Coaching Doctors? How Coaching can Help enable their Performance!

A significant amount of my active professional career was linked with the Pharmaceutical Industry, during which I have met/interacted and closely worked with thousands of Doctors. Many of these doctors I met were magnificent technically, and some were also excellent caregivers. Many were obviously under pressure, stressed, and with limited time.

After a brief pause, for over the last four months, I am actively engaged in working closely with the Doctors. However, this time around the role is entirely different, and now I am helping the doctors hone their Emotional Self as an Executive Coach.

Does Empathy have Beneficial Outcomes in Patients?

Over these years, and more so in the last four months, I felt that there is a piece of strong evidence that when the patient perceives the doctor is empathic the patient has better health outcomes; they get better quicker. As Medicine is an evidence-based field, I wanted to back my perception with evidence, and as I was doing my desk research, I got some great research articles around the same. One such research paper worth a read is Why empathy has a beneficial impact on others in medicine: unifying theories

When patients feel that the healthcare providers were listening to them and cared about their values, they could focus on healing and our family’s well being. When patients feel dismissed, ignored or judged by the health caregivers patients spend a good deal of emotional energy on frustration, feeling disillusioned about why the protocol seemed more critical than our particular concerns, seeking second opinions and feeling angry or confused about their situation. Time, space, and gratitude can lead to excellent outcomes.

While I believe that most doctors aim to be empathic and compassionate, the reality is sometimes otherwise. Being in a hurry, time-poor, stressed, under pressure, tired, hungry, angry, or burnt-out can erode even the best of intention. Tension, stress, and burnout undermine empathy and limit our capacity for discernment, attunement, and active listening. Self-awareness, mindfulness, and emotional intelligence allow us to notice when we are losing touch with our values and intentions and to realize when empathy is waning.

The following two video shows nuances of the same:

“Most errors are mistakes in thinking. And part of what causes these cognitive errors is our inner feelings, feelings we do not readily admit to and often don’t realize.”

The tools of self-awareness and emotional intelligence are significant in avoiding burnout and optimizing patient-centered care. Indeed effective caregiving requires both an understanding of the scientific evidence and a compassionate intention to understand the needs of each patient. Head, heart, and gut play a role in human connection.

The need for EI in Medical Education

Indian Medical schools do an excellent job, for the most part, at teaching to our left brains, encouraging cognitive skills of memory and problem solving, fixing issues as if they are puzzles or maths. Patients are more complex than riddles and maths problems, of course. Patients are unpredictable, frightened, joyous, mute, vulnerable, or full of bravado. A doctor or an emotionally intelligent nurse can respond so much more effectively than the scientist who has a routine, or reactive strategy to this changing landscape.

Medical school does not allow much time to teach empathy, compassion, emotional intelligence, unconscious bias, or listening to the narrative. It teaches anatomy, pharmacology, differential diagnosis, and risk assessment — those other ‘soft skills’ need to be learned incidentally if they are even named at all. In my experience working closely with doctors, it is a random event if a doctor has gained these skills at medical school or in the early years of their career.

Over the last 100 years, medical training in India and around the world has focused more and more on evidence-based science, and we have seen radical improvements in health across the board as a result. However, there is potential to subsequently dismiss the healing value of empathy and compassion, which play their role in people getting better. There is significant research now being undertaken around the world to understand more about the parts of empathy, compassion, mindfulness, and human connection in healing.

Also, I would like to request the respective #MedicalCouncils of both State and Centre to emphasize the need for #EQ in the practitioner's overall effectiveness and better patient outcomes. I can go further to emphasize that such Pieces of training/Workshops be considered as part of the CME's and due credits to be awarded to the respective doctors.

What made me focus on Coaching Doctors?

While short training sessions might raise a person’s awareness, they do little to change habits in the medium to longer term. As a Behavioural Coach and EQ Practitioner, I emphasize this during my Workshops. Self-awareness, mindfulness, unconscious bias, emotional intelligence, empathy, and compassion are the skills that can be learned. In my experience, a person who works with a coach over a period of time is more likely to embed their insights; in other words, change their behavior. Coaching over a while provides a psychologically safe forum to be accountable to one’s self. The relationship is built on trust, allowing the doctor to be vulnerable, own their intentions and short-comings, be creative in their thinking and change. Attending a short training session will probably not have an impact for long, in changing habits, especially if the environment remains the same.

