Leadership in medicine is hard work. Physician leaders are asked to guide teams, support colleagues, manage change and make decisions that affect patients, doctors and the organization. They often do this while staying connected to clinical care and navigating the same pressures facing the physicians they lead.
At Colorado Permanente Medical Group (CPMG), coaching has become one way to support those leaders and make leadership more sustainable.
The idea is not to reserve coaching only for executives. It is also not to frame coaching as remediation. Instead, Colorado Permanente Medical Group leaders describe it as a practical investment in people who are doing complex jobs.
“It’s very normalized, and it’s not seen as needing help,” said Lise Barbour, MD, vice president of people and culture at Colorado Permanente Medical Group. “This is the cost of doing business. These are really difficult jobs.”
For Colorado Permanente, coaching is part of a broader physician well-being strategy that includes leadership accountability, annual measurement, wellness-centered leadership training and efforts to embed well-being into everyday operations.
Colorado Permanente Medical Group is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Normalize coaching
Colorado Permanente’s coaching work began with an internal executive coach. The internal job was phased out over time, but the coach created her own consulting company while staying connected to the organization.
That relationship helped Colorado Permanente Medical Group continue offering coaching with a company that already had a solid foundation of knowledge about CPMG and its culture and complexities. More importantly, it helped the organization broaden how coaching was used.
“At that time, we started saying, coaching shouldn’t just be for upper-level leaders,” Dr. Barbour said. “It should be for any leaders who are needing support.”
The organization began funding about 20 or 30 coaching engagements a year for leaders at different levels.
That expansion reflected a broader belief: leadership development and well-being are connected. Leaders who are supported may be better positioned to support their teams, respond to concerns and model sustainable ways of working.
The AMA’s Joy in Medicine® Health System Recognition Program includes leadership among its six domains for organizational well-being, along with assessment, commitment, efficiency of practice environment, teamwork and support.
Learn what scales
Like many organizations, Colorado Permanente Medical Group tested whether group coaching could help scale support.
In 2021 and 2022, the organization experimented with group coaching. Dr. Barbour even presented a poster on the work with the coach at the American Conference on Physician Health®. The experience had value. People who attended had a positive experience, she said. But the format did not scale as well as leaders hoped.
The barriers were practical. Fixed meeting times were hard for busy leaders. Participants were not always able to be fully present in the virtual setting. The sessions had to be virtual because of the COVID-19 public health emergency and the organization’s geographic spread.
“What we learned is that having fixed times for people to have to show up and attend group coaching sessions was really difficult,” Dr. Barbour said.
Ultimately, Colorado Permanente stopped group coaching and doubled down on one-on-one coaching.
That willingness to pivot is an important part of the story. The organization did not abandon coaching because one format was imperfect. It changed the format to better fit leaders’ needs.
Use data carefully
Colorado Permanente Medical Group has also started using data to offer coaching more strategically. The group embeds the Mini Z survey into its annual physician engagement survey. The Mini Z is a validated tool that can help organizations assess burnout and other parts of professional well-being. The AMA STEPS Forward® toolkit on burnout assessment includes the Mini Z among other validated tools.
Using team-level engagement data, Colorado Permanente identified teams that could benefit from additional support with engagement or burnout. Leaders of these teams were offered coaching to give them tools and a thought partner to help them shape improvement strategies. Dr. Barbour said the organization is now funding coaching for about 20 or 25 leaders who are growing their leadership skills in managing engagement and burnout.
That required thoughtful communication and emphasizing coaching as an additional tool for leaders.
“We had to phrase that sensitively,” she said. “But most of the leaders were really enthusiastic about it and very excited to take advantage of that.”
That response suggests coaching has been positioned in a way that lowers stigma. Leaders are not being singled out as failing. They are being offered support to help them succeed. The coaching is fully funded in the organization’s strategy budget.
As the leader in physician well-being, the AMA provides organizational solutions that help physicians and health systems optimize practice efficiency, reduce burnout, and rediscover the Joy in Medicine.
Model it from the top
Senior leadership support has helped normalize coaching across Colorado Permanente Medical Group. In fact, Dr. Barbour said the organization’s past three CEOs have had dedicated executive coaches and were open about using coaching. Upper-level leaders also use coaches at different points during their terms. The board chair has a coach, and new board directors are offered access to coaching as well..
“Our upper leadership is 1000% bought into coaching,” Dr. Barbour said.
That visible modeling matters. It sends a message that coaching is not only for new leaders or leaders facing challenges. It is a tool for continuous improvement.
Some senior leaders also share well-being and sustainability goals with the organization.
“It’s really modeling like everybody needs this sort of help and support, and we’re all working to continuously improve,” she said.
That type of modeling can help make well-being part of leadership culture, not a separate initiative.
Support new leaders
Coaching also supports physicians as they step into leadership roles. Colorado Permanente has started wellness-centered leadership training as part of a broader leadership training program. The first cohorts have already taken part.
“It aligns so well with investing in the success and future of our teams,” said Heidi Clune, MD, wellness director at Colorado Permanente Medical Group.
For Dr. Clune, coaching was personally powerful as a new leader because it gave her tools she needed in the role.
The value is not only technical. It also helps communicate that leadership is difficult and that the organization is willing to support people who take on those roles.
That message can matter when physicians are considering leadership. They may be more willing to step forward if they see that coaching, training and peer support are part of the role.
It is powerful when people who have gone through coaching and moved up in leadership can endorse that support to others, emphasized Dr. Clune.
Choose external support
Colorado Permanente has considered internal coaching models. Some leaders completed coaching certification, and the organization funded about five professional staff members, including human resources business partners, to become certified as coaches.
Still, Colorado Permanente has continued to work with an external coaching partner.
Part of the reason is opportunity cost. Dr. Barbour said leaders have asked whether physicians should be trained as internal coaches. But pulling physicians out of clinical work to coach colleagues carries its own tradeoffs.
The other reason is psychological safety. Even when internal coaches follow strict confidentiality, some leaders may feel safer talking with someone outside the organization.
“There still is that sense of, ‘I’m talking with this person who’s not even in my company,’” Dr. Barbour said. That distance may allow leaders to be more open about challenges and growth areas.
What to do next
For health systems looking to strengthen coaching, Colorado Permanente’s experience suggests several practical steps.
Start by defining coaching as leadership support, not remediation. Make it visible from the top. Build it into the budget. Use data carefully to offer support where it may help most. Be willing to test formats, but change course when a model does not fit physicians’ real schedules.
Most of all, connect coaching to the larger goal: helping leaders build sustainable careers while supporting the physicians and teams they lead.
AMA STEPS Forward offers real-world solutions to common challenges in healthcare today. Explore a variety of innovative, physician-developed resources designed to help prevent physician burnout, optimize workflows, improve well-being and enhance patient care.
