1
00:00:00,000 --> 00:00:05,860
Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

2
00:00:05,860 --> 00:00:11,260
to build their own research program, whether or not they have a mentor.

3
00:00:11,260 --> 00:00:17,340
As clinicians, we spend a decade or more as trainees learning to take care of patients.

4
00:00:17,340 --> 00:00:22,380
When we finally start our careers, we want to build research programs, but then we find

5
00:00:22,380 --> 00:00:27,780
that our years of clinical training did not adequately prepare us to lead our research

6
00:00:27,780 --> 00:00:29,200
program.

7
00:00:29,200 --> 00:00:35,480
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

8
00:00:35,480 --> 00:00:40,580
However, clinicians hold the keys to the greatest research breakthroughs.

9
00:00:40,580 --> 00:00:46,200
For this reason, the Clinician Researcher podcast exists to give academic clinicians

10
00:00:46,200 --> 00:00:51,800
the tools to build their own research program, whether or not they have a mentor.

11
00:00:51,800 --> 00:01:01,320
Now introducing your host, Toyosi Onwuemene.

12
00:01:01,320 --> 00:01:04,600
Welcome to the Clinician Researcher podcast.

13
00:01:04,600 --> 00:01:09,480
I'm your host, Toyosi Onwuemene, and it is such a pleasure to be talking with you today.

14
00:01:09,480 --> 00:01:11,480
Thank you for tuning in.

15
00:01:11,480 --> 00:01:19,320
Well, yesterday I talked about why we should say no, and the question that arises is that,

16
00:01:19,320 --> 00:01:21,040
well, how do you say no?

17
00:01:21,040 --> 00:01:22,560
How do you say no?

18
00:01:22,560 --> 00:01:27,840
Because it's super hard to say no, and if it was easy, everybody would be doing it.

19
00:01:27,840 --> 00:01:34,240
We learned yesterday about the importance of saying no, because it means that you are

20
00:01:34,240 --> 00:01:40,160
able to create time and space to advance as a clinician researcher, as you really want

21
00:01:40,160 --> 00:01:41,160
to.

22
00:01:41,160 --> 00:01:44,680
And so today we are going to continue that conversation, and we're going to talk about

23
00:01:44,680 --> 00:01:47,360
how to say no.

24
00:01:47,360 --> 00:01:53,920
And when it comes to saying no, I don't want you to do it like me, where you start to say

25
00:01:53,920 --> 00:02:01,080
no, and then you end up somehow finding the words yes coming out of your mouth, or you're

26
00:02:01,080 --> 00:02:08,480
feeling so much pressure in the moment that instead of saying no, you know you should

27
00:02:08,480 --> 00:02:12,320
say no, you feel like, okay, let me just go ahead and say yes.

28
00:02:12,320 --> 00:02:16,800
So I want to share with you, I want to share with you a couple of things that are important

29
00:02:16,800 --> 00:02:20,280
to think about in saying no.

30
00:02:20,280 --> 00:02:23,040
So how to say no.

31
00:02:23,040 --> 00:02:30,480
So the first thing I'm going to start with is talking about how do you manage, let's

32
00:02:30,480 --> 00:02:31,760
say the no committee.

33
00:02:31,760 --> 00:02:37,240
Actually, before we do that, let's go back to where we started with yesterday's episode.

34
00:02:37,240 --> 00:02:42,400
So we talked about the importance of saying no, and that the reason you say no is that

35
00:02:42,400 --> 00:02:46,360
you recognize that no and yes go together.

36
00:02:46,360 --> 00:02:50,400
So you're never ever really saying no in isolation.

37
00:02:50,400 --> 00:02:54,160
Every day you say no, you're also saying yes, and vice versa.

38
00:02:54,160 --> 00:02:56,960
Every day you say yes, you're also saying no.

39
00:02:56,960 --> 00:03:00,760
And so the question is, do you really understand the two sides of the coin?

40
00:03:00,760 --> 00:03:05,720
When you're saying yes, oh my goodness, yes, I'll do this, then what are you saying no

41
00:03:05,720 --> 00:03:09,760
to so that you can create space for the thing you said yes to?

42
00:03:09,760 --> 00:03:14,280
And similarly, when you say no to something, what you're really saying is that, well, I

43
00:03:14,280 --> 00:03:16,560
have a bigger yes in the background.

44
00:03:16,560 --> 00:03:18,880
You can't see it, but there's something bigger.

45
00:03:18,880 --> 00:03:23,360
There's a reason why the no is coming forth because I'm really saying yes to something

46
00:03:23,360 --> 00:03:24,720
else.

47
00:03:24,720 --> 00:03:28,720
So I just want to start there from the perspective of you got to know that every time you say

48
00:03:28,720 --> 00:03:29,920
no, you're saying yes.

49
00:03:29,920 --> 00:03:32,080
OK, so that does lead me to number one.

