Doctor as Coach - The Challenge

It's the quintessential hospital scene - a group of doctors dressed in white coats with stethoscopes draped around their necks, going from patient to patient discussing diagnoses and treatment plans.

Having been part of these ward rounds many times, I also know that they are arranged in a particular pecking order - the specialists and most senior doctors right up front, followed by the trainee specialists (registrars), and then the junior doctors with notebooks and pens in hand, waiting to jot down instructions from their seniors.

The real show begins when the procession arrives at a patient's bedside. The admitting doctor - usually the junior doctor who was on call overnight - will present why the patient came to hospital, what was found on examination and through investigations, the diagnosis and treatment prescribed.

What happens next depends on the personalities of the particular senior doctors present. The gentler ones will ask clarifying questions, may use the moment to teach on a particular topic, or will propose changes to the treatment plan. The not-so-gentle ones will critique, argue or even humiliate the junior, in front of the patient and the nursing staff.

This latter approach is all too common in our hospitals, particularly in the larger academic hospitals. Not only does it happen on ward rounds, but it is carried through to the day-to-day activities of the departments and units. Top-down, expert-led, directive leadership that relies on the most senior doctor dictating the way forward.

The impact is that the juniors are left feeling fearful and disempowered, knowing that their ideas are neither wanted nor appreciated.

Where does coaching come in?

When I work with doctors as coaching clients I'm often astounded at the levels of apathy and even outright disillusionment that exists in our public hospitals. I'm not surprised, though. What else can one expect when people aren't given the opportunity to think for themselves and where the environment is not safe for their voices to be heard?

This is where coaching come in. A coach is someone who:

• Believes in your highest potential.
• Is committed to your growth and development.
• Enables you to shine without feeling threatened that your light will in any way dim theirs.

Doctors are intelligent and hard-working; that's how they got into medical school in the first place! A coaching approach offers doctor leaders an opportunity to tap into the intelligence of their team so that it can be used, not only to deliver excellent patient care, but also to find innovative solutions to the many challenges that characterise our health system.

Imagine a ward round where all voices are valid, valued and respected. What would that make available in terms of people's thinking and performance? How might it enhance the quality of patient care?

Dr Maria Phalime is a Leadership Coach who works with doctors and leaders in the private sector, helping them to develop the inner skills to perform at their best in their work and lives. Sign up for regular updates.