Dear Director,
I’ve been a medical director for a few years and have done some leadership courses, but I feel like I’ve reached the point where getting one on one coaching may help me reach my potential. What options are out there for me to consider?
Although leadership courses and even self-guided learning by reading can elevate your management and leadership game, there does come a time where many of us have benefitted and learned by getting outside our own heads and gaining outside expertise and perspective.
Depending on your own situation, you may be able to get feedback and discuss issues with your chief medical officer, a hospital system medical director, or even some sort of regional vice president if you’re in a large group. On the other hand, what I’ve found is that being a medical director can be a lonely job. You can’t be too transparent about issues and asking for help with any of those potential resources I mentioned because you may end up seeming needy or not competent. Even your immediate boss may not have the time to spend with you to sort out a problem and help you grow. Often, I’ve had conversations with people above me who just want to tell me what to do without a complete understanding of the problem or a desire to help me figure out the best solution.
There are several types of professionals who may be able to help, including mentors, consultants, executive coaches, or even therapists. Through the years, I’ve worked with several individuals in different roles, depending on what my goal was.
Mentors
I had an amazing mentor early in my career. I attribute much of the success I had as a department chair to him. My mentor was an experienced chair who not only shared his professional experiences and advice but took me along to meetings that I had no business being in. I really had an administrative apprenticeship with the benefit of someone who would answer my questions and was willing to advise me. But I recognize that I was fortunate, and most people don’t get that kind of mentorship.
Mentors typically teach by sharing personal experiences and can be very beneficial in advising younger docs in their careers. This could range from providing a better understanding of hospital politics to improving communication with consultants or nurses. They can (and should be) extraordinarily helpful in providing encouragement for career progression and professional development. Mentorship is usually provided over a long period of time and could have scheduled or informal meetings, though meeting frequency is typically thought about over months, and not weeks.
I have a friend who is a senior academic physician, and he has found benefit in what he describes as “peer mentoring.” These are occasional meetings with other senior colleagues who can provide advice about what the other is going through. Mentorship is really about getting advice from someone else based on their personal experiences. I still meet with my mentor, though, the busier we get, the harder it is to get together. We share stories and issues, and he’ll still advise me on how to figure out a strategy for the situation I’m in. It is always helpful (and fun to get together), even if I leave without a clear solution.
Consultants
Consultants can be great to work with if you have a specific issue that requires outside expertise and advice. Typically, consultants are hired by the hospital and should bring an additional level of expertise to the problem. Consultants are analytical and solution driven based on data and typically provide a lot of reports that are then used to implement change within an organization. Consultants may be used to improve ED flow or patient satisfaction and should be able to provide targeted recommendations.
Working with consultants can be intense and may involve daily meetings for several weeks to months depending on the project. While consultants can solve particular problems, and could even give direction on group communication, they are unlikely to help your leadership development journey.
Executive Coaching
My wife is an aerospace engineer who had executive coaching intermittently throughout her career as she climbed the leadership ladder. Most organizations understand how impactful coaching leaders can be to the organization as a whole. Throughout most of my career, very few people I knew in medicine had worked with an executive coach. In fact, typically when I heard about someone getting referred to an executive coach, it was for remediation or seen as a punitive measure to help someone overcome a deficit or a fault, rather than being seen as an opportunity to help our successful leaders become even more successful.
Interestingly enough, over the last couple of years, I’ve known several docs who used executive coaching. Some had it as part of an MBA program, some had it offered by their group, and I’ve had a couple friends take advantage of it through their large academic medical centers. And a couple of people decided to invest in themselves and sought it out on their own.
An executive coach partners with their client to explore opportunities to help the client reach their goals. The process is designed to improve leadership and management skills, enhance performance, and help professionals achieve their personal and professional goals. It is estimated that approximately 30 to 50% of Fortune 500 companies use executive coaches and approximately 60% of these companies offer coaching to mid and senior level managers. Studies show that the return on investment (ROI) varies from 500-788%, due to the potential impact on productivity, employee satisfaction and retention, and leadership efficiency.
Most senior leaders across industries have worked with executive coaches, and many of them continue to do so on a regular basis. Common themes that I see with healthcare leaders are challenges related to improving communication and collaboration (i.e. with nurse leaders, ED team members, other physicians, or the executive team), time management and work life balance, or attaining a greater leadership presence. I also see a lot of “imposter syndrome, particularly for newer or younger medical directors. Emergency physicians have a lot of skills that we bring to leadership positions, but we also routinely get put into difficult situations where we need to figure it out. By exploring topics like your strengths, fears, and values, an executive coach can help.