50
00:03:32,080 --> 00:03:33,440
And what is number one?

51
00:03:33,440 --> 00:03:41,360
Well, number one is that if you say no, it's because you recognize that there's a bigger

52
00:03:41,360 --> 00:03:44,260
yes that you're supposed to say, right?

53
00:03:44,260 --> 00:03:47,960
You recognize that there is a bigger yes somewhere.

54
00:03:47,960 --> 00:03:53,720
OK, so if there is a bigger yes, the question is, what is that yes?

55
00:03:53,720 --> 00:03:59,440
And so the number one way how to say no is to figure out your yes.

56
00:03:59,440 --> 00:04:05,300
Figure out what is the thing that is so important that occupies a high priority for you such

57
00:04:05,300 --> 00:04:10,440
that there is a list of things that come and no matter what it is, as long as it falls

58
00:04:10,440 --> 00:04:14,360
below that high priority, the answer is an automatic no.

59
00:04:14,360 --> 00:04:16,260
And that's really important.

60
00:04:16,260 --> 00:04:19,560
But it also is important to clarify what that yes is.

61
00:04:19,560 --> 00:04:24,980
For example, if you're a clinician researcher or an aspiring clinician researcher, and by

62
00:04:24,980 --> 00:04:26,680
the way, I'm not wedded to any names.

63
00:04:26,680 --> 00:04:29,720
The podcast is Clinician Period Researcher.

64
00:04:29,720 --> 00:04:32,760
And I know sometimes I start seeing clinician researcher and people are like, but I'm a

65
00:04:32,760 --> 00:04:34,480
clinician scientist.

66
00:04:34,480 --> 00:04:36,960
And then someone else is like, I'm a physician scientist.

67
00:04:36,960 --> 00:04:37,960
It's OK.

68
00:04:37,960 --> 00:04:38,960
It's OK.

69
00:04:38,960 --> 00:04:39,960
Don't panic.

70
00:04:39,960 --> 00:04:40,960
I'm fine.

71
00:04:40,960 --> 00:04:43,520
And whatever you want to call yourself, I support you.

72
00:04:43,520 --> 00:04:46,960
OK, so you're an aspiring clinician scientist.

73
00:04:46,960 --> 00:04:49,560
That was a digression.

74
00:04:49,560 --> 00:04:52,120
You're an aspiring clinician scientist.

75
00:04:52,120 --> 00:05:01,820
And you recognize that in order for you to get your science out there, to establish your

76
00:05:01,820 --> 00:05:07,520
research program, and to become known for what you do, you do need to create time and

77
00:05:07,520 --> 00:05:09,440
space for your science.

78
00:05:09,440 --> 00:05:15,360
You need to create time and space for the thinking, for the working, for the writing

79
00:05:15,360 --> 00:05:18,840
that it takes to be able to move your work forward.

80
00:05:18,840 --> 00:05:24,040
And therefore, if you're a clinician scientist, one of your highest priorities is moving your

81
00:05:24,040 --> 00:05:25,840
work forward.

82
00:05:25,840 --> 00:05:32,920
Therefore, everything that gets in the way of you moving your work forward is a no.

83
00:05:32,920 --> 00:05:35,680
It should be a no.

84
00:05:35,680 --> 00:05:37,320
You hope it's a no.

85
00:05:37,320 --> 00:05:40,080
But here's the thing, though.

86
00:05:40,080 --> 00:05:46,760
The thing that's needed to allow you to lead in your research is not always obvious.

87
00:05:46,760 --> 00:05:48,760
And sometimes it feels like, yeah, there's space.

88
00:05:48,760 --> 00:05:51,080
I can do that later.

89
00:05:51,080 --> 00:05:55,080
That's why you've got to recognize what it is you're trying to protect, what's your bigger

90
00:05:55,080 --> 00:05:56,080
yes.

91
00:05:56,080 --> 00:06:02,720
And then you've got to figure out how to protect it so that, yes, you're not just going to

92
00:06:02,720 --> 00:06:06,240
sit in your lab or sit in your research program and do that all the time.

93
00:06:06,240 --> 00:06:10,680
You do have other things you have to do, including eating and sleeping, meeting with other people,

94
00:06:10,680 --> 00:06:11,680
seeing patients.

95
00:06:11,680 --> 00:06:13,480
You've got a lot of stuff in there.

96
00:06:13,480 --> 00:06:17,520
And so the question is, what is the optimal time for you to do the work?

97
00:06:17,520 --> 00:06:18,840
That's the big yes.

98
00:06:18,840 --> 00:06:21,720
OK, I'm a clinician scientist.

99
00:06:21,720 --> 00:06:26,840
My research, in order to move it forward, I need about four hours of writing time daily.

100
00:06:26,840 --> 00:06:28,160
OK, that's a lot of time.

101
00:06:28,160 --> 00:06:30,820
I don't know how many people who have that, but maybe you do.

