Why you should say "no."

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene. Welcome to the Clinician Researcher podcast. I'm your host, Toyosi Onwuemene, and it is an absolute privilege to be here talking with you. Thank you for listening. The only reason I'm able to talk is because you keep listening to me. So I just want to say thank you for being here. And I want to invite you, if you are looking for an opportunity to coach with somebody in academic medicine who can help you as you transition from clinician to clinician scientist, I would love to be your coach.

1:32 Reach out to me by DM on Facebook or Instagram. I'm Tiosi Unwemona. I'm on LinkedIn as well. And I would love to talk with you about some of our offerings to help you succeed as a clinician who is transitioning to becoming a physician scientist. Okay. So today I am talking about why you should say no. Okay. I said the word. It's the N-O word. And I want to tell you that the problem with this word, N-O, N-O, no, it is such a hard word to say for me today. But I look at my children, or at least more when they were two, right? They're two years old. We call it the terrible twos. And the reason we call it the terrible twos is because of this word, no.

2:15 Like suddenly children discover this word called no and they use it all the time. And we try to discourage them from saying no. But now as an academic physician, I envy young children who can say no so easily. And they don't say no just to be difficult. They say no because they genuinely don't want it. They just don't want broccoli. Of course they don't want broccoli. No. You know, they say no. So why do we struggle as academics to say no? And I blame my mother. I blame every time she dissuaded me from saying no and tried to teach me to always say yes. Okay, okay, so I don't blame my mother.

2:55 But I think what I'm saying is that it actually is an absolute gift that children have that I think we had as children where we could so easily say no to anything we didn't want to do that is so much harder right now. But I'm here to talk to you about why we should say no, why it's so important to our academic careers, why it's so important to our health and well-being to learn to go back to our two-year-old self and say no. Okay, so I'm talking today about five reasons why you should say no. And it is so important to be able to learn to say no and to be able to learn how to say no.

3:40 And in a future episode, I'll talk about how to say no. But today I really just want to sell you on the idea of saying no. And before I give you these five things, the first thing I really want to share with you is that no is only half of the equation. No is only half of the equation. In reality, every time we say no, we're actually saying yes. Like no and yes are two sides of the same coin. And so in academic medicine, many times we feel pressure to say yes. And what's not obvious when we say yes is that we're really saying no at the same time. You might say yes to the thing that's right in front of you, but what are you saying no to?

4:24 And the reason it's challenging for us in academic medicine is that the thing to which we are saying no is often hidden in the background, out of sight, out of mind. And the thing to which we're saying yes is the thing that's most front and center, usually the urgent, not important things. You've heard about that matrix that goes from things that are urgent and not important to not urgent, but important. And it talks about a matrix of four, and I can't recall it all right now. But the things that are most important in that matrix are the things that are not urgent, but important. But they tend to be the things that are most silent. And when we say yes, what we forget is that there's a list of things that are not urgent, but very important that we're probably saying no to.

5:15 And so no and yes are actually two sides of the same coin. And the reason we need to understand the saying of no is that every time we say no, we're saying yes to something more important than the thing in front of us right now. But if we say yes, then we're saying no to something else that we're saying is less important. And so whenever we say no, we need to understand what we're saying. Whenever we say yes, we need to understand what we're saying no to. Whenever we say no, we should understand what we're saying yes to. Okay. So having understood that, no and yes always travel together. Every time you say no, you are also saying yes.

5:56 And every time you say yes, you are always saying no. And you know, I want to double down on that a little bit more to say that one of the things that is really easy for us to do is to forget everything else that happens when we're not at work. For example, many times when we say yes to the extra three patients tacked onto our schedule at the end of the day, then what we're really saying no to is our son's basketball game that starts at 6 p.m. We're going to be late to that. But now it's important, but it's not urgent. You know, if you don't show up to the game, it'll be okay. I mean, or will it? But those are the things that sometimes we miss.

6:37 We miss out on because we're so, so unaware in the moment of what it costs us to actually say yes. So I want to just make that a little bit more explicit if it wasn't already. Okay. So the number one reason to say no is because you are saying yes to something. And so what are you saying yes to? Number one, you're saying yes to allocating your time efficiently. Okay, there are 24 hours in a day. And if we could, if we could rub a lamp and a genie could come out, I bet that we, if we could, could expand our day to have more than 24 hours, but we can't.

7:17 We really do have 24 hours in the day because we've decided that 24 hours are what mark the day. And so we don't have more time. So here's the thing. There are so many things that we have to do. The list is endless. I don't have to tell you. You have an endless list of to-dos. And there is not enough time in the day for all of it. And I heard a quote and I can't remember who said it. I will put it in the show notes as soon as I find it. It says, there is never enough time in the day to do the things you don't want to do. In reality, you will never have enough time to do the things you don't want to do. And so you want to be clear about the things you want to do so that you can make sure you're saying yes to them.

8:01 The reason you say no is so that you can manage your time effectively. You say no because you already have things that need to be done. And by saying no, you give yourself time and space and permission to do those things to which you've already committed. And so if you're going to be successful as a clinician scientist, saying no helps you manage your time. If you say no, number two, you have more time to focus on your research. Okay, so let me tell you that most of the time when people are asking you to do things, they're not asking you to do things that enhance your specific research project or your specific goal.

8:46 They might be asking you to say yes to something that helps advance their project that you're also contributing to. But who is leading your research program? And the answer is that you are. You're the one leading your own program. And to be honest, you're the leader of it because if you don't lead it, nobody else is going to do it. And so it is so important for you to prioritize the program that has your name on it, the program that doesn't move forward unless you lead it, because guess what? If you don't lead it, nobody else is going to. The collaboration that you're working on is super important. And I'm not diminishing the strength of that collaboration, but I'm just saying that if you didn't show up to that collaboration, somebody else would be found to replace you because somebody else is leading it and that collaboration is their priority.

