Refusing a request from a patient or colleague can feel difficult to do, but there are ways to make it easier, Abi Rimmer hears Chris Tiplady, consultant haematologist, Northumbria Healthcare NHS Foundation Trust, says, “You cannot and should not say yes to every request for treatment, tests, or your time. It can be harmful, wasteful, inappropriate—or even illegal. A relationship based on information, openness, trust, understanding, and self-awareness should help when it comes to those difficult occasions when you have to say no to your patients. “‘No’ is one of those short, primal words from very early in language development. When said, it’s invariably accompanied by obvious, often unconscious, changes in your body language and tone. If that denial is unexpected, questionable, or delivered in a paternalistic way we should not be surprised by the similarly primitive emotions like anger and sadness such a word provokes. The doctor-patient relationship is too important to risk, it must