Chief Complaint: "Should I Say No?"

No.

👆 a complete sentence.

But still a hard one to get out, especially when you are cursed blessed with:

• Passion

• Curiosity

• Brains

• Skills

People keep dropping interesting project ideas on your front stoop like a cat drops dead mice. And sometimes, you’re about as happy to see them.

You’ve heard the aphorisms plenty:

• “Your ‘yes’ can’t mean yes until your ‘no’ means no”

• “Every 'yes' is a 'no' to something else. Choose wisely.”

• “Boundaries are built one 'no' at a time.”

You get it.

But sometimes a ‘yes’ project looks a lot like a ‘no’ project, and vice versa. How do you tell the difference?

The 100x Rule

I stole borrowed this from Josh Spector. I’m subscribed to his For the Interested newsletter and get a lot out of it.

It’s simple: only commit to something if you’re willing to do it 100 times.

Here’s why:

1. Forces long-term thinking

   Most things worth doing take time. Impulsively saying yes to a project that will/should take 5 years is a great way to make future-you hate current-you.

2. Gives you room to get better over time

   A common pathology among healthcare professionals is the need to do things perfectly from the jump. But that’s a ridiculous way to move through life. It’s freeing to start from the assumption that you’ll have 100 tries to get it right before you turn off the lights.

3. Gets you through slumps

   It’s never going to be smooth sailing all the way through. Before ER, George Clooney defended the world from a second invasion of killer tomatoes. I doubt that was his dream role, but I think we’re all glad he kept on acting.

4. A measure of progress

   Data-based decisions are good. But when you are just starting out, you usually don’t have much data. And whatever you do have is too limited to count for much. So simply counting the number of times you’ve done something can be a good initial metric.

5. Tests your enthusiasm

   Are you really excited about the idea, or is it just shiny and new? If you can’t commit to 100 dates, I wouldn’t propose marriage.

This is my 19th newsletter issue. Which means I have at least 81 to go!

81 is a big number, but rather than being daunted, I’m comforted. This newsletter has changed shape and length a few times already. It’s evolving. It didn’t start perfect, and it isn’t perfect now. But over the next 81 issues, it’ll get a whole lot closer!

Is the 100x Rule always applicable?

I think yes, for the most part. But you might have to interpret it a little differently, depending on the situation.

For example:

• “Want to co-author a paper on this with me?”

  • Are you willing to…

    • Edit the draft 100 times?

    • Read 100 papers for background/sourcing?

    • Give 100 pieces of feedback to the first author/trainee you’re helping?

• “Will you take over the QA curriculum for the residents?”

  • Are you willing to…

    • Create 100 session plans?

    • Review 100 QA project proposals?

    • Lead 100 RCAs?

• “Can you Chair this committee?”

  • Are you willing to…

    • Lead 100 committee meetings?

    • Respond to 100 emails from committee members?

    • Approve the minutes from 100 meetings?

I think you get the idea.

Plan:

• Sit down with a pad of paper and write a list of the projects/ideas that you could pursue, now or in the new year.

• For each one, think of a way to apply the 100x rule.

• Cross out (and politely decline) any that fail the 100x test.

• Wait for future-you to thank current-you.

Spot Check:

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