Doctors are a pretty assertive bunch. Even so, I think it’s good to be reminded of the following success motto: Do the Ask!

This motto – one of several I live by – refers to a certain division of labor: it’s your job to ask for whatever it is you’re looking for. And it’s the other person’s job to give you a ‘yes’ or a ‘no.’

Pretty straightforward concept, isn’t it. Yet, I regularly have conversations during which it’s clear that the person I’m conversing with does not live by this motto – to their detriment. In some cases the person is too ‘shy’ to ask for whatever it is they want (from me or from another person). They leave empty-handed from interactions that potentially could have led to some very beneficial results, often for both parties. In other cases, the person does the ask but only after first negotiating against themselves, imagining how the other person will react, and ultimately making a much more modest request than they may have otherwise achieved. You may recall that during Barack Obama’s first term, many of his supporters were frustrated with his tendency, as they saw it, to negotiate with himself before negotiating with his opposition.

This latter point highlights that the concept of Do the Ask! Plays out in many aspects of life and in many different ways. Do the Ask! can be deployed in politics, business, professional life, and personal life. A few examples:

  • Asking for a salary increase
  • Asking to get it in writing
  • Asking the insurance provider (HMO or other) for higher reimbursement
  • During employment negotiations, asking for lower on-call frequency
  • Asking someone on a date
  • Asking a colleague for help
  • Asking your significant other or family member for help in doing chores

Yes, all of the above are possible, even negotiating higher reimbursement for your services if you’re in a scarcity specialty or geographic location.

The question arises why, although the benefits may seem obvious, it often is hard to Do the Ask! Now let me give an example that may seem far afield but that leads me to answering my question.

During my tenure teaching interviewing and presentation skills for the oral boards, a common occurrence was observing an exam candidate who, for instance, when presenting a case would stumble and then seemingly give up. You could track this change in their eyes: One moment they’re struggling but still in the game; the next moment the fighting has left them. The candidate decided at that point that they had failed their mock exam. In my feedback I would repeat to them, sometimes thunderously so, “It’s your job to interview the patient and to present the case to the best of your ability. You are going to screw up at some point – because everyone does. No one is perfect. BUT it is NOT your job to pass or fail yourself. That is the job of the examiner. You do your job and let them do their job!”

The point here is that a common reason a person stops themselves from doing the ask is due to judging themselves negatively; by becoming their own judge and jury, and rendering a negative verdict. This may strike you as an example of negative cognitions. And it likely is. Some cognitive therapy may be in order. But what if there is some justification for the negative self assessment? Here are two examples of the latter.

A psychiatry resident fails to confront a patient in psychotherapy with them about their unpaid bills. Despite increasing discomfort with their own continued avoidance and, perhaps, with growing resentment of the patient for placing them in this predicament, the resident still avoids doing the ask. Why? Because they do not have faith in the quality of their work. My response is, “Then improve the quality of your psychotherapeutic skills to the point where you are convinced of the benefits of what you offer the patient. Then Do the Ask!” In this case the hesitancy to Do the Ask! could have spurred some self-reflection and provided motivation for improvement.

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Another example: a young man in treatment for depression is ‘shy’ about asking people he’s interested in out on dates. In justification he tells you he’s asked many people on dates but has been turned down every time and “just doesn’t want to hurt anymore.” You ask him why he believes he’s been turned down. He says he doesn’t know. You ask him if he has friends who might help him better understand by giving him their perspective. He says he does have such friends and thinks this is a good idea. At the next visit he says that he “heard an earful from his close friends” who told in so many words that he needs to improve his grooming and learn to maintain eye contact. He is better groomed at this visit, shaved and with a fresh haircut. Also, he asks if you could recommend a way he can become better “at small talk.”

Until next time,

Dr. Jack


Today’s Quotes

“They always say time changes things, but you actually have to change them yourself.”
– Andy Warhol, The Philosophy of Andy Warhol

“Never interrupt someone doing something you said couldn’t be done.”
– Amelia Earhart

“You’re not lost in the storm, Marilyn. You are the storm.”
– Colin Clark, My Week with Marilyn