101026 Owning your time is coming
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Speaker: [00:00:00] This episode is titled The Trap is Built One Reasonable Yes at a Time I'm Dr. Stacey Ishman, and this is the Academic Medicine Strategy Podcast. You love the work, your calendar says otherwise. Each week, I share the systems that help academic physicians own their time and build a career that matches what matters to them.
Speaker: I use these systems in my own career, and I coach physicians through them every week. Let's get into it Now, I wanna just start with this idea of how painful it is when your clinic is booked out months. Clinic's booked out three months, you have no time or energy left for the work that you actually care about, and yet the year-end requests just keep on coming.
Speaker: So I waited for years for someone to tell me that I could say no. You can start today. And I want you to know that everything I teach on Monday when we have a webinar to talk about how to handle this is the method I [00:01:00] use with every coaching client. At the end, I'm gonna tell you how to work with me and my team.
Speaker: Now, I wanna tell you a little bit about my story. I started in 2015. I started way before that, but in 2015, I was on four editorial boards at once, and I was an associate editor of the Journal of Clinical Sleep Medicine, and it cost me more than eight hours a week. And where did that time come from?
Speaker: It came from family time, it came from research time, it came from time to finish my notes. It came from all of that energy that I might have had around the things that kept my career percolating. And why did I do it? I did it because I thought this was gonna be the thing that helped build my national reputation, that's gonna get me promoted.
Speaker: That's how I'm gonna become an associate and then a full professor. It was the acknowledgement that the work I was doing was acknowledged. But I didn't like the work. I really didn't like the work. I knew that it was a privilege to be able to do it. I understand the value of the work. I could help [00:02:00] impact what was happening in the future in terms of what happened with the literature.
Speaker: I could help bring great things to light that maybe wouldn't have been. I could help make sure things that weren't being done very well weren't gonna make it in the literature, and yet I didn't like the work. So at the same time, I was really interested in working with my academy, and I was elected to the American Academy of Otolaryngology's Board of Governors.
Speaker: I was elected as the chair, and I was really excited. I was chair-elect. I was, like, on cloud nine, and an editor of JAMA Otolaryngology came to me and said, "Given all of the things you're doing," it put me on the board of directors, the executive committee of the board of directors, did I have time to continue on to the JAMA Otolaryngology board?
Speaker: And in fact, it was the light bulb that I needed. I had not for one minute thought, "Gosh, this is an opportunity to stop doing things that don't fill my cup, and to give those to somebody else or to sponsor somebody else, or to just say no." So I stepped back, and I realized in that [00:03:00] moment I didn't have to step back from just that one board.
Speaker: There were three other boards that I was on and an associate editor role, all of which I could say no to at the same time, and that was maybe one of the best days of my life is when I messaged every single one of those entities and said, "I am letting you know I have this great new opportunity. It's gonna take a lot of my time, and so I'm gonna have to say no to doing this."
Speaker: And it turns out I could have done that at any time. In fact, one of them, when I asked Journal of Clinical Sleep Medicine how long was my term, they said there is no term limit. And I was like, "Ooh, okay my term's ending in two months. I'm gonna sponsor this person to take over the role." And they were excited to take over the role.
Speaker: They did a great job. But it had never occurred to me that I could have given myself that permission at any time. Thank God Jay said to me, "Hey, is this a time that you need to step back and take a little bit of time?" And I still went on to become an associate professor. I, three years later after that, I became a full professor, and I [00:04:00] had better work-life integration.
Speaker: I really loved what I did. And so I want you to know Be smarter than me. Figure it out. Look at what you're doing. See what you love, see what you don't love, and find ways to give yourself permission to say no to those things. At this point, I'm still a pediatric otolaryngologist. I'm currently working as a chief medical officer, and I've been a professor for a number of years.
Speaker: I have over 230 public publications. I've been the primary investigator on numerous foundation grants and NIH grants. But this part, this thing that I thought was so important to my national reputation, didn't need it. Could have done one of them, by the way. I could have acknowledged that associate editor journal was probably more than enough to show people I was acknowledged for my expertise, so the other four, unnecessary to begin with.
Speaker: But most of us think that busy means we need more discipline. How do we get out of this? The trap is built one reasonable yes at a time. Every one of those was a [00:05:00] reasonable yes, and if you were deciding one request at a time with nothing else to decide by, it is easy to see that those yeses look free until you see what it replaces.
Speaker: There is research out there. If you look at The American Economic Review from 2017, there was a conversation about what women do. It was written by Babcock and colleagues, and women were oftentimes asked to take on low promotability tasks way more often than men, and we accepted them more often than men did.
Speaker: So this is not an individual problem. It's not that I just keep saying yes. It's that there's a systematic approach to who gets this low promotable or non-promotable work, and it is more common than it goes to women, which means there's also great system fixes for us to be very aware and thoughtful as we look at some of this low promotability work and how we distribute it.
Speaker: And I work with someone named Sarah, one of the clients I work with, and she said, "I originally thought I already had strong [00:06:00] resilience and time management skills, but the program that we're talking about today showed me just how much more I could grow." I will also tell you, I recently got to work with a group at Cedar Sinai, and we went through, and one of the beautiful things that they did is they looked at all of this sort of non-promotable, low promotable work and said, "What is everybody doing?
