What is Physician Coaching? A Definition

I’m starting a new blog series all about physician coaching. We will cover the basics of what physician coaching is and isn’t, what the coach and the coachees bring to the session, the tools, the evidence, coach training, and how it can be utilized in graduate medical training.

Today, I want to ensure we are all working off the same definition of professional coaching.

I always like to start with what it is NOT.

It is not advising.

It is not mentoring.

It is not consulting.

It is not therapy.

All of these roles are critical but different than coaching.

An advisor is someone who uses their expertise to help direct someone toward success. In GME, the expertise lies in understanding and meeting the program benchmarks and ACGME/ABFM requirements, navigating the system within the residency for rural rotations, away rotations, and vacations, mapping evaluations to milestones, milestones to outcomes, and improving ITE scores to increase success odds of passing the boards, and so much more.

A mentor is someone with more experience in a shared career path that helps guide a mentee by imparting wisdom and offering perspective. The mentee looks up to and wants to emulate that person, at least in some regards.

A consultant has the expertise and comes in from the outside to assess and make recommendations for improvement. (Not shown in the image below - they would be in the lower right quadrant)

A therapist is someone trained primarily in the behavioral sciences that helps individuals with a DSM-V diagnosis that is impairing their day-to-day functioning, recover and heal. I do like the analogy of someone down in a hole. The therapist helps them climb up and out. A coach meets them on level ground, or along the positive trajectory out of the hole during the overlapping transition, and asks where do you want to go and how do you want to get there.. A therapist is the expert in diagnosis and developing the therapeutic plan, though they often do such via inquiry. 

I'm a visual person, so I'm adding this modification of a popular visual: 

Coaching, by the official International Coaching Federation (ICF), is defined as:

“partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential. The process of coaching often unlocks previously untapped sources of imagination, productivity and leadership.

We all have goals we want to reach, challenges we’re striving to overcome and times when we feel stuck. Partnering with a coach can change your life, setting you on a path to greater personal and professional fulfillment.”

Dr Kerri Palamara, Associate Professor of Medicine at Harvard Medical School, the Director of Well-Being at Mass. General Hospital (MGH), and the Director of Physician Coaching Program at MGH uses a slide of a stagecoach to explain coaching. The stagecoach is where the word 'coach' evolved (a 16th century Hungarian village know for such quality horse-drawn carriages, they began being called by the name of the village). It is the actual vehicle that takes someone from where they are to where they want to be. She reminds everyone she trains that as a coach, they are not the driver, the navigator, or the destination designer. The coach is the person who simply holds the space to help the individual get to where they want to be. 

One of the biggest points I love to make about a coach is that they see you as whole, capable, and resourceful. They know you have your own best answers and they become your thought partner in finding them. One coachee told me, "You draw the answers out of me." 

So to really try to tie all of these elements up in one definition as if you are the one being coached: A coach  partners with you (there is relationship) in conversation. They hold you in positive regard, create a safe space to explore and mine your thinking, emotions, and actions. A coach will reflect what they hear back to you; give you silence; inquire; and frame/reframe in order for you to generate new insights and perspectives, enhance your mental flexibility, and gain clarity and confidence as you formulate your goals and strategies. All of this grows your capacity to optimize your professional and personal potential and impact. 

Coaching has been around the corporate world for decades. Initially reserved for the leaders of Fortune 500 companies who realized the power of coaching to help those with high-pressure jobs function at their highest level.

It’s been around in medicine for a little over a decade. Atul Guwande, MD, MPH, surgeon, writer, and public health researcher, was among the first to write about it in his New Yorker article, The Coach in the Operating Room, 2011. He realized the impact his tennis coach had had on his proficiency and wondered what would it be like to have one for surgical techniques. Initially, he focused on the technical benefits from a surgical standpoint before expanding to a broader application of coaching in medicine.

Semantics are always evolving. I use the term physician-coach, to imply that the coach themself is a physician. (There is a whole white paper coming out on this soon, stay tuned). However, it is notable that there are others who coach physicians outside of the profession. In my experience, physicians appreciate that their coach understands their context and at least has experience within the healthcare industry. There is a lot less to explain and define. There was a recent paper explaining the competencies needed to coach physicians. As you look through them, you will likely see why physicians gravitate toward physicians. 

My own mentor, Dr. Frank V. DeGruy, former Woodward-Chisholm Professor and Chair
Department of Family Medicine at the University of Colorado School of Medicine had this to say about coaching when I started my journey over four years ago:

“I use a professional coach regularly, and it improves my leadership and decision-making every month. I grew up as a competitive diver, and every diver has a coach. For that matter, every competitive athlete and team, even the best, have coaches. I could not imagine that my professional work, which is infinitely more complex and consequential, would not benefit from expert, professional scrutiny and feedback. It has. In my opinion, professional coaching is the most effective form of continuing education. A professional coach can help you see your blind spots; can help you clarify your decision-making process; can help you build more constructive and therapeutic relationships with patients and colleagues. Engaging a professional coach has been the best professional investment of my career.” 

I believe coaching is a foundational tool to help individuals, teams, and groups who will then influence their local circles, and collectively the larger GME and healthcare cultures so we can all enjoy our chosen careers and impact the overall well-being of our patients. 

I hope this has been a helpful introduction to what coaching is. Next week, we will unpack the various components that the coach and the coachee bring to a session, then in future weeks review the tools,  evidence, and applications of physician coaching in medical education. 

Until then, Have a joy-filled day!  Tonya

Although I primarily partner with family medicine residency programs to coach faculty and residents, I will work with individuals whose program isn't quite ready to have an external coach. Set up a call to discuss.

Original April 2023, Updated 6/2024