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Coaching in Medicine

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What is it about physicians? The stereotype of the brilliant and bold surgeon who reigns over the operating room whose mantra is “A chance to cut is a chance to cure.” The ever-smiling pediatrician wearing a bowtie with small elephant on his stethoscope. And the pipe-smoking psychiatrist, steeped in Freud and saying little. None of whom listens to anyone without an MD, and often not to them. Many physicians have life and death in their hands – literally. As physicians our training is to “fix it.” Jerome Groopman shares with us that doctors usually get it right. Sometimes they don’t. “Most errors are mistakes in thinking. And part of what causes these cognitive errors is our inner feelings, feelings we do not readily admit to and often don’t realize.”

My work in coaching physicians lives at the interface of what they know – getting it right – and what they often don’t realize – that being an effective executive leader requires additional skills and moving from linear to complex thinking. Once they realize the value of coaching in getting them there, they are ideal clients. Meet them where they live, in science. Show them the evidence, the research and they’re ready to go.

Years ago I coached an energetic, fearless surgeon who was failing badly in a new role. He was a skilled technician, performing procedures on desperate patients, often saving their lives after other surgeons had given up. He had been a rising star in an academic medical center where surgeons ruled and often were less than tactful with their colleagues, surgeons and non-surgeons alike.

I met this doctor after the CEO of a more cordial medical facility recruited him to be a department chair.  Intra- and interprofessional relationships mattered at the new organization. Employees stayed forever, dedicated to the mission of putting patients first.

He was tasked to turn a failing department around, to update technologies and offer new services—big and important challenges. My coaching client had started his tenure by immediately making changes, without spending The First 90 Days (one of the first books I asked him to read) or learning the new culture and its people. His approach came from the stereotypical academic medical center, which means it was long on telling and short on listening.

He had been hired to “turn the department around” and he was doing just that in the style of the organization he had been recruited from. That old methodology of succeeding wasn’t working in the new system. He was bewildered by the switch in attitude toward him, by his colleagues complaining about him and his style. When I met him, I was the latest in a series of coaches, some of whom believed he was misguided and others who believed he was uncoachable, a lost cause.

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5 Comments

  1. Gautam Gulati

    November 26, 2014 at 12:49 pm

    Well said, Maggie! This is a very important field that needs even greater attention. Medical professionals are prized resources that are often overlooked by the system. They need to be further nurtured to help ‘lead’ us in a dynamic and rapidly changing health environment. To prevent burnout and dis-satisfaction among physicians, we need to coach our greatest thinkers to also become the greatest leaders. Glad folks like you are on the case.

    Reply

  2. Joe Bormel

    November 26, 2014 at 1:21 pm

    Margaret,
    Fantastic article, in style (the story), substance (recommended paths with clear outcomes and references), and a rallying call (for leadership and management.)

    Based on my prior experience, especially with the wonderful works of Michael Watkins you referenced, I’m further persuaded by the validity of your recommendations. If I were to add one note, it would be on the critical need for weekly one-on-ones between executives and their subordinates. This goes a long way in achieving effectiveness. Failing to do this, often through a failure of self-management (with a component of time managment) is “the noise before defeat.”

    Again, great article. Thank you.

    -Joe

    Reply

  3. Diane Scott

    December 15, 2014 at 1:50 pm

    Margaret,
    Well stated. When speaking of the value of coaching, physicians and healthcare organizations may be reluctant to buy-in to the measurable outcomes that come about with increasing the capacity of physician to team build and develop superior relations. You spoke well of the data: demonstrating the data to physicians who were raised to assess data, then implement results speak to the process by which they were schooled. It meets them where they are at and helps advance their practice for their own well being and the patients they care for-
    Well done!
    Diane Scott
    iOpener Institute

    Reply

  4. George Anderson

    May 12, 2015 at 12:45 pm

    This is an excellent article. I coach physicians who are often mandated to coaching for impulse control/anger management.
    I find the use of stories both positive and negative from healthcare to be effective in getting buy in for reluctant participants.

    I also use Pre and Post EI Assessments along with client workbooks focused on skill enhancement in emotional intelligence.

    Reply

  5. George Anderson

    May 12, 2015 at 12:45 pm

    This is an excellent article. I coach physicians who are often mandated to coaching for impulse control/anger management.
    I find the use of stories both positive and negative from healthcare to be effective in getting buy in for reluctant participants.

    I also use Pre and Post EI Assessments along with client workbooks focused on skill enhancement in emotional intelligence.

    Reply

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