Boundaries….it’s okay to say “no”

Boundaries exist in society or in the society of medicine. The culture is to say, yes, keep your head down and do, as you're told, don't create any waves. What I'm going to challenge you today is to actually rethink reshape your outlook on boundaries. I’m an 80s kid, and I distinctly remember the “Just Say No” campaign that discouraged drug use…ironic since medicine prescribes drugs, though they are prescription and not street. Yet at some point we in medicine forget to say no. We, as physicians, forget to draw boundaries. We forgot the power of no. Such a simple word, but a word we have quit using. “No” can be used to help draw boundaries, which are healthy in order to keep us sane, uphold our dignity as well as humanity. As people pleasers, type A personalities physicians need to advocate…not only for patients but for ourselves [as Dr. Kane mentioned].

-We use motivational interviewing with patients…we can also use it with HR or admin to have a reasonable work environment.

-We don’t always have to be ‘busy.’ Being in the moment is important.

-Self care is not selfish.

It really is okay to say no, or to draw boundaries in other words/formats. During my fourth year of medical school, I rotated through outpatient addiction medicine. One thing that did help me was to practice saying no in the mirror so I would have the confidence to say no as much as yes. Admittingly, it took practice even after a couple of years of being an attending. I learned that boundaries are self preserving.

I would challenge the reader to practice saying no to things that don’t fill your cup, and yes to more positive life experiences. Try it for 30 days, then 60, then 90….and it just might become a habit!

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