129. NO Is Just the Beginning: A Physician's Guide to Asking

One conversation can change your career. But first, you have to be willing to ask.

In this episode, I'm joined by my friend Dr. Kristine Goins on The Physician's Guide to Doctoring to talk about one of my favorite topics: asking.

Whether you're negotiating your contract, requesting a different schedule, asking for support at home, or advocating for yourself in medicine, the biggest obstacle usually isn't strategy. It's believing you're allowed to ask in the first place.

We talk about why physicians are conditioned to avoid asking, how to move through the fear of hearing "no," and why connecting to what you actually want changes every negotiation.

In this episode, we discuss:

• Why asking is a skill every physician needs
• How medical culture teaches us to silence our own needs
• Reframing "no" as information instead of rejection
• The role of curiosity in successful negotiation
• Why your deepest desire matters more than negotiation scripts
• How to know if you're asking for enough
• A real example of negotiating a locums incentive by honoring your own value

A quick heads-up: Parts of this recording were unfortunately corrupted, and AI replaced portions of my voice during the editing process. It sounds a little strange in a few spots, but the conversation was too valuable not to share. Thanks for sticking with it.

If this episode makes you realize you've been settling for less than you need, I hope it reminds you that asking isn't selfish. It's a skill. And it's one worth practicing.

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Strategy Coaching Session with Dr. Toya

Transcript

 Hey, Doc. I am back with another episode where I was the guest on another podcast, and I was interviewed by my dear friend, Dr. Kristine Goins, and she was guest hosting on a podcast, The Physician's Guide to Doctoring. I don't know if you listen to it. Um, I actually don't listen to the podcast, I'll be real with you.

But Kristine is somebody who I love. She is a travel coach. Let me just make sure I remember her title. She helps physicians practice and live abroad. I can't remember her exact title, but I know what she does is amazing. I love her. She is this unique, independent, beautiful soul, and every time I see her, I'm like, "You look so fabulous.

You're living such a fabulous life." And she's helping other physicians live fabulous lives, so of course I love her so dearly. And she invited me to talk about asking and negotiation, and this is a good one, y'all. Except for the fact that I don't know if it was in getting the podcast on my editing software or what happened, but parts of the recording, like, were corrupted, and my voice was taken over by AI.

So I think something was wrong with the file, and it filled in my actual voice with just AI reading the transcript, so it sounds super weird. And I only realized that it was parts of the entire thing after I had deleted the beginning, 'cause I freaked out 'cause I was like, "Whose voice is this?"

And then I was like, "Oh, shit, that's true of the entire thing." But the episode is too good to not share it. So bear with me. There'll be some weird-sounding parts of this, and I think it also changed her voice as well, but because she is American and the algorithms, they, they know how to reproduce American voices, not so much Trinidadian ones, she kinda sounds okay.

Because I know her, I can tell where it's changed, but you can't really tell. But with me, it's very obvious. So I hope you don't get too distracted, and you can still get all of the wonderfulness of  this episode. I hope you enjoy 

In this episode, we're diving into the power of asking. From navigating medical culture to overcoming the fear of hearing no. Today, my guest, Dr. Toya shares how asking for what we want can lead to greater freedom, confidence and fulfillment in both our personal and professional lives. Welcome everyone. I'm your host, Dr.

Kristine Goins, and I am so excited. I'm excited to introduce our guest today, Dr. Latoya, Luces Sampson, known as Dr. Toya. She's a board certified OBGYN, perinatal mental health specialist and coach who dedicates her work to empowering physician moms to find confidence and joy through self advocacy and System building and self care.

Welcome Dr. Toya I was wondering if you could share with us your journey in how asking actually became a central component of your work.

Yeah. So I am in general, pretty bold person, but I'm also a physician and a woman. So there's the socialization that you are not supposed to ask, especially in medical culture, where it's like, you've figured it out yourself. Asking is selfish, like all the things that come with that. So I did have work to do and it was through my journey in entrepreneurship where I realized, no, you have to ask because nobody's going to just give you anything.

And the people that are the most successful are the ones that just ask, and they ask again, and they ask again, and they realize that no, it's just an invitation to ask some more. So, um, it is, like you said, it is a central component of not only my coaching, but of my life, because everything, there's so many things in your life that if you just ask, you will be surprised at.

