The Surprising Effects of Telling Patients and Colleagues “I Don’t Know”

Cardiologist Kevin Campbell, MD, on a single and powerful phrase that physicians and CEOs have in common.

Recently I read an interesting on leadership published at In this particular story, author Curt Hanke writes about the many positive outcomes found in the three simple words: “I don’t know.” At first blush, we may think that a business leader — let alone a physician — speaking these words would cease to incite confidence. However, as Mr. Hanke demonstrates, the words “I don’t know” can actually provide inspiration and even motivate teams to perform better than they otherwise would have.

As physicians, we lead fellow caregivers with a common goal — the best outcome for our patients. Our teams look to us for confident judgments during crisis (such as during a code blue), and for guidance when making day to day clinical decisions. We also lead patients and their families, sometimes on very challenging journeys through brutal, even devastating diseases. In such instances, being a good leader can be the most important part of our job.

Yet with leadership comes responsibility; the individuals we lead look to us to show confidence and provide guidance in uncertain times. In this regard, the demands are not terribly dissimilar from leading in the business world: We must be prepared with knowledge of the problem and the best available approaches. We must be aware of the strengths and weaknesses of each individual on our team (including ourselves), and we must be able to motivate those in very different roles to band together for common good. On the patient side, we must lead with compassion. We must understand things from others’ perspective, and factor their needs into our decisions. We must lead with honesty.

To both groups, we must be able to say, “I don’t know,” when appropriate. According to Mr. Henke’s article, there are four distinct and powerful effects of this act. Below, I have adapted them to the context of the medical world.

You create possibilities: As a leader, saying, “I don’t know” may create an opportunity to bond with patients, families, and team members. Having the courage to articulate your shortcomings may actually garner more respect and tighten bonds through your honesty.

You spark engagement: By ceding the reins on occasion, you may be providing opportunities for others to take center stage and bring forward ideas that they may have otherwise kept to themselves. You are effectively empowering your teammates to think more creatively and trusting them to find “ownership” in working to solve a particular clinical mystery or treatment problem.

You avoid complacency: Getting stumped on occasion can motivate you to learn more and to be better at your work. Not knowing the answer right away might make you reflect on a particular skill set and evaluate whether the time has come to change your approach. Added benefit: When the leader in a group works to improve, it often inspires growth among team members as well.

You inspire during difficult times: A culture that’s unafraid of “I don’t know” produces engaged team members, and these engaged team members are more productive. Ultimately, of course, a more productive medical team results in more positive patient outcomes.

The most effective leaders know their own limits and don’t try to hide them from the team that is inspired to follow them. Indeed, having the courage to say “I don’t know” may prove the tipping point toward discovering the most accurate diagnosis and prescribing the most effective treatment plan. As Socrates stated, “The only true wisdom is in knowing [what] you don’t know.”

has practiced cardiology for 17 years at both Duke University Medical Center and University of North Carolina Healthcare and has written several books, including “Losing Our Way In Healthcare: The Impact of Reform” and “Women and Cardiovascular Disease: Addressing Disparities In Care.” He is a regular contributor for U.S. News, and also appears regularly on multiple national media outlets, including Fox News, CBS, CNN and MSNBC. Dr. Campbell serves on the advisory board for Healthcare Analytics News, hosts a regular show called “The Clinical Divide,” and serves as a volunteer on annual medical relief missions to remote islands in the South Pacific.

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