Somewhere in our culture we decided that you were incompetent if you said “I Don’t Know.” It’s unfortunate, because it’s created a society that often fakes it when they shouldn’t. That can lead to dire consequences. There’s a real power in saying “I Don’t Know” and we should embrace it. This is true for everyone, but particularly doctors. Here’s an excerpt from an article that talked about this phrase:
As physicians, we aim for perfection. We want to have all the answers. All the time. Especially standing at the front of a room full of more junior learners. But that’s not real life. Every day, we see patients that give us cause to look up something or consult a colleague. This uncertainty and life-long learning needs to be built into, and even explicitly role-modelled in teaching. Not only is it not feasible nor realistic to be prepared for every clinical teaching session, it frankly looks pretty fake when it’s attempted. Sure, every medical resident should have the management of common life threatening problems like seizures and hyperkalemia at their fingertips (which no chief resident would need to prepare in advance), but the diagnostic criteria for rare diseases can (and should) be looked-up rather than portrayed as something that people should just know.
Often, one of the most powerful teaching points that can be made during clinical teaching is to say, “I don’t know.” Not only will it make people appreciate you for your honesty; but it also permits the more junior learner to feel less anxious and less alone.
I still remember my first real job out of college. I was hired to essentially be a backup to everything that my boss did. They wanted her to be able to take a vacation and so I needed to be able to do anything that she could do (sounds a bit like what doctors are required to do when they enter the field). On one of my first days someone came in with a major problem and I had no idea how to solve it. I turned to my boss and asked her how to solve it. I was a bit stressed and worried about getting it fixed. She calmly told me, “John, I don’t know how to fix it…but we’ll figure it out.”
That one moment taught me a great lesson in life. You don’t have to know everything. It’s ok to say I don’t know and you can work to find a solution to the problem.
We should have this expectation from our doctors. They may not know the answer right off the top of their head. We should be ok with that and ok with them making sure they give us the best answer possible. I remember a doctor once telling me that the body of medical knowledge is so big that it’s impossible for the human mind to know it all. What does that mean? It means that there are plenty of cases where the doctor should say that they don’t know and we should be ok with that. It also means that we should leverage technology to help doctors find the answers to those challenging questions.
As the article states, being able to say “I Don’t Know” shouldn’t let doctors (or us in our own lives) not know how to handle common problems. We need a baseline of understanding and not knowing some things is incompetence and you can’t shield yourself from incompetence with the phrase “I Don’t Know.” If you do, that will definitely catch up to you.
It’s a powerful thing to say “I don’t know, but I’ll figure it out.”