How many things will come to you and with such ease, because there's this thought that asking is this scary, big thing. It really doesn't have to be all that. Yeah. It, the journey has been through entrepreneurship, but then it just makes sense for all aspects of my life. 

And that makes a lot of sense as like a fellow entrepreneur.

It's so central. When we think about physician and the importance of self advocacy, especially in high stress. Professions like medicine, even for physicians who may not be entrepreneurs, why do you think it's a fundamental skill for doctors who really want to expand their options in life and work? 

Yeah, because you don't get what you don't ask for.

And it doesn't have to just be for entrepreneurs like us. This is for employed physicians. For residents, for everyone, and I feel like the residents and that generation have it down pretty much, maybe a little bit too much, but definitely for those of us that have come up in the culture of this is selfish, this is not what you're supposed to do, the worst they can say is no, the absolute worst.

But the best thing is that you can get exactly what you want and even more. And that is where I think I differ with a lot of people when I talk about negotiation, because asking it is a negotiation by another name, right? If you ask in your personal life, you say it's asking, but if it's in a professional setting, you're negotiating.

And a lot of things focus on the structure of how to do it and the strategy where I really focus on you and your desires and what you want and connecting to it. So it really is for everyone, right? Because when you are connected to what you actually want and why it's important, oftentimes your ask has to be much bigger to honor that desire.

There's a whole method to it in the way that I think about it and the way that I coach my clients and that I encourage everybody else to think about it as well. 

Yeah, and so I guess before we get into really the strategies that coach your clients around in terms of how you utilize these tools in order to help them to get exactly what they want, just even backtracking a little bit, a lot of doctors admit to feeling really hesitant to ask for what they want.

Whether it's a better schedule, remote opportunities, compensation, increases, like, from your perspective, why is asking so hard for physicians, especially when they're already quite accomplished? 

It's the culture. You are taught against it. There was even that recent article, I think it was in the New York Times, about newer doctors wanting change and older  doctors saying that it's impossible.

When you ask for a lighter schedule or you ask for more pay, it is almost like an insult to the people that have gone through it and suffered through who have set up the system the way that it is, where they were able to greatly benefit from it and not acknowledging that it was a system that was built for them and not for us, especially as women in medicine.

So you may get a lot of external feedback that asking is not okay. Especially when it comes to wellness and the ability to not burn out. I recently heard an older doctor talk about how her employee was calling out too much. When you get into it, she called out four times in that year. And it was because she was going through fertility treatment.

So it's like asking for the time off was when you heard her. mentioned this story in the beginning, it was like, she's always out and this is medicine. We just have to show up and she's always asking for this and that. But then when you get deeper into it, she was out for very real reasons. And so when you get feedback like that constantly, I know I can ask, they are going to think I'm lazy.

They are going to think that I'm not dedicated. Patients are going to be upset. We carry the weight of so many other people's expectations. That asking feels like something that is wrong and selfish. So then we don't do it and we're getting externally that, yes, you should not do it. 

So it's a lot of external feedback that is negative around us asking for what we want and many times what we need, even as humans.

As we're moving along in this profession, so that the fear of maybe judgment and fear of getting this criticism or perceived criticism. And I also hear a lot from doctors, just the fear of rejection is really common, especially for people who are used to achieving high standards and what they want and what they receive.

And so. What advice would you give to doctors who feel, you know, they're afraid to hear no when they ask for what they want, and they're afraid of criticism from others for asking for what they want? 

So it depends on the context. So if it's a negotiation context professionally or any other place where you would consider it a negotiation, no is an invitation.

No is just get the no out of the way and then keep going. But a response of no is usually something that should trigger curiosity. Why is it no? What are the objections? What are the unmet needs of this person? Why are they not on your side?

Because in general, as physicians, we're generally good people. You're generally asking for things that are reasonable and Honoring yourself and for your life and for your health and all of those things. So why is this person saying no, and it's your job to just continue asking, to ask sideways, to mainly listen and see what information can I gain from this?

No, just know it is not personal, even though it may feel that way and to just keep going because. The worst thing that could happen is that you hear the 

no. So actually take that no as an invitation to become more curious about why and ask more questions and to get more information that could then lead you into the next step.