102
00:06:30,820 --> 00:06:33,400
But maybe it's not four hours all at once.

103
00:06:33,400 --> 00:06:39,200
In the early hours of the morning, you're a great thinker and you're a great writer

104
00:06:39,200 --> 00:06:40,200
at the same time.

105
00:06:40,200 --> 00:06:44,200
And so you protect that time of the morning where you do your best thinking and your best

106
00:06:44,200 --> 00:06:45,200
writing.

107
00:06:45,200 --> 00:06:48,760
OK, so maybe that protected time is about an hour, an hour and a half.

108
00:06:48,760 --> 00:06:49,960
OK, you have it.

109
00:06:49,960 --> 00:06:51,640
It's in there every morning.

110
00:06:51,640 --> 00:06:59,920
OK, the remaining two and a, what's that, about an hour and a half, two hours may not

111
00:06:59,920 --> 00:07:03,640
be dedicated focus writing time, but maybe that's the time you meet with your research

112
00:07:03,640 --> 00:07:04,640
group.

113
00:07:04,640 --> 00:07:05,640
And so there it is.

114
00:07:05,640 --> 00:07:08,560
There is a time in the week where you meet with your research group.

115
00:07:08,560 --> 00:07:11,360
OK, you have mentees in your program.

116
00:07:11,360 --> 00:07:13,760
And if you don't, you should find them.

117
00:07:13,760 --> 00:07:17,480
And these mentees are going to meet with you because they're helping you move work forward.

118
00:07:17,480 --> 00:07:18,480
Or maybe they're not mentees.

119
00:07:18,480 --> 00:07:20,200
Maybe they're research staff.

120
00:07:20,200 --> 00:07:21,200
They're going to move work forward.

121
00:07:21,200 --> 00:07:25,880
And you want to create time to meet with them so that you can look and see the hours in

122
00:07:25,880 --> 00:07:28,040
the day in which you meet with these people.

123
00:07:28,040 --> 00:07:32,920
Now, when it's a hardcore meeting, that's not difficult to say.

124
00:07:32,920 --> 00:07:35,080
It's not difficult to say no when another meeting comes up.

125
00:07:35,080 --> 00:07:36,680
It's like, oh, I have this meeting.

126
00:07:36,680 --> 00:07:38,520
Other people are meeting with me.

127
00:07:38,520 --> 00:07:44,320
But the meetings we have with ourselves, that's really, it's easier for us to justify giving

128
00:07:44,320 --> 00:07:46,120
those times away.

129
00:07:46,120 --> 00:07:50,900
And so it's important for us to recognize how important our research time, our writing,

130
00:07:50,900 --> 00:07:57,480
our thinking time is to our forward advancement so that we can guard that time generously.

131
00:07:57,480 --> 00:08:02,000
And so every time somebody says, hey, there's a patient who needs to be seen in two days

132
00:08:02,000 --> 00:08:06,360
during your writing time, the answer is actually no.

133
00:08:06,360 --> 00:08:07,880
And yes, the patient needs to be seen.

134
00:08:07,880 --> 00:08:10,980
And yes, it is an emergency.

135
00:08:10,980 --> 00:08:13,380
And who else can help in that time?

136
00:08:13,380 --> 00:08:15,000
Because I actually do have a meeting.

137
00:08:15,000 --> 00:08:16,000
And it's not with someone else.

138
00:08:16,000 --> 00:08:17,000
It's with myself.

139
00:08:17,000 --> 00:08:20,160
And if I cancel that meeting, I'm canceling a commitment to myself.

140
00:08:20,160 --> 00:08:21,960
And I don't get that time back.

141
00:08:21,960 --> 00:08:22,960
Right?

142
00:08:22,960 --> 00:08:24,840
It's like, well, maybe the patient needs to be seen.

143
00:08:24,840 --> 00:08:26,600
When else can the patient need to be seen?

144
00:08:26,600 --> 00:08:30,720
It's not within that one and a half hours of optimal writing time.

145
00:08:30,720 --> 00:08:31,720
OK.

146
00:08:31,720 --> 00:08:32,920
So I'm giving that as an example.

147
00:08:32,920 --> 00:08:37,640
But what I'm really telling you, number one, is how to say no is to really understand how

148
00:08:37,640 --> 00:08:38,800
big the yes is.

149
00:08:38,800 --> 00:08:40,840
So I gave an example of writing time.

150
00:08:40,840 --> 00:08:45,060
Easy to give away, but so critical to moving you forward, you really should have a very

151
00:08:45,060 --> 00:08:50,360
high threshold for things that you say yes to that move that time out of the way.

152
00:08:50,360 --> 00:08:53,940
And as a clinician scientist, you literally have to fight for that time because people

153
00:08:53,940 --> 00:08:55,440
are always fighting to take it away from you.

154
00:08:55,440 --> 00:08:58,000
They're like, well, I don't see anything else on your schedule.

