important for you to prioritize the program that has your name on it, the

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program that doesn't move forward unless you lead it, because guess what?

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If you don't lead it, nobody else is going to.

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The collaboration that you're working on is super important.

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And I'm not diminishing the strength of that collaboration, but I'm just saying that if

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you didn't show up to that collaboration, somebody else would be found to replace you

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because somebody else is leading it and that collaboration is their priority.

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But the thing that you do, the research that you lead, that nobody else will lead if you

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don't lead it, you've got to create space for that.

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And so when you say no, you're saying yes to your research program.

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You're saying yes to advancing your work.

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You're saying yes to the impact you came to make.

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You're saying yes to analyzing your work.

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You're saying yes to finding space to write up your findings.

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You're saying yes to publishing.

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You're saying yes to advancing your academic career so that you can do more of the thing

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that brings you joy, of the thing that helps you make impact.

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That's one of the reasons why you say no.

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Reason number three is to prevent burnout.

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Okay.

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There is only so much of you to go around and there are so many requests that continue

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to come in.

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And if you said yes from morning until night, where is the space for you to rest, relax,

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or recharge?

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Where is the space for your outside interests and pursuits?

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Where is the space for your family?

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And so we know intuitively that we need to say no.

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We know.

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But then why are we always saying yes?

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And so when we say yes to things that we don't even have space to do, what we're doing is

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over committing.

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And we're physicians.

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We are really, really big on commitments.

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And so when we can't meet our commitments, we feel like we failed.

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We feel bad or we work super hard to meet these commitments.

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And then we burn sleep or we burn time with family or we burn time that we should be doing

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other things just so that we can meet these commitments that we said yes to.

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And so you want to say no so that you don't burn out.

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You protect your physical and mental well-being and you make sure that you actually have energy

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to bring to the work that matters.

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And here's the thing.

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The person who's asking you to say yes is not going to blow up if you say no.

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They're happy when you don't over commit to something you cannot do.

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They appreciate the honesty that they are not waiting for you to bring what you're never

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going to be able to pull off because you're over committed.

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And so one of the reasons you say no is to prevent burnout, but also to help people be

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able to trust you that your yes is a true yes and that your no is a true no.

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Okay, reason number four is that you can have a lot of stuff that you do, but is it quality?

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Is it high quality?

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And so you say yes to this project here and yes to that project there and yes and you're

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saying yes, but are you able to have enough time and space and focus to produce work that

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is high quality?

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You are known by the quality of the work that you produce.

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You've all met somebody who has a lot of stuff they've produced that's not very high quality.

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You don't necessarily respect the work they do.

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You know that you want to produce the best work because your name is on it and you want

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to maintain your reputation.

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And so you want to produce high quality work and the reason you say no is so that you can

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be selective in your focus so that you can deliver high quality research so you can deliver

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high quality.

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And the only way you get there is by saying no to excess to excess so that you can focus

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on quality.

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And it allows you to produce research contributions that are meaningful to you and to others.

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It allows you to enhance your reputation in a way that being overburdened and being overcommitted

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does not allow you to do.

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Number five is career advancement.

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There are very, very specific things in academic medicine that allow you to advance.

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Some are very obvious like publishing and getting grants.

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Publishing is not really in your hands, right?

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The publisher decides whether they publish your paper or not based on the recommendations

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of the reviewers, but you control your submissions, right?

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You control how many manuscripts you submit.

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You control how many grants you submit as well.

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In order to advance your career, there are some very clear metrics that kind of go across

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academic institutions that if you produce either writing or you produce grants, production

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of manuscripts that are published, published manuscripts and funded grants is one thing

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that gets you advanced, that gets you career advancement in most academic centers.

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Even when you're not a clinician scientist, these things do count.

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When you say no, what you're saying yes to is more time for the things that actually

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allow you to be promoted.

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Sometimes I hear people say, well, I don't really want to be promoted.

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It's not really about the physical or the title of moving from say assistant professor

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to associate professor or associate professor to professor.

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It's not really about the name because many people don't really care for the name.

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It's about what it demonstrates in terms of how far you've come, what you've done, right?

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To be able to move from one level to the other, you have to produce a certain body of knowledge,

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a certain body of scholarship that's associated with you.

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And it's hard to do that.

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And so it's not so much about advancement just in changing titles.

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It's about advancement in the kind of work you have to produce to be able to advance

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in the academy.

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And I know it's not so straightforward.

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I know people are eligible for promotion who don't get promoted or for whatever reason

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don't get tenure.

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I'm not really talking about that.

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What I'm talking about is what it costs to be somebody who is different today than who

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you were five years ago.

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You can't get there by doing the same thing over and over again.

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And so to advance in your career, to advance as a person, to grow, saying no allows you

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to devote time to doing the things that help you advance.

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Saying no allows you to open the door to high quality research collaborations.

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Saying no allows you to say yes to grant opportunities that just kind of look like they came out

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of nowhere.

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Saying no allows you to say yes to the right leadership roles.

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Saying no allows you to say yes to your career.

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And so those are just five reasons that you should say no.

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And it really is, we could flip it on its own head and say five reasons to say yes.

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And in fact, maybe on the next podcast episode, I'll tell you a little bit more explicitly

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about why and when you should say yes.

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But saying no is saying yes.

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And it's just saying no allows you to make more explicit the reason for which you are

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saying yes.

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Okay.

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So if you want to take time to talk with me about saying no, this is something that's

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so difficult for academics, how to say no, I want you to send me a DM and say, Dr. Lemmona,

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I struggle to say no.

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How can I get better at saying no?

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I'm over committed and doing all this stuff.

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None of it is moving me forward.

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How do I get better about saying no?

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Send me a DM.

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I'm on LinkedIn.

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I'm also on Facebook.

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I'm on Instagram as well.

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Send me a DM.

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I'm on Twitter as well.

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But how you can get better at saying no.

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Okay, that ends today's episode.

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I'm going to thank you so much for taking the time to listen to me.

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All right.

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I'll talk to you again the next time.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.