An executive coach typically works with an individual on a regular basis via 45–60-minute appointments (typically virtual), often every other week for about 4-6 months. The process is driven by the client as compared to mentoring or consulting, which is typically driven by those professionals. Coaching is a collaborative and goal-oriented partnership between a coach and the client focusing on unlocking the leader’s potential rather than prescribing solutions.
Coaches ask questions, listen, and provide feedback to help the client explore new perspectives, and ultimately make positive change. Unlike consulting or mentoring, executive coaching is not about giving advice but about facilitating growth through self-discovery and accountability. One of the goals of executive coaching is for the client to develop new problem solving “muscles,” so when faced with challenging situations in the future, the client can draw on that “muscle memory” and isn’t meeting with the coach indefinitely.
For physician administrators, executive coaching can be especially valuable in navigating complex leadership challenges, such as managing teams, resolving workplace conflicts, and leading organizational change. Coaching can help them develop emotional intelligence, communication skills, and resilience, allowing them to lead more effectively in high-stress environments. Coaching also supports work-life balance and burnout prevention by encouraging better delegation, boundary-setting, and stress management techniques. Ultimately, executive coaching empowers leaders to become more strategic, influential, and adaptable, benefiting both their personal growth and the overall success of their organization.
An executive coach can work with an individual to explore the challenges that are impeding their success as well as co-create an action plan with the client to help them become more successful.
Teaching as a Manager
Inside of the hospital, the term coach or coaching gets thrown around a lot. As a longtime manager, I cannot tell you how many times I have been told to “coach” a doctor or our nurse leadership says that they will provide coaching to an individual regarding performance. There is a difference in having an executive coach who will work with you, versus being a manager providing coaching to employees. A traditional manager will provide teaching to their team about ways to do something better. This could be about improving patient satisfaction or improving productivity. This teaching is much like a football coach would teach blocking techniques. Here is how you stand and here is the position for your legs and arms when engaging with your opponent so that you do not get knocked over. These are technical skills that can generally be taught to groups of people the same way. I have power points I’ve developed through the years to teach ways to improve patient satisfaction, efficiency, and productivity.
We all know that best practice for improving your patient’s satisfaction is to introduce yourself as well as introduce yourself to everyone else in the room, sit down, provide your business card, etc. I can teach these kinds of basics to any doc, but it may not inspire change or help the individual understand what their particular roadblock is to achieve success. Management could also include putting an underperforming provider on a performance improvement plan (PIP). This is a management tool to point out specific areas of poor performance, formally hold the person accountable with improvement metrics and a timeline, and have associated consequences, potentially loss of job. While there may be teaching and offering improvement suggestions to the provider, this is management and not executive coaching. The above techniques can be called managing, teaching, or even coaching, but they don’t follow the model of executive coaching which would be focused on the individual better understanding their own actions and helping to develop strategies for improvement.
Therapy
I can’t talk about helping professions and personal growth and not mention therapy or counseling. While therapists and coaches share some techniques, the two modalities serve different purposes. Coaching is future-focused and action-oriented while therapy focuses on understanding and resolving past conflict. In other words, therapy helps one understand the past so they can better understand the future. Therapy works to uncover and heal emotional issues. Therapy is diagnostic and treatment based. Mental health conditions are treated using evidenced-based psychological techniques. One might consider therapy if your emotional state is interfering with your activities of daily living or if you are struggling with emotional distress, anxiety or depression, or another mental health disorder. It’s notable that some executive coaching clients may also be actively engaged in therapy.
Conclusion
All physicians are required to be leaders. We can all benefit by having a mentor. And we can’t know everything about everything, so expertise from a consultant can fill a specific role as well. However, there are times when we might need assistance in honing our administrative skills, enhancing our leadership and communication styles within the clinical setting, or finding balance outside the hospital to boost our effectiveness within it. Coaches play a vital role in this developmental journey. They help leaders gain self-awareness, identify blind spots, and hold the leader accountable for their actions and commitments. This support ensures consistent progress toward their goals. Ultimately, the goal of coaching is to improve a leader’s overall effectiveness, contributing to the success of the organization. It’s sounds like getting an executive coach may be exactly what you’re looking for and it seems to me that executive coaching should probably be used more often in our healthcare world.
Photo by Sasun Bughdaryan on Unsplash
