The Path to Physician Coaching

So, you’re in the middle of a dilemma and you’ve heard about this thing called physician coaching that some people engage in to work through their quandaries. But, you’re not sure about it. What is it like to be in coaching? Several images come to mind when you contemplate the term: a basketball coach cheering from the sidelines, the scholarly coach of a college debate team forwarding readings, or the literal vehicle – a coach - that transports tourists from site to site. Physician coaching has elements of all of these, but the common feature is forward movement toward a goal.

Succinctly, coaching takes clients from their present state to a future state through:

1) defining the outcome that the client wishes to get from coaching;

2) illuminating the barriers that prevent them from attaining that goal;

3) determining steps to take to overcome those barriers;

4) taking those steps; and throughout

5) developing insight with the goal of sustaining gains made in the process.   

A coach does all the above through reflective inquiry – a process of questioning, reflecting back your responses, then further questioning to allow you to see yourself in a new light. Reflective inquiry uncovers beliefs, perceptions and values that function either as roadblocks or promoters of progress. The insight you develop from this process allows you to see a way out of your dilemma. Next, the coach facilitates a discussion to develop a plan for achieving your goals and, most importantly, to sustain that growth. Note that coaching does not involve diagnosing problems or giving advice. A coach is a thought partner and insight facilitator.

While the description of coaching above sounds linear, like most growth and development that sticks, it is actually more serpentine, iterative, and contemplative. As these states can, at times feel unsettling – especially for physicians,  the coach’s job is to create an environment where you feel safe and can trust that solutions will emerge, through insight developed from coaching, for you to be successful.

Here is a case example to illustrate:

Dr. B., a general internist in a health care system outpatient practice, turned to coaching because she was burning out from the way she was expected to practice medicine in that system. Seeing 25+ complex patients per day required at least 2 hours of work per night after clinical hours. While she loved the patients, she saw the way that she had to practice as unsustainable for her health and her relationships with her spouse and children. In coaching she uncovered a limiting belief that she could only achieve financial security if she worked as an employed physician. Further, she came to realize that what really, really mattered to her professionally was to engage meaningfully with patients – which meant taking the time they needed, not the time she was given. With these and other insights gained, she determined that she needed to explore other models of practice that could provide both reassurance that she would be okay financially as well as be able to practice in a more fulfilling manner. After said exploration, meeting with a financial adviser, and processing all of it with her spouse, she decided to join a direct primary care practice where her income is less, yet adequate, and her satisfaction with her professional life exceeds her expectations!

While Dr. B.’s coaching story sounds tidy, she would tell you that there were days and weeks of discomfort, anxiety, and second-guessing. However, she would also share that, through coaching, she implicitly trusted the process because she learned to trust herself and what she valued.

Clients often describe coaching as a journey of self-discovery.  While it is not always comfortable to come face-to-face with ourselves, with the awareness that develops conscious decisions are made towards aligning one’s self with their unique path. Ultimately, that is what allows us to thrive. And, when we are thriving so are those around us – our patients, families, and our colleagues.   

Dr. Waxman is a Professor of Family Medicine at Atrium Health in Charlotte, NC.  Previously Interim Chair and Vice Chair of the Department of Family Medicine, he continues on the faculty there as well as serves as the Medical Director of Physician Well-being for Medical Education for Atrium Health and Medical Director of Patient-Centered Programming at Atrium CMC-Mercy. Dr. Waxman served on the Board of Directors for Planetree International, an organization committed to exceptional person-centered healthcare.