TL;DR
- Purpose: Knowing when and how to ask for help is one of the most important skills you’ll build in your first year. There’s a difference between being inexperienced and being lazy.
- First question to ask: Is this something I can answer myself with the right resource, or does it actually require another person’s judgment?
- Don’t miss:
- Asking too often, for things you could have looked up, signals poor preparation
- Asking too little, trying to look competent, is how patients get hurt
- The questions you ask should be the ones that genuinely need a human answer
- The rule: Do everything in your power to answer the question yourself first. Save interrupting your colleagues for the ones you can’t.
- In the app: Filling the gap between what you learn with experience and what is truly complex is why we built Blox. Before you go straight to your colleague, run the scenario through Blox IQ and figure out exactly where your uncertainty is. That way, when you do need to ask a question, you’re asking something specific.
There’s a big difference between being inexperienced and being lazy. Regardless of what industry you work in or what kind of support you have, there will always be a learning curve when starting a new job. Especially when it comes to medicine, you simply cannot know how to do everything, and there’s so much variability in how we manage patients. We can romanticize the idea that for every patient we should have a definitive, confident answer, but that’s just not how the real world works.
One of the things I struggled with the most as a new provider was figuring out when to bother my collaborating physician and when I just needed to handle it myself. The ER I worked in was staffed by one physician and one to three APPs at any given time. This was not a teaching facility, and we had no residents. If I had a nasty fracture I wasn’t sure how to manage at 1am, it was a toss up between waking up the on-call ortho (fun) or interrupting my doc, who was managing multiple transfers and level two patients.
There’s a balance between asking too much because you’re terrified and battling imposter syndrome, and not asking enough and risking poor management. This happens to everyone. MD, DO, PA, NP, RN, CRNA, doesn’t matter. Here’s a few things I’ve learned.
Why You Can’t Just Ask Every Time
Your colleagues have their own patient load. They’re not standing around waiting to be interrupted. For the most part, they want to help you, but they also need to do their job. If you’re going to interrupt them, it needs to actually require a more experienced perspective.
Not “does this UTI in a non-pregnant, healthy patient need a urine culture?” Not “when should this person see the orthopedist?” Those questions have answers that don’t need a human. The cases that need a human are the ones where the patient is medically complex or you’re genuinely uncomfortable because your gut is telling you something isn’t right.
There are Two Ways to Mess This Up
Version one looks like asking too much. The new grad who interrupts every fifteen minutes with something they could have looked up, or who has zero confidence, or who asks the same question twice because they didn’t write the answer down. This type of provider erodes trust fast because it signals you’re not making a sincere effort before you interrupt.
Version two is the opposite. The provider who never asks, who makes calls they’re not confident in rather than admit they don’t know what to do, who guesses when they don’t have to. This provider’s ego will get them in trouble 10/10 times.
The goal is somewhere in the middle. Exhaust what you can figure out on your own first, then ask clearly and ask once.
What “Do the Work First” Actually Means
“Come prepared.” “Know what you’re asking.” Right, okay, but how?
Before you interrupt someone, think about the information they actually need to help answer the question. Say you have a 20-year-old male who had a mountain biking accident. It really doesn’t matter that he’s had a cholecystectomy, that he takes hydroxyzine for sleep, or that he lives with his mother. If you’re calling ortho, or asking your SP, give them the need-to-know info.
“I have a 20-year-old male who had a mountain biking accident. I scanned him and he’s ok except for this nasty, closed, comminuted distal tib fracture. Here’s his imaging. He’s neurovascularly intact and feeling better after some pain meds. I’m planning to put him in a long leg splint and have him see Dr. X tomorrow. Does that sound reasonable to you?”
You should be able to clearly state what the presentation is, what you’re thinking, what you’ve already considered, and what specifically you’re uncertain about. Not “I’m not sure what to do with this patient.” That’s not a question, and it wastes everyone’s time.
Another solid question sounds like: “I’ve got a 38-year-old with a 4mm ureteral stone, pain controlled, no fever, creatinine normal. I’m thinking discharge with tamsulosin and pain meds and have him see urology in a week or so. Does that sound reasonable?“
That takes thirty seconds to answer. It shows you’ve done the workup, thought about it, and landed on a plan. It gives the person something specific to react to, and over time, it builds trust because the person you’re asking knows you’re actually thinking about this.
That prep doesn’t have to be long. With the right resources, it takes a few minutes: confirm your management, check the referral indications, identify what your specific question is. That’s it. It’s also exactly why we built Blox. Not as a replacement for clinical judgment, but as the resource you check before you walk back in the room or before you find your attending.
When You Do Ask
Be direct. State the case briefly, what you’re thinking, and what you’re uncertain about. Don’t apologize for asking. “Sorry, I know you’re busy” tells them you’re not sure the question is worth asking, which makes the whole exchange less confident than it needs to be.
If you received feedback on a similar case before and you’re applying it now, say so. “Last week you told me you like to manage patients with condition X by doing Y. I’m seeing something similar today and here’s what I’m doing differently.” That shows you’re building on what you’re learning.
And if you were wrong about something, own it. “I called it X but it was Y. Here’s what I missed.” No one expects you to be right every time but they do expect you to be honest when you’re not.
The best way to build a strong reputation as a new provider isn’t to never ask questions, it’s to ask the right ones. When you need something to bounce your thinking off of before you walk back in the room, pull up Blox. Use it to work through the case, review red flags, clinical pearls, and differentials, and figure out where your uncertainty actually is.