Yep. The next step. And which could lead you to, to the yes. And at the very least, You would have some explanation because what I think is worse than the no is the no and the story you tell yourself about why you got the no, because if you have no idea, or it's in your mind that it's because I'm this and this, that's why they said no.

And. It could not even be that. So even the peace, the mental relaxation that you would get from knowing the reason, that curiosity is the answer to almost every question. And it definitely, when you hear the no, because it can either lead you to the next step or a little bit of peace surrounding the situation.

Beautiful. And so what are some of those steps? Let's say after someone does hear the no, that physicians can begin to take either moving forward or even just becoming more comfortable with asking to begin with, whether it's in their personal lives practice setting or they're negotiating with potential clients.

Yeah. So I take it all the way back. And this, I feel like is a step that a lot of people overlook or just don't even know about. Yeah. Perfect. And that's the connection to what you are actually asking and your why. And I usually use the term desire, which I think freaks some people out. They're like, Oh, it sounds dirty or it sounds like a feminine thing.

And so men say they can't use it, but everybody has desires. And anything that you want is a desire. So that's why I like using that term. And it's a little bit sexy, so I like it. So really connecting to that desire, and not the superficial reason, but the deep reason for why you are asking. And example that I like to use is somebody that I helped through this process.

She was asking for reimbursement. for a coaching program that she was in. And when I asked her why I've been paying for it myself, and I want to use the money to travel. I was like, that is a noble reason, but I feel like there's something more. And when we got into it, we found out that this coaching program that she wanted the hospital system to pay for saved her from burnout.

She was going to leave medicine. She had already applied to an accountant. Training program. She was serious about leaving medicine. She was unhappy. Her children were unhappy because she was unhappy. Her marriage was falling apart, but the lessons that she learned from this coaching program saved her and saved her career in medicine.

So when you think about the reason like that, you show up a completely different way to this ask and this negotiation, when you have that, not just in your mind, but in your heart and you are so connected to it. And then the next step is honoring that desire because it is so impactful. Are you asking for enough?

And usually the answer is no. Because if I am honoring myself, then I'm going to ask for way more support with this program. I'm going to make sure that this is an ongoing expense and that I can go to all the in person events and everything like that. So the first step is knowing what it is on a deep personal level, connecting to it.

And then making sure that your ask is honoring that desire. And then you think, okay, let me think about the other person, right? Who are you talking to? And this is the part that I think diverges a lot from traditional asking negotiation. I focus on where your attention is. Either your attention is on yourself and that desire, or your attention is out on the other person and what they would benefit from for this ask.

Even with the two of those, you're still staying connected, but when you're actually in the negotiation, when you're in the ask, you use different language. You use I and me when you're talking about attention all the way in. When you're talking about attention out, you're talking about you and what they would benefit from.

You have to know who is going to respond better to which approach and also know two important things. You keep the approaches completely separate from each other when you're talking about it. But knowing that you can switch, if the other person is not responding well, you can switch and then put your attention on them.

But when you are mixing things up and everything's all confusing, your message can get lost. So that was like a very quick and dirty overview of how I like to think about it and how I teach my clients. It's a very unique way that I just love so much. 

I really love the idea of. Connecting to your desire and your why, because I feel like that's something that we almost have to practice more as physicians.

I feel like it's something that almost gets taught out of us to focus so much on giving and serving others that we really lose a connection to ourselves and our deepest values and what we really want. So I really love that aspect and idea of doing the I, or maybe the you, or maybe even a we. Depending on what that looks like.

I'm wondering for your clients, how do you help them gain the information or knowledge or clarity that they may need to enter into that conversation, knowing which side to start with? Is it the you or is it the I? 

Yeah. And that's really the knowledge that they come in with usually, or that they've asked already and gotten the no, and that's where you get the information from the no.

With this particular client that I'm thinking about, she had a very good relationship with the person who ended up being her CEO. So she knew that this person was a woman, had also experienced burnout. So she would relate deeply to the why and would have responded well. To connecting to it and using that I language because she would be able to see herself in it.

Now, if it was her CEO who really did not care, had his focus very much on the health system and how it would benefit. Him, then it's obvious which one to go and focus on. So there's a little bit of work and research that can be done just tapping into the knowledge you already have. And then from the experiences of having the ask, because a lot of times the, "no" has already come.

Or the no has come sideways where you saw somebody else get a no, and then you're scared to ask yourself, which happens a lot, you just use all of the information that you have available to you. 

