When I was deciding whether to leave full-time clinical medicine, I asked my most trusted colleagues what they thought. Most of them did not understand why I would leave something I had worked so hard to build. Others suggested I not make a change so early in my career. My family did not understand the new job either, not even my husband. In the end I did it anyway.

After asking so many opinions I still went with my gut. Then why even ask?

I was not asking for an opinion. I was asking for permission. It took me a long time to both realize and admit that.

The asking was not the problem. The problem was that I did not know what I was doing while I did it. I thought I was running an analysis. I was running an audition, and I had already picked the winner.

I heard it in someone else differently

A colleague called me while I was sitting in a Walgreens parking lot, waiting on a prescription for my daughter. It was dusk and the South Florida sky was turning the color of orange and raspberry sherbet, the scoops melting into one another. We had worked closely together for years. In all that time she had never once called to ask my opinion about anything.

“I have this opportunity to apply for a new position that has opened up. I never intended to go for something like that but it seems like the most natural next step for me.”

The benefit of the job was a change in title, and really nothing more. The downside was giving up most of what she had spent her career building.

She is one of the most driven, goal-focused people I know. Motivation has never been her problem. But she did not sound like someone weighing a decision. She sounded like someone asking for a signature. From me.

I chose not to give her my opinion. I honestly did not know what to tell her. So I asked questions instead.

What is it that you feel this job will give you that your current job would not? A title, notoriety, recognition of the ability to reach that level.

What is it that you would miss about your current job? Everything. I am very happy where I am.

To me the answers pointed in an obvious direction. In her own mind, until she said them out loud, that direction was completely hidden from her. In fifteen minutes she went from wanting something bigger to seeing that she was already in the right place. The prize had never really been the job. The prize was being wanted, and being chosen.

I did not find that for her. I just kept her in the room with it long enough for her to find it herself.

We shop until we get the answer

Watch what happens the next time you ask someone for direction on a decision and they tell you something you did not want to hear. You do not change your mind. You go find someone else to ask, hoping the first answer was a one-off.

If you wanted information, one credible answer would be enough. When you want permission, you keep asking until you get it. A colleague, then a mentor, then your sister, then someone at a conference who barely knows you. And when you finally hear the answer you were after, you hand that one voice all the weight in the world. That one voice wins against all the others.

We also edit the background and the question for our audience, consciously or not, to help mold the answer toward what we are hoping to get. We have been doing it since childhood. We ask our most cautious friend one version and our boldest friend another. By the time the question leaves our mouth it has already been built to produce the answer we wanted.

Three tells

First, you already know which answer you are hoping for. Notice the small drop in your chest when someone hands you the other one.

Second, you keep asking. This is the one I still do, even knowing the pattern I fall into.

Third, the question changes with the audience. If the sentence shifts depending on who is across from you, you are managing the response, not seeking it.

If all three are true, stop collecting opinions. You are not short on data. You are short on self-confidence.

What to do instead

Before you ask another person what they think, write down the sentence you have not said out loud. One line, no hedging. The actual sentence, in the plainest words you have.

Then answer three things underneath it. Who, if anyone, have you said this to? What would change tomorrow if you said it out loud? What are you afraid it would cost you?

Writing it down is not a commitment. It is not resigning, not applying, not telling anyone. You have permission to look at it and decide not to move. That is a decision too, and it is a better one when you make it on purpose.

Then look at the question itself. Is it a yes-or-no question? If it is, change it to one that asks what. Instead of “Should I quit,” which sounds like the real question and almost never is, ask what is intolerable here. What am I trying to run away from. What is it that this new position will give me that the old one does not. What am I running toward.

Those answers lead to completely different decisions. One of them is a new job. The other one might be a conversation you have been avoiding.

Lauren Fine is a board-certified allergist-immunologist and the founder of Permission to Change, a coaching practice for high-achieving women and physicians who feel stuck in lives they built to other people’s specifications. Her work centers on ikigai and the quiet but costly difference between the rules we inherit and the ones we choose for ourselves.

She is an associate professor of medical education and assistant dean of clinical skills education at Nova Southeastern University’s Dr. Kiran C. Patel College of Allopathic Medicine, and she still sees patients at the Miami VA Medical Center. She holds a faculty appointment with the Harvard Macy Institute.

She brought her ideas about ikigai and self-authored change to the TEDx stage in “Permission to Change: Finding Your Ikigai,” and she continues them each week on her Substack of the same name, a running exploration of what it means to give ourselves permission to make changes. Her scholarship spans medical education, clinical skills assessment, narrative-based medicine, and physician well-being, with work appearing in Cureus, Academic Medicine, Medical Science Educator, and the Journal of Allergy and Clinical Immunology.

She writes, coaches, and connects with readers on Substack and shares updates on Instagram.