155
00:08:58,000 --> 00:08:59,800
I see that you're meeting with nobody.

156
00:08:59,800 --> 00:09:01,640
Therefore, you must be free.

157
00:09:01,640 --> 00:09:05,340
Just because you look free, just because they think you're free doesn't mean you have to

158
00:09:05,340 --> 00:09:06,600
agree that you're free.

159
00:09:06,600 --> 00:09:07,600
OK.

160
00:09:07,600 --> 00:09:10,960
So the how is really understand what the big yes is.

161
00:09:10,960 --> 00:09:11,960
OK.

162
00:09:11,960 --> 00:09:17,640
The other piece of that is if you say, OK, I'll move my writing time from early in the

163
00:09:17,640 --> 00:09:19,440
morning to like 3 p.m.

164
00:09:19,440 --> 00:09:21,000
I'll just make this out.

165
00:09:21,000 --> 00:09:24,160
I'll go do the patient care that they need me to do.

166
00:09:24,160 --> 00:09:26,080
And I can come back to my writing at 3 p.m.

167
00:09:26,080 --> 00:09:29,560
Number one, you're not you're not you're not your best writer at 3 p.m.

168
00:09:29,560 --> 00:09:30,560
So that's that's a problem.

169
00:09:30,560 --> 00:09:34,680
But number two, if you're starting your writing at 3 p.m., what are you going to do your clinic

170
00:09:34,680 --> 00:09:36,680
notes for those patients that you saw earlier?

171
00:09:36,680 --> 00:09:40,480
Oh, so now we're pushing the day to where you're about.

172
00:09:40,480 --> 00:09:45,920
Maybe you're going to be here 5, 6 p.m. and your kid has a soccer game that starts at

173
00:09:45,920 --> 00:09:49,760
430 that you had already made a commitment to be at.

174
00:09:49,760 --> 00:09:50,940
That's a big yes.

175
00:09:50,940 --> 00:09:56,960
The soccer game that you made a commitment to be at the other stuff that the emergency

176
00:09:56,960 --> 00:09:59,960
patient care activity that took away your writing time in the morning that pushed your

177
00:09:59,960 --> 00:10:04,240
writing time to the afternoon that also gave you extra work to do at the end of the day.

178
00:10:04,240 --> 00:10:09,760
Those are notes because of the big yes of got to move my research forward and the big

179
00:10:09,760 --> 00:10:13,080
yes of I'm committed to this time spent with family.

180
00:10:13,080 --> 00:10:18,640
And so how to say no is to recognize your yeses and to clarify what those are.

181
00:10:18,640 --> 00:10:20,160
That's number one.

182
00:10:20,160 --> 00:10:22,200
Number two, people talk about the no committee.

183
00:10:22,200 --> 00:10:24,640
So I'm going to talk about the no committee.

184
00:10:24,640 --> 00:10:31,240
And the no committee I feel is a mixed one for me because I love the idea of a no committee.

185
00:10:31,240 --> 00:10:35,440
But here's the thing, you're the one making decisions for your life and your career.

186
00:10:35,440 --> 00:10:39,680
And it's great when you have someone or a group of people that you can sit with and

187
00:10:39,680 --> 00:10:41,920
say I need to say no, how do I do it?

188
00:10:41,920 --> 00:10:42,920
That's great.

189
00:10:42,920 --> 00:10:47,560
But remember that in the process of growing as a clinician scientist, we're adulting as

190
00:10:47,560 --> 00:10:48,560
well.

191
00:10:48,560 --> 00:10:52,640
We're going from where we need a big bad brother to protect us all the time to where we are

192
00:10:52,640 --> 00:10:55,520
able to make those decisions on our own.

193
00:10:55,520 --> 00:10:59,280
And so I don't have anything against the no committee.

194
00:10:59,280 --> 00:11:05,320
But when I think about a no committee, what I think about is making sure you have space

195
00:11:05,320 --> 00:11:11,240
on a regular basis, not just for saying no, to be able to reflect back to you what's critical,

196
00:11:11,240 --> 00:11:14,160
what's important, what are the things you should invest in, where are the places you

197
00:11:14,160 --> 00:11:16,280
should go, those kinds of things.

198
00:11:16,280 --> 00:11:19,640
Like what are the opportunities you should be thinking about.

199
00:11:19,640 --> 00:11:25,120
So have a platform regularly to be able to voice those things so you can practice for

200
00:11:25,120 --> 00:11:28,720
yourself what yes looks like in your life.

201
00:11:28,720 --> 00:11:34,240
So I'm not necessarily, I think I'm not big on the no committee because I think you should

202
00:11:34,240 --> 00:11:38,200
be able to get to a place where you can say no by yourself.

203
00:11:38,200 --> 00:11:43,480
But what I do want to say is that yes to the no committee, but I want you to think about

204
00:11:43,480 --> 00:11:45,220
it a little bit more broadly.