You use what you have and gather that information. And I really love how you spoke about enough. Like, how do you know that even when you're asking, are you asking for enough?

I feel like. A lot of times as doctors, we operate in a scarcity mindset, really feeling as though we have to make do with what we have, what we've been given. And so how do you begin to help clients to shift toward a more abundant mindset where they can ask more effectively and ask fully in what they want to get that enough?

Yeah. On the surface. If what you think about asking for makes you a little bit nauseous, then that's just enough. But a little bit deeper, more seriously, is that first step. So when you are so deeply connected to your why, regardless of what you think will be the outcome of this ask, what is honoring that request?

You will know what is enough once you think of it deeply and connect to it deeply and not staying on that superficial level. Another example would be from myself. So I do locums, I'm an OBGYN, and I get called quite frequently for last minute shifts. The hospital is very busy. And one time, very recently, I got called for a shift the day of, and I asked for an incentive, which is not something that a lot of people would do.

And they offered 500, and I hope you don't mind that I'm going to talk about numbers because I like transparency. So they said 500 was the incentive. Now, a lot of people have been like, oh my gosh, yes. They're giving me extra money, but I have to take a step back and think about what is it that is the cost to me, right?

What do I want in this situation? When I think about my desire to just be okay, because that's what it was at that point, because I didn't necessarily need the money. I knew it would be great to have a little bit of extra, but when I think about my value and my level of burnout that I've had in the past, and everything that I would have to give up to go into this.

Shift. I have to get childcare. I have to take time away from my husband. I have to drive. And then this place is very busy. So I'm honoring myself, my desire to be okay. And to not burn out by saying, no, I'm not going to come in for 500. I'm actually going to come in for 2, 000 extra. Of course she was like, no way.

But I knew if I had gone in for less, I would have regretted it, especially because that shift was very busy and there was a shoulder dystocia. There was a hemorrhage, all these things. And what would have happened if I'd said yes? I will be cursing myself every minute of that shift because I did not honor myself.

So when you think about what it is you want and what you have to give up, what does it actually mean to you on a very deep level, not just they need help. And I'm a doctor and it wouldn't take that much to rearrange my schedule. So if you think about it on that superficial level, it's easy to dishonor yourself and your desires and just say okay to anything, but that deep connection will have you asking for enough, and it may seem outrageous to some people, it may even seem selfish to some people, but that is not your concern.

It's really deep because thinking about ways to honor yourself. And to honor what you really want, your deepest, most precious desires. It's just something that I don't think we talk about enough as physicians and especially as women physicians. So it's really beautiful to just even be in conversation about that and to.

Just open up the possibility than ideas for a doc that it's possible to get all of the things that you want and to be able to still care about other than serve, but meet your deepest needs and desires primarily. So if there was one core lesson you'd like our audience to take away about the power of asking, what would it be?

Just the knowledge that it is a superpower, and it sounds  hyperbolic and it sounds silly, but I truly believe that it is a superpower that we all have. Not just women, not just physicians, not just moms, everyone. And The most powerful people in this world. There are lots of reasons why they're powerful, but they also ask unabashedly with no excuses, unapologetically.

And you have that power within you. You just have to use it. You just have to be brave enough. You just have to honor yourself enough because. On the other side of it, there's no telling what benefits you would get from just asking. 

Thank you so much, Dr. Toya. Thank you for sharing with us today.  Beautiful. So you've heard it. If you are trying to ask for something, if you're trying to negotiate, get what you want, honor yourself, reach out to Dr. Toya. And that concludes today's episode of the Physician's Guide to Doctoring.

Thank you so much for joining us and until next time, stay well, be free.  

 Okay, doc, could you stand to listen to the AI-generated version of my voice? Besides that, wasn't it a great episode? Oh my gosh, I forgot how much I love talking about asking, and I actually forgot about this episode until I listened through it, and I was just like, "Oh my gosh, I miss doing that." 'Cause I don't do a lot of asking negotiation coaching anymore, because my current clients have gotten everything they want because I'm a phenomenal coach, and they're phenomenal women, of course.

So it was a pleasure for me to listen back and edit despite the fact that AI tried to change to this beautiful Trinidadian accent. So I hope you enjoyed it, and I will see you on the next episode of Stethoscopes and Strollers.