This article explores the role of physician coaching for burnout prevention. As a psychiatrist, it took me only a few minutes in practice to realize that everyone needs a therapist (at least once in their lives). Doctors, nurses, and all healthcare practitioners (HCPs) are no different.
In fact, their needs are evidently higher than the average population. Prevalence rates of burnout and mental illness are higher, and exposure to toxic stress and micro traumas are pervasive. Our HCPs work in challenging environments subject to enormous stresses often at the cost of significant detriment to their own well being, be this physical, emotional, cognitive, relational, and/or spiritual.
Until the root systemic causes are fixed (our proposed solutions here) our coalface medical staff need all the support they can get. This is where the role of physician coaching for burnout prevention comes in to create thriving doctors.
While access to a therapist would be invaluable for dealing with the frequent occupational trauma and resultant emotional dysregulation so many of us feel, most doctors surveyed are reluctant to engage in mental health treatment due to fear of professional consequences (explored in this article).
In reality, there are not enough therapists in the world to deal with all the trauma; and I would argue that mental health professionals should be reserved for those most in need, including ourselves. As a doctor with mental illness and addiction, I am SO grateful for the clinical intervention of my colleagues. I just wish I had gotten help earlier. But that is another story.
So where does coaching fit in?
The answer to ‘what is coaching’ is a novel itself; and physician coaching is several chapters.
A useful definition of coaching is:
“… a nondirective process that draws upon techniques from positive psychology and both cognitive-behavioural and solution-focused therapies to help people thrive personally and professionally, by increasing their self-awareness, building on their strengths, and applying their insights creatively so they can move forward.” (Askin, 2008)
Carol Kauffman, PhD, Director of the Coaching and Positive Psychology Initiative at Harvard Medical School, has further explained:
“Positive psychology theory and research will provide the scientific legs upon which the field of coaching can firmly stand …. There are psychometrically robust measures to assess strengths and empirically testable positive interventions that have been found to increase happiness, productivity and life satisfaction.”
Physicians have unique challenges when it comes to professional and personal development. Not only are we high achievers riddled with perfectionism, self-doubt, guilt, strong moral codes, and an unhealthy affinity for work, we are also afraid of being vulnerable. Our fear extends into seeking help, in case our reputations or careers are affected. In the US there is a reality that in some states, previous health records including mental health treatment, can be disclosed in litigation. This makes coaching an attractive option because it is not mental health treatment, yet has positive effects.
The aim of coaching is to support clinicians understand themselves and their own priorities and values better. Furthermore, coaching aims to teach skills in reframing thinking styles, overcoming cognitive barriers, and moving from surviving to thriving in (or outside) medicine.
Coaching can help physicians to move past burnout to create well-being, balance and career fulfillment.
Foundational to coaching is that the client is seen as whole, capable, and resourceful. Most academic medicine coaches use a causal-coaching approach rooted in positive cognitive psychology.
In summary, coaching is officially defined as a trusted partnering relationship with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential – in other words, to develop into thriving doctors.
Physician coaching can help with a wide variety of challenges both common to and unique to medicine. The ultimate goal is set by the client, and most commonly this is around physicians who want a rewarding and healthy career as well as a rich and full life outside of medicine.
Such challenges range from career development, change management, work-life balance, and leadership development, to burnout, malpractice, licensing & credentialing issues, addiction, and non-clinical psychological challenges. Perfectionism is a common trait among doctors, and has its advantages and drawbacks.
In general, coaching usually helps the physician establish their own values & priorities, a greater self-understanding, and clarity on what their next life goals or career steps could be, and how to achieve them.
Coaching helps physician clients develop the clarity, courage and self-compassion needed to move toward what matters most to them.
Furthermore, group coaching programs are available, with a growing evidence base around physician coaching for burnout prevention. These programs typically last 3-6 months and will take a group of physicians through a growth and discovery process by covering a number of essential topics not taught in med school.
These topics may include stress management, personal values, personal thinking styles and personality, self-compassion, dealing with impostor syndrome, and work-life balance.
Confidentiality and ideally separation from the employer are key to genuine engagement and connection when it comes to defended and fearful clinicians. That is one reason why we developed a number of evidence-based group programs of physician coaching for burnout prevention.
Here are a few specific physician coaching goals that we have supported colleagues with:
Coaching is not psychotherapy, counselling, mental health assessment, CBT, or analysis. While some elements of any of these specialised practices might be adapted in coaching, professional coaching has its own framework and approach.
First, coaches are not mentors; mentors are those looked up to and emulated. Coaches are not advisors; advisors guide, direct and give advice. Coaches are not therapists. Therapists diagnose and treat those with DSMV mental health conditions.
It’s vitally important to emphasise to colleagues that if you need clinical help, you need to get it. Professional coaching is no substitute for clinical care. You would never go to a skilled orthopedic surgeon for your carpentry requirements. Similarly, there are psychiatrists and therapists with niches and expertise in helping medical colleagues. Go to them.
Physician coaching with an accredited and experience coach helps physicians to move past burnout to create well-being, balance, and career fulfilment, to become thriving doctors.
There is also growing evidence on physician coaching for burnout prevention. An essential part of a holistic strategy to tackle the global physician burnout pandemic.
If you are interested in accessing a Physicians Anonymous approved coach, please check out our carefully selected, experienced, wise, and values-aligned coaches here.
In Part 2 of this series, we examine the evidence base for coaching in physician wellbeing, how to find a good coach, and how to tell if they’re right for you.
We hope that this article has helped you understand more about physician coaching and how it might help you and other physicians become thriving doctors.
If you are interested in accessing evidence-based group coaching programs for Residents, Attendings, or any other type of physician, please contact us to find out more. Investing now in your doctors will pay for itself many times over if it reduces just one drop out or prolonged absence.