I know you have experienced this. You have been in a conference or at the scope with colleagues when someone asks you a question or wants a diagnosis or perhaps your philosophy of how to make a particular diagnosis. Often, my answer is "I have no idea".

This has been a problem of mine since I began practicing in 1982. It is downright embarrassing at times, because if I have some time to think, I usually can propose a diagnosis or a differential diagnosis. It is particularly embarrassing, however, in conferences attended by numerous colleagues.

Why does this happen? I am no psychologist or psychiatrist, but my sense of it is that it is simply not like regular practice where I will sit back and think for a few minutes in the privacy of my mind -- without all the distractions. Almost always, when there is time for a few seconds to pass, a potential solution will occur.

I am curious to know whether others reading this blog experience similar problems and what they do to override or combat them. I can envision a few potential solutions, to wit:

1. Anticipate the question. This is not always easy to do at the scope, but it is possible in conferences where data is presented. Oftentimes there are a few minutes to prepare mentally.

2. Redirect the question with a question (to give you time to think), such as "Will you please clarify your question?"

3. Simply admit that you don't know, but will get back to the group at a later time (admittedly a difficult position to be in).

Please follow-up with me below. I am really curious to know your experiences.