Tips on Saying 'No' as a Dermatology Leader, With Adam Friedman, MD

At LEADderm 2026, held August 29-30 in Newport Beach, California, Adam Friedman, MD, FAAD, professor and chair of dermatology at the George Washington University School of Medicine & Health Sciences in Washington, DC, led a table discussion on a skill he says gets little attention in clinical training: saying no.1,2

In his interview with HCPLive at the meeting, Friedman spoke on how he built the session around what he calls the power of yes, and even more so, the power of no. He said the topic doubles as a chance for self-reflection, since he considers himself terrible at saying no himself.

LEADderm, founded by Jennifer Soung, MD, was designed to address what organizers call dermatology's missing curriculum, skills such as mentorship, negotiation, and practice management rarely covered in clinical training. Friedman built his table discussion around his own struggle with overcommitment as its starting point, framing career growth as a series of choices about where limited time goes.

"The biggest issue for any of us full-on yes responders is we're afraid if we say no, the opportunities disappear. I can tell you that is absolutely not true, unless you say no in the wrong way, which is also very possible," Friedman said.

Friedman said early-career dermatologists should say yes to nearly everything, since even small opportunities can open unexpected doors. As responsibilities and leadership roles accumulate, he said the same habit dilutes a person's attention across too many commitments and starts undermining their reputation. He added this is not multitasking, since real multitasking does not exist, only a gradual erosion of focus.

His first tip for saying no: never answer on the spot. Friedman recommends buying time to weigh whether an opportunity serves a career or personal goal, and whether it would energize rather than drain. His second approach borrows from shared decision-making in patient care, looping the person who made the request back into the decision instead of delivering an outright no.

Friedman said the approach shifts the burden of refusing away from the dermatologist alone, since the person asking often reaches the same conclusion independently. He added the payoff is being better respected for giving fewer commitments full attention, rather than spreading effort across too many and showing the request was considered seriously rather than dismissed.

Editor's Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Friedman had no relevant disclosures of note.

References

1. LEADderm. About LEADderm: the missing curriculum. leadderm.org.

2. Conference Preview: 2026 LEADderm Conference in Newport Beach, CA. HCPLive. https://www.hcplive.com/view/conference-preview-2026-leadderm-conference-newport-beach-ca.