Back in November 2021, I wrote a piece about learning to say no to vendors. At the time, I was receiving around 400 emails per business day, a couple dozen phone calls, and a handful of LinkedIn requests—all from companies wanting “just 30 minutes” of my time.
I made a resolution then to be more protective of my time. I internalized the idea that my time is a resource with real cost, and that spending it on every vendor pitch that came my way was no different than handing out cash to strangers.
It didn’t work.
Despite saying no constantly, I learned toward the end of 2025 that I had taken more Teams meetings than anyone else in my company—including other members of our executive team. This says nothing of the Google Meet calls, Zoom sessions, and other platforms. Somewhere along the way, my “no” had too many exceptions.
The Healthcare Cost Squeeze
Here’s the reality as we embark on 2026. Our costs are going up, just like everyone else’s. Our vendors want to be paid more than last year for the same products and services. Our staff need raises that roughly match inflation, or their standard of living declines. Equipment costs more. Software licenses cost more. Everything costs more.
But in healthcare—unlike most other industries—we can’t simply pass those cost increases along to our customers.
The baseline for diagnostic medical imaging and other healthcare procedures is set by Medicare. Commercial insurance contracts are typically negotiated as a percentage of Medicare rates. When Medicare adjusts its physician fee schedule, that adjustment ripples through to every payer contract we have. We don’t set our prices based on our costs; our prices are set for us by forces largely outside our control.
The math is unforgiving. Our costs rise while our reimbursements stay flat or decline. The 2026 Medicare Physician Fee Schedule delivers a net -2% impact to radiology. We have to absorb those losses somewhere. And we do it by doing more with less—by consuming fewer products and services this year than we did last.
The 2026 Resolution
Therefore, I resolve to say no to every vendor in 2026 that I didn’t specifically reach out to.
Not “no, unless you have a compelling pitch.” Not “no, but send me some materials.” Just no.
The value proposition of your products and services doesn’t matter to me right now. The quality of your sales pitch is irrelevant. You could be offering exactly what we need at exactly the right price, and the answer is still no—because we need to spend on fewer things, not find better things to spend on.
If a product or service is on my priority list to the point that I planned to reach out anyway, we’ll talk. Otherwise, we won’t.
Please Don’t Take It Personally
I know you’re just doing your job. Sales is hard. Cold outreach is harder. You have quotas to meet and families to feed, and I respect the hustle.
But I’m doing my job too. My job is to serve my organization, my team, and ultimately the patients who depend on the healthcare services we provide. Right now, that means being ruthless about where our resources go.
I may be polite about declining. I built a tool specifically to help generate context-aware responses to vendor outreach. But polite or not, the answer is no.
No meetings. No demos. No “quick calls.” No exceptions.
If circumstances change and we find ourselves actively shopping for what you’re selling, I’ll find you. Until then, please respect that no means no.
If you’re an IT vendor and someone sent you a link to this post, it’s not personal. It’s math.