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Fam Pract Manag. 1998;5(7):71-72

It's not your imagination: You do have more to do these days and you are expected to get it all done in less time. Technology has put more in front of you to read and created more ways for the world to reach you 24 hours a day.

We have created an ATM mentality. Whether machine or making a request of a human being, we expect instant assistance. Physicians are not spared. The petitions for your time keep coming in. Requests to serve on another board or committee that needs your expertise, pleas to attend a few more meetings on local health issues and invitations to talk to community groups about healthy lifestyles will continue to escalate.

So how do you cope with the ever-increasing demands on your time? First, accept the fact that you can't do it all anymore. There was a time when good efficiency techniques allowed you to balance a large portion of your priorities even without a planner. Those days are gone! Second, stop thinking that if you just work smarter, not harder, you'll get it all done. No matter how smart you are, you still can't get everything done. Advances in technology and demands for information will always outpace your abilities to complete some tasks and goals. Third, know what you really want to do with your life and time. It's easiest to say “no” to something when you know in your heart exactly what you want to say a resounding “yes!” to. If you use a planner, keep your priorities in clear view as you schedule your activities. At least, write them on a small index card and put the card where you will be reminded of them daily. This awareness creates the power to say “no.”

The most common mistake

It may surprise you to learn that the most frequently used and most ineffective way to say “no” is to declare, “I don't have time to get involved.” Nobody cares if you don't have time because they don't have time either. So what happens? You allow yourself to be persuaded (out of guilt) to accept the assignment. But it doesn't have to be this way. There's more than one way to say “no” effectively. The next time Tom Jones, chair of the “Run for Healthy Hearts,” asks you to “just show up for a few short meetings,” take advantage of one of the following techniques to protect your time and still preserve the relationship.

The pleasant no

“Tom, the run sounds a lot more fun than what I'm going to be doing at that time, but I'm going to have to say ‘no.’ Thanks.” Said sincerely, this response upholds the value of the other person and the request. It is a kinder, gentler no — but still a no.

The conditional no

“Tom, I can't be at the meetings, but I'll be glad to help set things up the night before the run and be in charge of registration the day of the event.” Often overlooked, this is one of the most versatile and valuable ways of saying no. You've set conditions for saying “yes” without giving up your higher priorities.

If Tom counters that he needs you to stay for the complete event and help clean up at the end of the day, be sure to weigh your priorities before reacting. Remember you are still the one in control of your response.

The sleep-on-it no

“Tom, let me think about your request.” Often a quick “yes” is a reflex reaction to feelings of guilt, fear of hurting someone or the strong desire to serve or have fun. Giving yourself time to assess your priorities ensures a sincere response on your part. To assuage the person's legitimate fear (based on past experience with others) that you might never get back with an answer, add these words: “… and I'll let you know by noon tomorrow, Tom, if that's not too late for you.” If, after thinking about it, you deliver a negative reply on schedule the next day, Tom will know at least that you've given his request serious consideration.

The alternative-solution no

“Tom, I can't help out with the heart run, but I know Dr. Markus will be glad to assist you.” This tells the person with the request that you value him or her and the investment of time he or she is making. It also shows your willingness to help solve the problem. Obviously, any time you volunteer someone else, you should check with that individual first.

The secret-weapon no

“Tom, I'm not able to make the heart run a priority right now.” That's all you say. Tom will probably expect you to explain and may even say, “Well, what are you doing instead?” No explanation is needed. It's really not anybody's place to ask you to defend your priorities. So, if you really know what your priorities are and you want to protect them at all costs, this no is for you.

Some people will not accept your first response. Don't be afraid to stand your ground. These techniques give you a more professional and personable approach to the popular adage “Which part of ‘no’ do you not understand?”

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Copyright © 1998 by the American Academy of Family Physicians.

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