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What is Physician Coaching? Coach Training

We have been in a series looking at various aspects of physician coaching. We started with the definition and moved on to the coach and coachee components, the tools and approaches, and the evidence for physician coaching. This week, I want to move the conversation to attempt to answer one of the most common questions I receive. “If I want to receive coach training, where would you recommend?” This will be an incomplete response but, hopefully, give you more understanding. I have only one perspective to give in the setting of hundreds of coach training programs. 

 

A couple of things to help start the conversation. 1. Coaching is an unregulated field. 2. Remember that, to date, most of the positive studies in coaching physicians are grounded in positive psychology and its relatives – strengths and values, appreciative inquiry, etc. I have an inherent bias that coach training should be grounded in those approaches, not just goals, action planning, and accountability. Really, effective coaching engages and expands psychological flexibility. 

   

Coach training can take various forms-

Individual training

Basic – weekend courses, sessions at medical CME conferences, etc. If you look for them, you will find them.

 Formalized certifications:

-University-based – many universities have a certificate coach training program, including Northwestern, Duke, Duquesne (where some of my colleagues trained) and UC Davis - where my friend and former senior resident, Dr. Kelly Derbin obtained her training. She uses her skills both within her organization and outside.

-Coach Training Institutions – these are numerous - literally hundreds. No governing body qualifies when a course meets a "certificate" level. Generally, it implies a more extensive training process than a weekend course. I will highlight just a couple – if I don’t mention one, it certainly does not imply they aren’t great:

1. Life Coach School (LCS). This is where I obtained my first certification. It gives a robust foundational understanding of positive cognitive coaching and emotional processing. Dr. Katrina Ubell was the first physician I knew to train there. She’s been wildly impactful for physicians who are optimizing their weight. I had many of my patients listen to her podcast because the approach was so refreshing. When I was enrolled, we had six months of (1) weekly meetings in a small group with a master-certified coach supervising and training us for an hour, (2) one hour of peer coaching each week with our partner, (3) an hour of video training, (4) reading assignments and (5) worksheets -with coaching evaluations in small groups each month. It concluded with a practicum and written exam. Since that time, LCS has moved toward more of a self-study model, so check with current or more recently enrolled physicians to hear their take on the new setup. If being ICF- credentialed is important to you, it’s a bit harder from this program (but not impossible – more on this later). UPDATE: Fall of 2023 they've changed back to live teaching and cohorts but there seems to be some major changes occurring. Winter 2024. - There is a major overhaul afoot of the entire company. None of us know what training will look like there for the next cohorts.

2. Physician Coaching Institute. Dr. Francine Gaillour runs this organization. They also have a great emphasis on the positive cognitive approach. My friend and colleague, Dr. Corinna Muller, MFM, trained there, and she has impacted many patients and physicians with her skill set. She and I also peer-coached together - so personally, I can attest to the beneficial nature of her approach. 

3. Co-Active Institute (CTI). They are one of the oldest worldwide coach training programs. Well established with an excellent basis in pure coaching principles and positive aims. (I took their Foundations course while I was awaiting LCS to start. If I’m not mistaken, Dr. Gail Gazelle, one of the early leaders in physician coaching, did some training through them.)

4. Wellcoaches. This is one of the most successful coach training programs out there and was cofounded by Margaret Moore who also cofounded the Institute of Coaching at Harvard/McLean. They were innovators in the coach training world impacting sustainable lifestyle changes. The skillset gave tools important in patient care and beyond clinical medicine. I have several colleagues who trained with Wellcoaches, and they are pleased with their training.

5. For what it's worth, I tried to find the training program of Dr. Dike Drummond (the first family physician coach, that is also known as The HappyMD). However, I don't think The Academy of Coach Training, Bellevue, is still around, at least by that name (it has been a while).

6. Other effective physician coaches I know obtained coach certifications from Wayfinder, IPEC, CORE, Healthcare Coaching Institute, and PCCI. Costs and time commitments vary widely. If you're considering a training program, talk to a physician coach who trained there and even consider a coaching session with them. 

-A couple of notable mentions: While not stand-alone full coach skill training programs, they enhance a baseline coach approach for significant gain:

1. Lodestar Trauma Informed Coaching. While many coaching programs offer some tips on coaching around trauma, Lodestar goes the extra mile to focus on best practices. I personally saw my coaching approach improve with the additional training of the Trauma Mitigation Course.

2. Positive Intelligence. Dr. Shirzad Charmain's approach is based on a positive cognitive approach married to mindful presence. I benefitted from the Foundations course. They offer certification, but it does not, in my mind, replace a whole foundation of coach skill training. Several of my colleagues have gone on to earn their certification in PI to supplement their initial coach certifications, and clients love it.

