I think physicians in general have a hard time saying "No". While we can deliver bad news or discuss other negative issues at length, saying "No" is a struggle. This was clearly evident with the advent of HMO's last century when we were made the gatekeepers of care. Telling our patients "NO", that we were not ordering or performing various studies, interventions or other actions proved to be incredibly difficult for our profession. It also resulted in our difficulties in saying "No" to all the business folks who infiltrated, metastasized and now have "No" problems telling us "NO" when we want to care for our patients in the manner most appropriate for that patient.
I think physicians in general have a hard time saying "No". While we can deliver bad news or discuss other negative issues at length, saying "No" is a struggle. This was clearly evident with the advent of HMO's last century when we were made the gatekeepers of care. Telling our patients "NO", that we were not ordering or performing various studies, interventions or other actions proved to be incredibly difficult for our profession. It also resulted in our difficulties in saying "No" to all the business folks who infiltrated, metastasized and now have "No" problems telling us "NO" when we want to care for our patients in the manner most appropriate for that patient.