205
00:11:45,220 --> 00:11:49,160
Your committee you meet with regularly to help you say no should really be a committee

206
00:11:49,160 --> 00:11:52,680
that you meet with regularly to help you think about your career.

207
00:11:52,680 --> 00:11:54,900
And for me that looks like peer mentoring.

208
00:11:54,900 --> 00:11:57,760
For you that may look like something else.

209
00:11:57,760 --> 00:12:01,160
It looks like peer mentoring, it looks like meeting with a mentor, it looks like meeting

210
00:12:01,160 --> 00:12:06,400
with people who help you advance, whatever that looks like.

211
00:12:06,400 --> 00:12:08,480
But so let's call it a no committee.

212
00:12:08,480 --> 00:12:10,800
What I'm really asking you to do is think broadly.

213
00:12:10,800 --> 00:12:14,840
Who are the people who help you think about advancing your career?

214
00:12:14,840 --> 00:12:20,280
So you begin to have opportunities and spaces where you can practice saying this is what's

215
00:12:20,280 --> 00:12:24,440
a priority for me and for that reason this is a definite no.

216
00:12:24,440 --> 00:12:29,740
Okay, so the first thing I talked about was understanding your big yes, what you really

217
00:12:29,740 --> 00:12:31,640
are saying yes to.

218
00:12:31,640 --> 00:12:34,480
And number two is the no committee.

219
00:12:34,480 --> 00:12:37,200
Okay, number three is space.

220
00:12:37,200 --> 00:12:39,480
Okay, so there is a quote.

221
00:12:39,480 --> 00:12:47,160
I think it's by Viktor Frankl and he talks about how between stimulus and response there

222
00:12:47,160 --> 00:12:48,160
is a space.

223
00:12:48,160 --> 00:12:52,600
This idea I came across in the seven habits of highly effective people.

224
00:12:52,600 --> 00:12:56,560
And he says between stimulus and response there is a space.

225
00:12:56,560 --> 00:13:01,440
Now some of us are really good so that even though that stimulus and response the distance

226
00:13:01,440 --> 00:13:05,180
is just a couple of seconds, some of us are great.

227
00:13:05,180 --> 00:13:06,180
We can do that.

228
00:13:06,180 --> 00:13:10,880
So between stimulus and response between the hey can you do this for me and the 30 seconds

229
00:13:10,880 --> 00:13:12,680
later definitely no.

230
00:13:12,680 --> 00:13:13,680
We're good at that.

231
00:13:13,680 --> 00:13:17,920
For the rest of us, especially those of us who are struggling people pleasers, many physicians

232
00:13:17,920 --> 00:13:26,920
that I know, many of them women too, many people who are underrepresented in the academy,

233
00:13:26,920 --> 00:13:35,120
your first instinct is to say yes because our people pleasing instincts are to accept

234
00:13:35,120 --> 00:13:36,880
short term gain.

235
00:13:36,880 --> 00:13:41,380
If I say yes, you're going to be happy with me and I'm going to feel better.

236
00:13:41,380 --> 00:13:47,960
And so for us what we really need is a lot of space between the stimulus and the response.

237
00:13:47,960 --> 00:13:55,120
I need space between the stimulus and the response for that reason.

238
00:13:55,120 --> 00:13:59,400
One of the things that you get to learn to do or I'm encouraging you to learn to do is

239
00:13:59,400 --> 00:14:03,080
to really expand that space for yourself.

240
00:14:03,080 --> 00:14:06,640
Now in expanding that space it may be that you say hey let me sleep on it and get back

241
00:14:06,640 --> 00:14:07,640
to you tomorrow.

242
00:14:07,640 --> 00:14:14,320
Let me think about it for a day or two or you get to expand the space in such a way

243
00:14:14,320 --> 00:14:19,000
that you are so clear on what yes means that you don't even need too much time to think

244
00:14:19,000 --> 00:14:20,000
about it.

245
00:14:20,000 --> 00:14:24,080
It's like hey can you be available for this last minute meeting at 8 a.m. at your writing

246
00:14:24,080 --> 00:14:25,080
time?

247
00:14:25,080 --> 00:14:28,040
You're like no, no, definitely no.

248
00:14:28,040 --> 00:14:30,440
You already know that the answer is no.

249
00:14:30,440 --> 00:14:34,560
Now it could be that it's your chair who says I'm not sure you should keep working here.

250
00:14:34,560 --> 00:14:35,560
Can we talk about it?

251
00:14:35,560 --> 00:14:36,560
Okay.

252
00:14:36,560 --> 00:14:39,840
Then all of a sudden it's like okay, need to open up that space because this might be

253
00:14:39,840 --> 00:14:41,600
a really priority meeting.

254
00:14:41,600 --> 00:14:46,960
So there are things that are clear that might immediately allow you to in a sense expand

255
00:14:46,960 --> 00:14:50,520
that space because you already know what the answer is.