Speaker: Let's create a list. Let's figure out who's doing what, and then let's figure out some equitable ways to distribute it." So it was a beautiful way to approach this at a systems level, so everybody felt like what they were doing was acknowledged, important. Everybody needs to do some, but maybe it was inequitably distributed, and it was an opportunity to pass it around Now, let's talk about what a filter can change for you and why it's important.
Speaker: So it's the yeah, but. Every request is important. We don't get a lot of requests that are absolutely unimportant, maybe not as important to me as to somebody else, but so something good has got to go. There's always gonna be a choice between what you're saying yes to and then what you then have to say no to.
Speaker: So a filter means you can decide this [00:07:00] in advanced, so you are much easier to have a fast yes and a fast no without the guilt. It comes from the fact that you know you're saying no to something that's important. Now, as a mid-career physician, we worked on some of these words, and so one of the doctors I worked with said, "I said yes by reflex."
Speaker: She kept an endless to-do list, and it fed her anxiety, and she was just getting by, is the way she described it. And after we did this filter, she said she declined two commitments without worrying how people would react because they fit her filter. She started each day with the one most important thing, and she chooses which commitments fit her life and says no to the rest.
Speaker: I work with a woman named Karen, also fantastic, and what she said was, "Stacey is terrific at assisting individuals in maximizing their potential by helping them figure out what the most important thing is to them and leveraging the unique skills and talents." That is not something that only Karen was able to figure out.
Speaker: That's something everyone can figure out, and it's not specific to academic medicine. This is something you can do in any arena. I [00:08:00] absolutely work with people who are in private practice, who are hospital employed. It's not so much about where you work. It's about knowing what you care about and building a filter so you can make that easy yes and that easy no.
Speaker: Now, who is a filter gonna work for? Honestly, everyone. The mid-career physician who's looking at where they are and trying to figure out what's next. One of the people I worked with named Meredith was at a crossroad. She came to me and she said, "When I faced a crossroads in my career, I immediately reached out to Stacey.
Speaker: I knew she would give me practical, actionable steps and would call me out on my limiting beliefs and negative self-talk. 50 minutes later, I had a plan." I also work with Abby, who came for time management, and she said, "I joined this group program to help me with my time management, and I learned so much more along the way."
Speaker: Similarly, I love that Katie said she didn't even know she needed help. She said, "I didn't think I needed a coach. I met Stacey at the recommendation of a friend who was watching me trying to balance my work life. But after working with her for a few [00:09:00] months, I now realize how much I needed help." And if this is you or if this is somebody you know, we would love to give them a hand Now, I want you to think about one strategic move that you can carry out this week.
Speaker: So write down one yes from this month that you would not repeat, and then think about what it replaced. So I said yes to something. It turns out I really didn't want to or I didn't know what I, how to say no to it. I can tell you I have somebody who I've been coaching for a couple of years. I love working with her, but she literally, I said, "What did you say no to this week?"
Speaker: Because that's one of the things she's working on. And she looked at me sheepishly, and she's like, "Ugh, I said yes to this thing, and I immediately, as I said it, I knew I didn't wanna do it. It wasn't feeling right. I could do it, but I don't feel good about doing it." And then I asked for some sort of reciprocal piece, like I'm giving up my time for this, but when I need some help down the road, she asked her group and nobody said yes.
Speaker: And she realized, "Gosh, this isn't the kind of balance that I want. I wanna be in a [00:10:00] system where when I say yes, it's 'cause I know someone who's gonna say yes for me." So that's an example where you're trying to trade within the group, but oftentimes we're trying to trade within our own timeframe. I'm gonna say yes to writing this paper, which means I have to say no to working on my grant or to, getting my notes done on time sometimes is the trade-off we make, and I'm gonna hope that you don't do that one.
Speaker: But ask whether the trade match what you say matters most. So if you're here and you wanna make sure it's about your clinical time or your number one research project or getting home to family on time or making sure that you're playing mahjong according to the National Mahjong League rules, which is what my wife says all the time, then make sure that those match.
Speaker: So I want you to think about what you could do and how you can do it, and so that's one of the things we're gonna be doing next week on November 16th. We're doing a webinar where we're gonna help you go through and of do a values exercise which helps inform how you create that filter. You'll be able to name your top five values so that you understand where you're gonna be [00:11:00] able to do things that align your time with what you care about.
Speaker: Now, if you are interested at all and you have heard this podcast before November 16th of 2026, we are having a webinar at 7:00 PM Eastern Time. It's 60 minutes long. There is a replay available, but please join me live. By the end of that hour, you will have named your top five values and you'll see why discipline was never the problem.
Speaker: There is gonna be a registration link in the show notes. Please join me live if you can. But if you can't, register anyway and we'll get you the replay. And I wanna tell you people have enjoyed working with us in the group coaching. Candace was one of the people who worked with us in our Women in Otolaryngology group and she said, "I loved the group coaching format.
Speaker: It helped create community and solutions." And so what I want you to really recognize is this is your opportunity to give yourself some time. And every time I teach and everything I teach on Monday is the method I use with every coaching client. It's what my [00:12:00] team uses as we help take people through the Owning Your Time course.
Speaker: And at the end, we'll tell you how to work with us and with our team. Now, I wanna thank you very much for joining us today at the Academic Medicine Strategy podcast. If this episode helped, please follow the show so you don't miss the next one and send it to a colleague who is saying yes too much. To work with me and my team, visit amedsg.com.
Speaker: You'll also find AMedsG on Instagram and LinkedIn β
