Rebellion in EM 2019: The Most Powerful Words in Medicine via Anand Swaminathan

REBEL EM has been committed to critical appraisal of current research with application at the bedside to improve patient care. The constant influx of new published research makes it difficult to stay current with the latest and greatest. We had our 2nd annual Rebellion in EM conference from June 28th – 30th, 2019 in San Antonio, TX.  The opening keynote on day 3 of the conference was given by Anand Swaminathan, MD on the most powerful words in medicine.

As emergency clinicians, our words matter. Some words, though, matter more than others. Here we explore the most powerful words in medicine, why they are so powerful and how understanding their power can help us develop and grow.

Rebellion in EM 2019: The Most Powerful Words in Medicine via Anand Swaminathan, MD


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Critical Point #1: Medical Professionals are Uncomfortable Saying “I Don’t Know” but, it is Vital to our Development
  • Medical professionals are often “over-achievers” and often have enjoyed uninterrupted success academically
  • Medical culture has a pervasive aversion to admitting the limits of one’s abilities and skills.

Critical Point #2: The Ability to Say, “I Don’t Know”, is Governed by Three General Principles in Cognitive Psychology

  • The Dunning-Kruger Effect: We tend to overestimate our abilities and we are unaware, especially as novices, that we are doing it.
  • Mindset: Saying “I don’t know” isn’t an admission of failure but rather should be recognized as an opportunity for growth.
  • Resilience: Passionate perseverance is critical for development but re- quires us to admit and be comfortable with “I don’t know.”

Critical Point #3: Incorporation of These Psychological Principles into our Daily Lives Allows us to Improve as Medical Professionals and Human Beings


Anand Swaminathan MD, MPH
Assistant Professor of Emergency Medicine
St. Joseph’s Regional Medical Center
Twitter: @EMSwami


  1. Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77(6): 1121. PMID: 10626367
  2. Dweck CS. Mindset: The new psychology of success. New York, NY: Ballantine Books: 2006.
    Dweck CS. Motivational processes affecting learning. Am Psychol. 1986; 41(10): 1040– 1048.
  3. Duckworth A. Grit: The power of passion and perseverance. New York, NY: Scribner; 2016.
  4. ICE Blog: The Most Powerful Words in Medicine: “I Don’t Know”

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)

Cite this article as: Salim Rezaie, "Rebellion in EM 2019: The Most Powerful Words in Medicine via Anand Swaminathan", REBEL EM blog, July 11, 2019. Available at:

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