9:33 But the thing that you do, the research that you lead, that nobody else will lead if you don't lead it, you've got to create space for that. And so when you say no, you're saying yes to your research program. You're saying yes to advancing your work. You're saying yes to the impact you came to make. You're saying yes to analyzing your work. You're saying yes to finding space to write up your findings. You're saying yes to publishing. You're saying yes to advancing your academic career so that you can do more of the thing that brings you joy, of the thing that helps you make impact. That's one of the reasons why you say no.

10:17 Reason number three is to prevent burnout. Okay. There is only so much of you to go around and there are so many requests that continue to come in. And if you said yes from morning until night, where is the space for you to rest, relax, or recharge? Where is the space for your outside interests and pursuits? Where is the space for your family? And so we know intuitively that we need to say no. We know. But then why are we always saying yes? And so when we say yes to things that we don't even have space to do, what we're doing is over committing. And we're physicians.

10:58 We are really, really big on commitments. And so when we can't meet our commitments, we feel like we failed. We feel bad or we work super hard to meet these commitments. And then we burn sleep or we burn time with family or we burn time that we should be doing other things just so that we can meet these commitments that we said yes to. And so you want to say no so that you don't burn out. You protect your physical and mental well-being and you make sure that you actually have energy to bring to the work that matters. And here's the thing.

11:39 The person who's asking you to say yes is not going to blow up if you say no. They're happy when you don't over commit to something you cannot do. They appreciate the honesty that they are not waiting for you to bring what you're never going to be able to pull off because you're over committed. And so one of the reasons you say no is to prevent burnout, but also to help people be able to trust you that your yes is a true yes and that your no is a true no. Okay, reason number four is that you can have a lot of stuff that you do, but is it quality?

12:22 Is it high quality? And so you say yes to this project here and yes to that project there and yes and you're saying yes, but are you able to have enough time and space and focus to produce work that is high quality? You are known by the quality of the work that you produce. You've all met somebody who has a lot of stuff they've produced that's not very high quality. You don't necessarily respect the work they do. You know that you want to produce the best work because your name is on it and you want to maintain your reputation.

13:06 And so you want to produce high quality work and the reason you say no is so that you can be selective in your focus so that you can deliver high quality research so you can deliver high quality. And the only way you get there is by saying no to excess to excess so that you can focus on quality. And it allows you to produce research contributions that are meaningful to you and to others. It allows you to enhance your reputation in a way that being overburdened and being overcommitted does not allow you to do. Number five is career advancement.

13:49 There are very, very specific things in academic medicine that allow you to advance. Some are very obvious like publishing and getting grants. Publishing is not really in your hands, right? The publisher decides whether they publish your paper or not based on the recommendations of the reviewers, but you control your submissions, right? You control how many manuscripts you submit. You control how many grants you submit as well. In order to advance your career, there are some very clear metrics that kind of go across academic institutions that if you produce either writing or you produce grants, production of manuscripts that are published, published manuscripts and funded grants is one thing that gets you advanced, that gets you career advancement in most academic centers.

14:41 Even when you're not a clinician scientist, these things do count. When you say no, what you're saying yes to is more time for the things that actually allow you to be promoted. Sometimes I hear people say, well, I don't really want to be promoted. It's not really about the physical or the title of moving from say assistant professor to associate professor or associate professor to professor. It's not really about the name because many people don't really care for the name. It's about what it demonstrates in terms of how far you've come, what you've done, right? To be able to move from one level to the other, you have to produce a certain body of knowledge, a certain body of scholarship that's associated with you.

15:28 And it's hard to do that. And so it's not so much about advancement just in changing titles. It's about advancement in the kind of work you have to produce to be able to advance in the academy. And I know it's not so straightforward. I know people are eligible for promotion who don't get promoted or for whatever reason don't get tenure. I'm not really talking about that. What I'm talking about is what it costs to be somebody who is different today than who you were five years ago. You can't get there by doing the same thing over and over again. And so to advance in your career, to advance as a person, to grow, saying no allows you to devote time to doing the things that help you advance.

16:17 Saying no allows you to open the door to high quality research collaborations. Saying no allows you to say yes to grant opportunities that just kind of look like they came out of nowhere. Saying no allows you to say yes to the right leadership roles. Saying no allows you to say yes to your career. And so those are just five reasons that you should say no. And it really is, we could flip it on its own head and say five reasons to say yes. And in fact, maybe on the next podcast episode, I'll tell you a little bit more explicitly about why and when you should say yes.

16:58 But saying no is saying yes. And it's just saying no allows you to make more explicit the reason for which you are saying yes. Okay. So if you want to take time to talk with me about saying no, this is something that's so difficult for academics, how to say no, I want you to send me a DM and say, Dr. Lemmona, I struggle to say no. How can I get better at saying no? I'm over committed and doing all this stuff. None of it is moving me forward. How do I get better about saying no? Send me a DM. I'm on LinkedIn. I'm also on Facebook. I'm on Instagram as well. Send me a DM.

17:38 I'm on Twitter as well. But how you can get better at saying no. Okay, that ends today's episode. I'm going to thank you so much for taking the time to listen to me. All right. I'll talk to you again the next time. Thanks for listening to this episode of the Clinician Researcher Podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. If you found the information in this episode to be helpful, don't keep it all to yourself. Someone else needs to hear it.

18:20 So take a minute right now and share it. As you share this episode, you become part of our mission to help launch a new generation of clinician researchers who make transformative discoveries that change the way we do healthcare.