The Value of Saying “No”

Matthew D. Beal, MD | Cara A. Cipriano, MD, MSc | Joshua C. Patt, MD, MPH, FAAOS, FAOA

October 14, 2020


In medicine, we often hear about the importance of the Three A’s: Availability, Affability, and Ability. These traits were traditionally considered the key to building a career. They imply that obliging every request and doing as much as possible, at all times, is the best strategy to succeed. However, learning when and how to say no is just as critical to your professional development as saying yes.

Figuratively speaking, saying yes opens doors, while saying no closes them. There is an important time and place for each of these. Early in your career, saying yes is a great way to explore opportunities, forge collaborations, and discover your interests. This can apply to your clinical practice as well as research and administrative roles. As you start your career, there will be relatively few doors, and you may want to open most of them. However, the work you do, the expertise you gain, and the relationships you develop will create more doors; thus, your potential opportunities will increase exponentially.

Superficially, it may seem like the more opportunities and activities, the better. However, if you open every door, you will quickly have so many tasks that you cannot feasibly perform any of them well, let alone enjoy them. Taking on too many professional activities can decrease the quality of your work, lead to burnout, and jeopardize your personal life.

To prevent this from happening, it is important that you develop selectivity as an increasing number of doors appear before you. Identifying and prioritizing specific goals is important in this process. Establishing goals requires introspection, and can also benefit from discussions with your mentor, life partner, or coach. Once you have done this, whenever you encounter a door, ask yourself, “will opening this bring me closer to my goal?” If not, it may be best to decline that opportunity. A terrific book on our “must read” list is Essentialism by Greg McKeown. McKeown encourages successful people (after the initial years of saying yes to everything) to eliminate those activities which are non-essential and do not add to the person’s career growth and development.

Sometimes an opportunity will not have a direct benefit to you or have a clear answer as to how it may be important for your career trajectory. For example, you will likely be asked  by your leader or partners to participate on a committee, task force or project and this will be an opportunity for you to “take one for the team” and support the group effort.

As you get busier, and you re-evaluate your commitments, it will become clear that there will be a time to respectfully step away from non-essential commitments. The best way to do this is to be transparent and clear. Do not just stop showing up for meetings. Speak to the leader of the committee and explain that you need to step away to focus your energy on other priorities. A helpful hint here is to be ready with a replacement for your position.  


In sum, remember that saying no is just as important to your career as saying yes. Even in situations where saying no is the right thing to do does not necessarily make it easy. Be strategic and goal-oriented when choosing which opportunities to pursue and learn to gracefully say no to the rest.


DISCLOSURES: Dr. Beal AAOS: Board or committee member, American Orthopaedic Association, Board or committee member, Medacta: IP royalties; Paid consultant; Research support, National Institute of Health (NIAMS & NICHD), Zimmer, Stryker, Mako Surgical: Research support, Zimmer: Paid consultant Dr. Cipriano KCI: Paid consultant, Link Orthopaedics: Paid consultant, Musculoskeletal Tumor Society: Board or committee member Dr. Patt American Orthopaedic Association: Board or committee member, North American Spine Society: Board or committee member.

Read the AAOS Code of Conduct for Discussion Group Terms, Conditions and Disclaimers HERE.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s