256
00:14:50,520 --> 00:14:56,000
But for the most part you do need enough time to really evaluate the opportunity.

257
00:14:56,000 --> 00:15:00,000
One of the things that happens to us in academic medicine is that there are so many things

258
00:15:00,000 --> 00:15:05,520
that look great when they are talked about especially on the surface.

259
00:15:05,520 --> 00:15:10,040
When you go and you really sit down you think about it you're like no I don't think so.

260
00:15:10,040 --> 00:15:12,720
No, no, no, no, no thank you.

261
00:15:12,720 --> 00:15:17,200
But it really does take time for you to peel away the layers of who's asking you to do

262
00:15:17,200 --> 00:15:21,760
it, what's their position, how much do you owe them, what are all the awesome things

263
00:15:21,760 --> 00:15:26,220
you've done, they've done for you, where you feel like now you're obligated.

264
00:15:26,220 --> 00:15:31,340
It takes time to peel back all those layers to really understand how do I feel about this

265
00:15:31,340 --> 00:15:36,080
opportunity that I'm being offered and is this consistent with the direction that I

266
00:15:36,080 --> 00:15:38,560
want to go.

267
00:15:38,560 --> 00:15:41,440
So now that brings us to number four.

268
00:15:41,440 --> 00:15:46,000
Okay so number four is your direction.

269
00:15:46,000 --> 00:15:52,000
Okay you've got to understand where you're going and why it matters that that's where

270
00:15:52,000 --> 00:15:53,680
you want to go.

271
00:15:53,680 --> 00:15:57,520
So I spoke at the beginning about the bigger yes, you got to know what the bigger yes is

272
00:15:57,520 --> 00:16:02,200
and that's kind of situational like you know that at 8 a.m. there is a big yes to your

273
00:16:02,200 --> 00:16:05,560
writing therefore you say no to anything that wants to take over.

274
00:16:05,560 --> 00:16:10,200
You know that at 6 30 p.m. there's a big yes to the soccer game and so you know that anything

275
00:16:10,200 --> 00:16:14,000
that wants to take that space is a no unless it's really high priority.

276
00:16:14,000 --> 00:16:15,000
So that's a little bit situational.

277
00:16:15,000 --> 00:16:17,400
What I'm talking about is direction.

278
00:16:17,400 --> 00:16:19,120
Where do you want to go?

279
00:16:19,120 --> 00:16:23,440
Now if you want to be a clinician scientist where do you want to take your research?

280
00:16:23,440 --> 00:16:24,440
What do you see for yourself?

281
00:16:24,440 --> 00:16:26,680
What do you see for your research program?

282
00:16:26,680 --> 00:16:32,480
And having a clear direction helps you understand where you want to go and because you know

283
00:16:32,480 --> 00:16:37,800
where you want to go then you know what it costs to get there right because if you're

284
00:16:37,800 --> 00:16:42,600
going to fly to Cincinnati or wherever it is you're flying to you ought to get on a

285
00:16:42,600 --> 00:16:46,960
plane and it costs money to be on the plane but you know you're going to Cincinnati and

286
00:16:46,960 --> 00:16:51,760
you know how much flights to Cincinnati cost and therefore you're going to pay the price.

287
00:16:51,760 --> 00:16:53,600
It's the same way in our careers.

288
00:16:53,600 --> 00:16:58,080
We have a clear sense of direction of where we're going where we want to be then we have

289
00:16:58,080 --> 00:17:00,160
an understanding of what the price is.

290
00:17:00,160 --> 00:17:04,440
Now many times the price becomes very clear over time.

291
00:17:04,440 --> 00:17:06,080
It's like whoa is this how much it costs?

292
00:17:06,080 --> 00:17:10,880
I didn't know that but there's kind of like an accepted standard for what that price looks

293
00:17:10,880 --> 00:17:11,880
like.

294
00:17:11,880 --> 00:17:17,880
Therefore when you understand the direction you want for your career you ask this what

295
00:17:17,880 --> 00:17:21,480
is the price I pay to get to this place?

296
00:17:21,480 --> 00:17:23,280
What will it cost me?

297
00:17:23,280 --> 00:17:30,520
And then you work to pay the price and how that helps you say no is to ask yourself what

298
00:17:30,520 --> 00:17:36,080
are the things that people ask me to do that doesn't align with the price that I'm paying

299
00:17:36,080 --> 00:17:38,440
to get where I want to go?

300
00:17:38,440 --> 00:17:43,880
What are the things that people are asking me to do that costs me such that I can no

301
00:17:43,880 --> 00:17:47,440
longer pay the price for where I want to go?

