The concept of coaching has origins in the business world, but it is beginning to take root across medicine—in medical school, residency and in practice. Physician experts on coaching in medicine explain why it works, who benefits from it, how it can apply to patient care, and how it can help doctors reach the next level in their careers.
The experts spoke at an AMA Accelerating Change in Medical Education meeting hosted by Harvard Medical School. They detailed their coaching success stories and offered insights into the value of coaching in medical schools and throughout the educational continuum.
The AMA is reimagining medical education, training and lifelong learning for the digital age to help physicians adapt and grow at every stage of their careers. The AMA’s “Coaching in Medical Education: A Faculty Handbook” offers a framework for educators and administrators who create programs for coaching medical students.
Here is what the experts had to say.
Steve Adelman, MD, clinical associate professor of psychiatry, University of Massachusetts Medical School; director, Physician Health Services, a physician health program in Massachusetts. We absolutely need a culture of coaching in the medical profession. Because half of what we do in health care is about interacting, managing ourselves and managing other people. ...
We need to train coaches to operate at the medical school level. If you look at what's happening at some academic medical centers, they're already delivering coaching training to the middle cadre of medical leaders who work with practicing physicians on the front lines, and I think the same thing needs to happen with medical education.
Dr. Adelman: In terms of assisting students with significant substance use and mental health challenges, our physician health program, in Massachusetts, is already top of mind in our four medical schools. That being said, where we have really started to create a culture of coaching in medicine is at the level of practicing physicians. And we’re beginning to see a transformation for residents, some of whom come to us in search of referrals to skilled physician coaches. It isn't happening yet with medical students.
Self-referring to our physician health program for help with interpersonal challenges is a welcome phenomenon. It used to be that doctors would come to us only if they were referred because of a problem. These days more than a third of the doctors are referring themselves. But the medical students are so busy that they tend not to refer themselves.
At this point, they are more like the old-school doctors who seek help reluctantly, when there’s serious trouble, like addiction or impairment. Some medical schools have excellent mental health and counseling services, which is great, but that’s not the same as coaching.
Les Schwab, MD; internist, Atrius Health; Harnisch Scholar at the Institute of Coaching: I brought coaching into my exam room, and it has been enormously beneficial. I have gotten people to talk to me about their self-doubt—I'm too fat, I'm too lazy, I can't do it—allowing it to be observed as a barrier to change.
I have found a way to unwind that for them in a way that makes them feel capable. Also, another coaching kind of tool is setting SMART goals—ones that are specific, measurable, achievable, relevant and timely. So, we talk a little about incremental goals: “Your vision [may be] skiing with your grandchildren—and what can you do today?”
Dr. Schwab: Wherever you are at, you're on some rung of your developmental ladder, and you're reaching for the next one. Whether it’s the resident struggling to stay out of the “ejection seat,” the guy struggling to get his charts done, the midcareer doctor learning to revitalize his work, the division chief learning to be an effective leader, or the executive learning to deal strategically with hundreds of people— all have new challenges to master.
It’s always reaching for that next rung up. We need to get rid of beyond the notion of the hierarchy, of who’s higher and who is lower. Coaching [aims to help] you reach wherever your attainment needs to take you.