My experience as a practicing Behavioural Coach, and having worked with doctors in the past has convinced me that until there is a radical overhaul of the health care system, culture, structure, doctors need people like me to help them take care of others and chiefly to take care of themselves. The coaching helps expose people to their own biases and unconscious incompetencies, their self-limiting behaviors, and their beliefs.

Now comes the Question - Who can Coach Doctor?

Traditionally the mentors and supervisors of doctors are doctors. For technical skills, this is as it should be, however where the teaching doctor is also burnt out or lacking in human relationship and communication skills, this means the medicine is self-limiting. As a Behavioural Coach, this is my skill set. I have spent years learning how to assess and teach these skills. It is my daily job to observe patterns and discern how to help the person alter them, to identify and overcome their biases, to unearth and name their perspective to reflect on it and decide if it is serving a useful and compelling purpose, or limiting their development in some way.

"A structured intervention, usually with a set duration, using a non-directive approach to help individuals to solve their problems and unlock their potential."

Coaching is a process of push and pull where the coach has the coachee’s permission to hold them accountable. The coachee strives for their version of success, reaching for named and new goals and learning about the psychological aspects of their perception and their career. It has been such a privilege for me to bring my skills to meet this need, to walk beside doctors who are invested in their development and wellbeing, in the interests of serving others as well as they can. The doctors and their patients all benefit.

The following article got published in British Medical Journal A coach can improve the performance of any doctor, and further have documented the feedback of some doctors post Coaching engagements as below:

Doctor’s experience of coaching

“On completion of my foundation program, I found myself struggling and somewhat reluctant to commit to core training despite having wanted to be a surgeon for almost 15 years. The first and biggest revelation from coaching was that I didn’t really know, and certainly could not articulate what I valued.

“Working with a coach, I’ve gained a deeper understanding of my values and beliefs and adapted my behavior in alignment with them. Our sessions were insightful, constructive, and inspiring and always ended with me coming up with a series of steps to help me achieve the next step towards my goal of gaining better clarity about my path in medicine, even if that path was no longer a career in surgery.”

Consultant psychiatrist’s experience of coaching

“I was spurred to take part in coaching with the need to make a significant change in my work life. I was skeptical about coaching owing to my misconceptions about the self-indulgent nature of the process of ‘finding oneself’ that I had associated with life coaching.

“Coaching brought into focus aspects of my personality and my assumptions about my career in medicine that were both painful and life-changing. I am now making changes in my job that have led me to be re-energized, and I have a clearer vision of my life after medicine. For me, the coaching experience was one that I hoped I would find within the appraisal system but didn’t.”

What Next?

“Don’t limit yourself. Many people limit themselves to what they think they can do. You can go as far as your mind lets you. What you believe, remember, you can achieve.” ―Mary Kay Ash

When we become attached to familiar patterns, we sabotage our own lives. Feeling stuck is an illusion. There is nothing more natural than change. We spend most of our lives trying to decrease the amount of change we experience. We do everything possible to stabilize, routinize, and normalize.

We feel stuck not because we are being pinned to our lot in life by forces beyond our control. Instead, it’s because we’re subtly and subconsciously influenced to reinforce preexisting behavioral patterns.

Your most significant mindset shift in life comes when you recognize the power behind the belief that you can and will make things happen in your life. This is palpably different from merely believing something is possible. It’s this mindset shift that will make the difference in happiness, success, and every grand pursuit that you choose to make a part of your incredible journey.

Lastly, I request the Pharmaceutical fraternity to popularise the need and urgency of helping the Medical Professionals. Doctors are essential to most people’s wellbeing. We all need Doctors to maintain our health. Doctors by the nature of their work are under enormous pressure leading to higher rates than the general community of suicide, depression, substance abuse and burnout (per BeyondBlue’s National Mental Health Survey of Doctors and Medical Students).

Doctors do their best work when they are well. They are more patient, more present and kinder. Research has shown that health outcomes are better for patients when doctors are well and engaged in their work. #Coaching helps the doctor clarify their own meaning and to take action for their future, their own health and their patients’ health. When doctors are well the health outcomes are better for everyone.

I would appreciate your thoughts, views on the Article.