302
00:17:47,440 --> 00:17:51,060
This is such an important thing and to be honest this is where the NO Committee could

303
00:17:51,060 --> 00:17:58,560
be helpful because sometimes things seem shiny and you know they're cloaked in anxiety and

304
00:17:58,560 --> 00:18:03,120
worry and you're not wanting to displease someone who's really important but what's

305
00:18:03,120 --> 00:18:10,120
really really important is for you to pause and say hmm does this cost me in the area

306
00:18:10,120 --> 00:18:12,760
that I said I wanted to pay a price to get to?

307
00:18:12,760 --> 00:18:17,480
Like does it take away from my paying a price for that place so that I can get to the place

308
00:18:17,480 --> 00:18:20,600
that I want my career to go?

309
00:18:20,600 --> 00:18:23,540
So that's one of the things you need to think about, direction.

310
00:18:23,540 --> 00:18:27,660
Number five is being gracious and showing gratitude.

311
00:18:27,660 --> 00:18:31,880
So whenever people say hey can you do this always say thank you.

312
00:18:31,880 --> 00:18:35,240
It doesn't matter how awful the thing they're asking you to do maybe they're like you know

313
00:18:35,240 --> 00:18:39,640
what I've decided I'm going on vacation next week and I have a clinic full of patients

314
00:18:39,640 --> 00:18:42,600
and I see that you're free can you take my patients?

315
00:18:42,600 --> 00:18:48,640
No matter how ridiculous it seems always say thank you.

316
00:18:48,640 --> 00:18:50,480
And here are some reasons to say thank you.

317
00:18:50,480 --> 00:18:54,040
Now I don't believe in saying thank you when there's no good reason for thank you and so

318
00:18:54,040 --> 00:18:58,840
what I'm asking you to do in this situation is find a reason to say thank you.

319
00:18:58,840 --> 00:19:03,160
They're like well there are many faculty members throughout this department faculty members

320
00:19:03,160 --> 00:19:06,040
in our department and you chose me.

321
00:19:06,040 --> 00:19:11,120
It must be because you think that I am able and equal to the task.

322
00:19:11,120 --> 00:19:14,240
It may be that you think I'm a really nice person.

323
00:19:14,240 --> 00:19:19,200
Whatever it is thank you and yes you may have a few choice words for them you may think

324
00:19:19,200 --> 00:19:23,640
no this is ridiculous it doesn't matter just say thank you.

325
00:19:23,640 --> 00:19:29,000
Because being gracious allows you to deliver bad news you know that you have clinical training

326
00:19:29,000 --> 00:19:33,720
and you know that if you are going to deliver bad news you start off being as kind as possible

327
00:19:33,720 --> 00:19:38,840
as nice as possible and even if the person is losing it because they're anxious or they're

328
00:19:38,840 --> 00:19:44,520
afraid and they're angry you don't lose it you speak to them calmly and that's what this

329
00:19:44,520 --> 00:19:46,000
is.

330
00:19:46,000 --> 00:19:51,280
Somebody said hey you know what there's a medical director position opening up and yeah

331
00:19:51,280 --> 00:19:55,400
it'll take about probably six hours of your day three days a week.

332
00:19:55,400 --> 00:20:01,120
Now they won't tell you that they'll tell you it only takes an hour of your day.

333
00:20:01,120 --> 00:20:10,000
But I digress you say wow you thought about me for this amazing role thank you and whatever

334
00:20:10,000 --> 00:20:15,180
you say after that whatever you say after a gracious thank you is gold.

335
00:20:15,180 --> 00:20:19,400
Like it's hard to say thank you genuinely so please don't say thank you through clenched

336
00:20:19,400 --> 00:20:23,280
teeth because people can tell that you're not being sincere and I feel like well I don't

337
00:20:23,280 --> 00:20:27,800
feel sincere about the thank you then go take time to become sincere.

338
00:20:27,800 --> 00:20:31,840
Say let me think about it so you take the space and then you say what are all the good

339
00:20:31,840 --> 00:20:35,340
things I can find to show gratitude.

340
00:20:35,340 --> 00:20:39,960
Maybe you're thinking in that moment I'm so thankful that I know exactly what direction

341
00:20:39,960 --> 00:20:42,520
I'm going in so that I don't fall for this.

342
00:20:42,520 --> 00:20:46,200
Maybe that's what you're thinking and you're like thank you thank you for revealing to

343
00:20:46,200 --> 00:20:47,200
me my priorities.

344
00:20:47,200 --> 00:20:52,640
I mean you're not going to say that but whatever helps you recognize that you're going to show

345
00:20:52,640 --> 00:20:57,120
gratitude that's what I want you to do show gratitude.

346
00:20:57,120 --> 00:21:00,600
Okay and the reason you show gratitude is because whatever comes after that gratitude

347
00:21:00,600 --> 00:21:02,120
lands better.

348
00:21:02,120 --> 00:21:07,320
Thank you so much for thinking about me for this amazing opportunity and I would wish

349
00:21:07,320 --> 00:21:08,680
I could take it.

