Coaching in Medicine

During our coaching engagement he grilled me at every step – what was the data? Where was it published? Without the proof of peer-reviewed articles he seemed unenthusiastic and minimally engaged. A turning point came when I mentioned that Coursera offered a free online course in emotional intelligence, taught by Dr. Richard Boyatzis, an excellent and brilliant teacher with a world-class academic pedigree. Four weeks into the course my client said to me, “I didn’t realize there was so much science, such a body of literature, in motivation and leadership.”

And so our coaching continued, as did his questioning – with a difference. Now he had become deeply interested in the process. He met with each of his direct reports, apologized for his behavior and asked all for their suggestions on the future of the department. He began asking “what” questions and then listening for a maximum of three minutes before commenting. He learned to solicit opinions without appearing to attack the offerer. Eventually, and with the help of carefully chosen Harvard Business Review and medical journal articles, he learned to modulate his style to fit the organization and the importance of relationships.^,

I tell this story to illustrate the importance of evidence and of research to those who are schooled in hard science. Behavioral science is different from, say, chemistry, at least at the beginning levels. Variables in “soft sciences” are often measured in a more qualitative, or descriptive manner – measuring behavior, which is open to interpretation. In the “hard sciences” in which physicians train, variables are more amenable to a quantitative, or yes/no manner – measuring things. A quantitative conclusion is more concrete and often not open to interpretation. For example, “The elements combined to make a compound weighing 20 grams” compared with “When subject was confronted with x he did y and the explanation is z.”  There are 20g whether you measure in ounces or kilograms; there are 20g whether you use a digital scale or a balance. On the other hand, the explanation of behavior has a lot to do with whom explains it – what their training and assumptions are. The explanation is subject to variability depending upon the observer, just like coaching – and that is what causes the physician to hesitate, to overthink. Just as they don’t want to risk someone’s life on untested treatments, they are trained to be deeply skeptical of interpretations that are not thoroughly understood.

To get physicians, and other clients, to invest in coaching, I often have to explain the theory and research behind the practice. It is not enough to point to the results and say “It works!” I have to show why—they want to see the data and the interpretation. Doctors want to know the difference coaching can make in their success as leaders.

We know from research that client buy-in, and readiness to change is essential for coaching to be successful. As individual coaches, how can we support physicians and other “hard-science-oriented” clients? As an executive coach for physicians, I typically start with 360 interviews to learn others’ perceptions. Throughout our coaching engagement I share articles and books – the evidence. Since emotional intelligence is often a critical part of my clients’ leadership development, if possible I use the ability-based MSCEIT (Mayer-Salovey-Caruso Emotional Intelligence Test), a valid and reliable instrument that measures the taker’s emotional intelligence in four dimensions (perceiving, understanding and managing emotions, and facilitating thought) and offers suggestions to improve the taker’s emotional intelligence. Validity and reliability are foundations of the scientific method. The former refers to whether the test measures what it says it measures. The latter refers to the reproducibility of the test by other researchers. Physicians often are more trusting of instruments with these qualities.

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