3. Other notable ones include Brene' Brown's Dare to Lead, Martha Beck, Byron Katie, and Gallup Strengths Finders - a few that give additional tools for coaching, facilitating, and understanding integration for your clients. 

-This is a very incomplete list, but I can only speak to what I have experienced or what my friends and colleagues have.

 

Program/System-wide Coach Training

Again – there are likely others, but I will highlight the ones I know of in medicine that will give the basics of coach training to faculty or attending physicians:

Mass General Hospital Coach Training: Dr. Kerri Palamara partners with programs to train faculty to be novice coaches in an evidence-based approach and offers a curriculum for each training year. She uses the same format to train MGH/Harvard faculty novice coaches, which has been implemented in over 40 institutions. In addition to the positive studies with novice coaches for trainees, The Association of Women Surgeons had positive outcomes with this approach, as did the American Academy of Pediatric Surgery. I also have friends at Rush, Duke, and UCLA who have benefited from the program, which only takes about 10 hours or so of faculty time throughout the year. Overall, there were also positive responses from those trained as coaches. My understanding is that this approach was not as successful in coaching the physician faculty themselves. 

Wellcoaches will also come into an organization and train designated persons desiring coaching skills to a higher certified level. In fact, MGH utilized Wellcoaches to certify their physician coaches for faculty physicians at a less expensive rate than hiring external coaches. 

 

Accreditation

If you think of Certification as finishing your residency and fellowship training program, you can think of accreditation as passing your boards. The vast difference is that coaching is an unregulated industry, unlike medicine. There are a couple of accrediting bodies that have risen to the occasion to improve standards and ethics. These entities also review coach training programs and endorse their materials, methods, and ethics. 

 

The two largest ones in the US:

  1. International Coaching Federation (ICF). There are 3 basic levels ACC, PCC, MCC, which have an associated amount of experience and expertise with each. 
  2. National Board of Health and Wellness Coaches (NBHWC)

 

Most of the coach training programs I highlighted above are accredited by ICF and/or NBHWC – meaning that their coursework and some of the mentoring count toward your credential.

 

The Life Coach School is not ICF-accredited. My understanding is that their take on not being endorsed by ICF is both philosophically-principled and fiscally-based. Essentially, Brooke Castillo, LCS's owner and founder, started the company only 10 years after ICF was founded and appointed itself to an accrediting role. She saw no need to prove herself or pay them money to be approved when she felt her results spoke for themselves in an unregulated industry. In fact, many LCS coaches are very impactful and never go on to apply for ICF accreditation. One of the studies I mentioned last week was run entirely by LCS coaches, of which I believe I was the only one who had spent the extra time, effort, and money to gain the endorsement. So indeed, a lack of accreditation does not imply a lack of skill. LCS has also up-leveled its ethics, diversity, and mental health understanding/training over the last few years.

 

That being said, I chose to pursue my ICF ACC credential given the newness of coaching in residency programs, most of which are unaware of the nuances of training. They, therefore, appreciate knowing an independent body has vetted me as a coach. So, I went through the process and grew a bit with amazing mentor coaches. It took additional mentor coaching (time and money), submitting all the training I'd received, a meticulous recording of active coaching hours, a performance review (submitted coaching sessions critiqued by master coaches), documentation of additional course work, an organizational fee, and a written exam.

 

An upcoming potentially sticky issue around accreditation/credentialing is a Physician Specific Competency that Harvard/McLean's Institute of Coaching (IOC) is working on. I see both sides of the issue 1. Physicians can be considered a vulnerable population these days, as our work and training are incredibly stressful and unique. Many feel that coaches need specific skills in working with doctors to avoid harm. And indeed, I talked a couple of weeks ago about some of the EAP coaches that weren't as helpful because they lacked contextual understanding. 2. On the other hand, it does feel like another hoop to jump through and another financial cost similar to the medical MOC process, which we physicians have been dissatisfied with for years. But I'm resigned that it will likely happen, and embrace the pros and cons. 

 

A note about emerging coach hours: for most certifications and all credentialing bodies, coaches must complete a target number of coaching sessions. (Consider it similar to the 1650 continuity patient visits family medicine residents have historically needed to graduate.) Coaches must hit the number and usually do so by reduced or free coaching sessions - if you’re looking for a bargain. Also, make a note to log those hours if you will be credentialing.

 

Okay, I hope that answers most of the questions. I’m not even jumping into the executive, leadership, performance, business, life coach, etc. piece. Different ones emphasize different areas. What I can tell you is that the ones I listed above will prepare you to work with individuals in healthcare.

 

Next week, we will conclude the blog series with how coaching is being used in the GME world and its potential. 

Until then, have a joy-filled week! Tonya

Learn more about my hybrid coaching program for family medicine residencies.

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