350
00:21:08,680 --> 00:21:16,160
It would be amazing and I don't think it aligns with my priorities right now.

351
00:21:16,160 --> 00:21:19,160
Perhaps it's something that I will be ready for in about two years.

352
00:21:19,160 --> 00:21:21,920
I don't think I'm ready for it now.

353
00:21:21,920 --> 00:21:26,320
So we always want to show gratitude because gratitude helps you do the gracious thing

354
00:21:26,320 --> 00:21:31,680
that comes after gratitude is to find a way to say it in a way that's nice and kind.

355
00:21:31,680 --> 00:21:33,280
Okay and maybe that's the last thing.

356
00:21:33,280 --> 00:21:35,040
The last thing is to be kind.

357
00:21:35,040 --> 00:21:40,320
There are two people you need to be kind to whenever you say no the first person is you.

358
00:21:40,320 --> 00:21:42,320
Saying no is hard.

359
00:21:42,320 --> 00:21:48,320
If we are way beyond our terrible twos if you ever went through terrible twos saying

360
00:21:48,320 --> 00:21:54,760
no is hard work and so the kindness you show first is to yourself to recognize that it

361
00:21:54,760 --> 00:21:59,440
is hard and so to take the time to prepare to do it.

362
00:21:59,440 --> 00:22:05,760
Don't procrastinate don't defer it but take the time to do it to say no.

363
00:22:05,760 --> 00:22:10,680
Be kind to yourself and then also be kind to the person who's asked you to do it.

364
00:22:10,680 --> 00:22:14,720
Perhaps you know that they're being actually obnoxious they're actually being obnoxious

365
00:22:14,720 --> 00:22:16,280
you know it.

366
00:22:16,280 --> 00:22:25,320
Still be gracious and kind and say thank you and no I'm not able to to do this thing.

367
00:22:25,320 --> 00:22:31,880
Okay so I've given you a couple of reasons a couple of ways to say no and number one

368
00:22:31,880 --> 00:22:34,440
is to have a bigger yes.

369
00:22:34,440 --> 00:22:39,280
Number two is to have a no committee or a broad committee that you can talk to.

370
00:22:39,280 --> 00:22:42,720
Number three is to make sure that there is space between the stimulus the question that

371
00:22:42,720 --> 00:22:47,300
you're asked and the response that you're able to really think it through.

372
00:22:47,300 --> 00:22:52,000
Number four is to have a clear sense of the direction you're going in so you understand

373
00:22:52,000 --> 00:22:59,040
how much another price another charge costs in terms of your big direction.

374
00:22:59,040 --> 00:23:06,360
Number five is to show gratitude and number six is to be kind first to you and then to

375
00:23:06,360 --> 00:23:08,920
the person who made that request of you.

376
00:23:08,920 --> 00:23:13,760
All right I'm interested in hearing your thoughts saying no is super hard and so if you have

377
00:23:13,760 --> 00:23:18,520
ideas on how to say no I would love to hear it.

378
00:23:18,520 --> 00:23:23,680
Do me a favor leave a message for us on the podcast.

379
00:23:23,680 --> 00:23:29,240
There is a voicemail feature if you go to the website clinicianresearcherpodcast.com

380
00:23:29,240 --> 00:23:33,680
leave a voicemail and I will play your message in a future episode.

381
00:23:33,680 --> 00:23:38,880
Now it may take a while because I batch record these episodes and so you may be like three

382
00:23:38,880 --> 00:23:43,920
weeks from now and you're like I haven't heard my voicemail but be patient it will come

383
00:23:43,920 --> 00:23:48,760
but go ahead and share a voicemail share your ideas and I will use it and turn it into an

384
00:23:48,760 --> 00:23:49,760
episode.

385
00:23:49,760 --> 00:23:53,960
Okay that's the end of today's episode I want to thank you for sticking around this long.

386
00:23:53,960 --> 00:23:59,160
I look forward to the next time definitely share this with a friend or mentee or someone

387
00:23:59,160 --> 00:24:00,680
else who needs to hear it.

388
00:24:00,680 --> 00:24:10,000
All right I'll talk to you again the next time.

389
00:24:10,000 --> 00:24:15,320
Thanks for listening to this episode of the Clinician Researcher Podcast where academic

390
00:24:15,320 --> 00:24:21,200
clinicians learn the skills to build their own research program whether or not they have

391
00:24:21,200 --> 00:24:22,200
a mentor.

392
00:24:22,200 --> 00:24:27,760
If you found the information in this episode to be helpful don't keep it all to yourself

393
00:24:27,760 --> 00:24:34,040
someone else needs to hear it so take a minute right now and share it.

394
00:24:34,040 --> 00:24:39,480
As you share this episode you become part of our mission to help launch a new generation

395
00:24:39,480 --> 00:24:45,440
of clinician researchers who make transformative discoveries that change the way we do healthcare.