Brian Mitzman, MD, MS, University of Utah
4 min read
Key Points
  • As physicians, we spend the first half of our adult lives being told to always say yes, which can leave us overwhelmed and overcommitted.
  • Effective boundaries allow us to protect ourselves, focus on our needs, and pursue excellence.
  • Learn how to establish good boundaries at work and say no to opportunities that aren’t in line with your goals.

As physicians, we spend the first half of our adult lives being told to always say yes. The goal is to build that CV so you can make it to the next step. Set a foundation to show you have potential and you’ll get accepted to medical school. Show academic, research, and leadership promise to land that coveted residency spot. Document successes that describe a national presence in cardiothoracic surgery to match into that premiere fellowship. Continue grinding and you’ll be offered that promised first attending position. All of this is in addition to the basics of becoming a competent and safe cardiothoracic surgeon. At what point is it okay to start saying no to opportunities that aren’t in line with your necessities?

Dr. Brian Mitzman
Dr. Brian Mitzman

Focus on Your Needs

In the early part of your career, you will be hungry for opportunity. Perhaps you want to get involved in a specific society, so you accept every task force or committee request, no matter the workload or true benefit to your career. While this may be an acceptable approach initially, it’s important to take a breath and do some self-reflection. What do you want out of your career? Where are you trying to get to in 10 years? Once you know where you are trying to go, you can determine if an opportunity will help get you there or if it is just a line on a CV that will be glossed over. There are only 24 hours in a day. Even an hour towards a project without personal benefit is an hour taken away from working on that NIH K-Award Proposal or from requirements to maintain your role as a program director. More importantly, it’s time when you can take a breath and focus on your non-work needs.

How to Evaluate an Opportunity

In Give and Take – A Revolutionary Approach to Success, Adam Grant writes: “Giver burnout has less to do with the amount of giving and more with the amount of feedback about the impact of that giving. Givers don’t burn out when they devote too much time and energy to giving. They burn out when they’re working with people in need but are unable to help effectively.”

When you are evaluating an opportunity, think about what the ask is.  Are there clear metrics for success in this role or request? Will you be supported in a way that success is achievable?  While some projects may be long and arduous, knowing that there is a defined goal that can be met decreases the chance of excessive frustration and regret.

William Ury has made a career on when to say yes and how to say no.  In The Power of a Positive No: How to Say No and Still Get to Yes, he writes: “Saying no is a way for you to communicate with yourself. It forces you to breathe, which breaks the freeze response. It gathers your energy. It gets your adrenaline going. It reminds you of the [self-defense] class, your muscle memory, the support of the line [your peers], and the fact that you have the right to fight for your own safety.” 

Every “no” you use is different. It varies based on who is making the request. While it is very difficult to say no to trusted mentors or friends, bear in mind, they should have your interest at heart. That is the reason they are offering you an opportunity. Be clear, give a reason, and offer an alternative. Now may not be the right time, but how about in six months when another project finishes? Or maybe a project isn’t a great fit for you, but you know an excellent up-and-coming surgeon who would do a fantastic job. Saying ‘no’ is more than a single two-lettered word.

Protect Yourself and Be Rational

It is okay to say yes but set up realistic boundaries. Give a timeline for how long you are willing to take on this project. Ask for a commitment to resources upfront before agreeing. Be open about your current bandwidth and provide details about the amount of effort you can realistically provide at this time to the role.  All the above allow for the other party to reflect on the ask, and whether or not it is truly reasonable and thought out.

When all is said and done, “extra-curricular” work activities should bring joy and excitement to your already busy and fulfilling career. If your gut is sending you a warning signal and you don’t feel motivated by the opportunity, it’s better to take a step back and wait for the next request to come across your inbox.