I recently cared for a brain-injured patient who was having side effects from an antiepileptic medication. While trying to figure out what to do for him, I happened upon a colleague of mine (let’s call him Dr. Brain) who wrote one of the leading textbooks on traumatic brain injury, and I asked him, “How long do you need to give someone antiepileptic medications after a gunshot wound to the head?”
Dr. Brain was rushing to a busy clinic and probably running late, but he didn’t seem at all annoyed by my question. He stopped and gave me a thoughtful look.
“There’s no easy answer to that question,” he said.
“Oh,” I said, disappointed. (I had been hoping for an easy answer.)
“Of course, we know that seizure prophylaxis can prevent early post-traumatic seizures,” he said.
“Of course,” I echoed.
“But the evidence is far less compelling for late seizures,” he told me. “And of course, for penetrating brain injuries, it’s a whole different ballpark.”
I’m sure there were probably a few very angry patients who would’ve preferred he didn’t launch into an explanation superior to a Cochrane review and instead showed up to clinic on time. But I certainly learned a lot and was incredibly grateful. Dr. Brain is famous for giving informative answers to questions, and every time I ask him something, I wonder why I don’t ask him questions more often.
The fact of the matter is that every time I’ve asked a colleague for advice or information, I’ve found the experience to be incredibly rewarding — and I have a lot of knowledgeable coworkers. Dr. Paul Sax at NEJM Journal Watch calls these conversations “curbside consults” and says, “The pluses of doing curbsides are numerous, and extend beyond just helping our colleagues and their patients. It’s also a way of fostering a friendlier clinical environment, one which generates interesting referrals and open communication among different specialties.”
So Why Don’t I Ask Questions More Often?
There are several factors at play:
I don’t want to look ignorant or inexperienced. When you ask a question, you are essentially admitting that you don’t know the answer. And as doctors, we know everything, right?
I don’t want to waste my colleagues’ time. As much as I loved receiving a 10-minute impromptu lecture from Dr. Brain, I understand that he is an incredibly busy man, and it isn’t his job to be constantly teaching me.
I can look up the answer. With all the great apps I have on my phone and the internet at my fingertips, it seems lazy to ask somebody to spoon-feed me information.
Upon reflection, I don’t think that any of these are really legitimate reasons.
Are There Benefits to Asking for Advice?
Let’s take each one of these reasons for not asking for advice in turn and find out.
1) Does asking for advice cause others to see you as ignorant?
Every time I ask a colleague a question or for advice, they seem thrilled to have been asked. And I always love it when somebody asks for my advice. I’m not alone. Studies have shown that people think better of you when you ask them for advice, mostly because being asked for advice gives the other person a self-confidence boost, which in turn enhances their opinion of the advice seeker.
2) Will asking for advice waste people’s time?
The gripe about wasting their time is more legitimate perhaps. These days, doctors are busier than ever, and there isn’t as much time for knowledge sharing. The way I have dealt with this in the past is to try to ask questions at the other person’s convenience. For example, as a new physician, I worked with another doctor who was a wound management expert, and instead of bombarding him with questions when he was busy with other things, I tagged along while he made rounds in order to learn from him and ask questions when relevant. Obviously, this took up a lot of my time, but in the end, it was very rewarding.
3) Is the internet a better source of information than my colleagues?
You might be fine with subscriptions to journals and UpToDate, but I think everybody benefits from the hands-on training that we receive in residency, and when training ends, we lose that powerful resource for increasing our skills and knowledge. It’s been my experience that my colleagues are happy to have me in the room when they’re doing a procedure, and most patients are very understanding — and sometimes thrilled — to get the attention. If you’re in solo practice, it’s still worth trying to benefit from a kinesthetic way of learning: there are plenty of CME activities that provide hands-on demonstrations. For a solo practitioner, it’s well worth the extra money and travel.
Does Asking for Advice Get Harder as We Get More Experienced?
When I was brand-new out of training, it was easier to ask for advice. The longer you’re out of training, the harder it gets, because you feel like you’re expected to know everything and that you can only ask people who are older and wiser than you for advice. Except the truth is that people right out of training might be some of the best ones to provide information on the most up-to-date treatments. We’ve all met doctors who have been in practice for many years yet seem unaware of the latest treatment recommendations, and that’s not what I want to be.
Asking a coworker for help or advice might involve swallowing your pride a little and admitting that someone else knows more than you do. However, other doctors are a valuable source of learning, and if you’re lucky enough to work in a practice with knowledgeable physicians, you’d be doing yourself (and your patients) a disservice by not taking advantage of that knowledge base. I’m very thankful to work with doctors who not only know a lot but are happy to share that knowledge.
How do you feel about asking for advice — or about your colleagues asking you for advice?
Sara Cohen, MD, is a staff physician at Braintree Rehabilitation Hospital.
This post is part of the “Lifelong Learning” series. Posts on this topic include:
A Mid-Career Perspective on Lifelong Learning in Medicine, by John Mandrola, MD
Keeping Up with Core Medical Knowledge, by Natalie Levy, MD
Keep Learning Even When You’re Not Studying for the Boards, by Sara Cohen, MD
I Studied for the Internal Medicine Boards on the StairMaster, by Monique Tello, MD
Getting It Done: Four Tips for Learning Efficiently, by Jalan Burton, MD
Firstly, there is seizure predisposition, I have termed sizure Inherited Real Risk, that can be removed by inexpensive Quantum Therapy.
Secondly, when I asked advices about my first woman treated and healed to Neurologists, specialized in treating the sazures, they answered via email very bored by my question: “It is an anecdotal case”. Now, these “anedoctical cases are 5. See http://www.sisbq.org/uploads/5/6/8/7/5687930/rrc_epilessia.pdf
I’ve actually found that the older I get, the easier it is to ask for advice. In the pre-internet age I used to cold call experts when the literature didn’t offer the information I needed. I always got a welcome reception. People are flattered when you ask for their advice, and it can establish a lasting and valuable connection.