A coach can improve the performance of any doctorBMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1386 (Published 22 March 2016) Cite this as: BMJ 2016;352:i1386
- Victoria Cleak, consultant general adult psychiatrist
Coaching can help doctors with a range of common problems and should be available to all, says Victoria Cleak
Simon Wessely, president of the Royal College of Psychiatrists, recently wrote that research had established “that the highest standards of patient care are delivered by energetic, motivated and well rested doctors with a positive work-life balance.”1 However, doctors today face unprecedented stress, with increased scrutiny of their practice, and jeopardy if things go wrong. Coupled with this, they no longer enjoy the support of a team around them or the esteem of the public. This has led to an increase in burnout and doctors leaving the profession.
One way to overcome these problems is for doctors to undertake coaching sessions, generally reserved for those who are struggling or to enhance and support leadership skills in management roles.23 However, the NHS has been missing a trick by focusing solely on those at the top or those in difficulty: coaching should be widely available to all doctors.
A skilled coach can enable a doctor to manage a range of problems, including lack of reflection, burnout, and a lack of resilience. A coach can also help a doctor develop and harness leadership potential. Coaching is beginning to be offered as an add-on skill to educationalists in the NHS. The Royal College of Psychiatrists is also looking to develop coaching as part of its mentoring programme.
What is coaching?
The coach uses a range of skills such as goal formation, active listening, reflection, and non-judgmental inquiry, asking questions to get the coachee to think in new ways, to see alternative perspectives, and to identify and overcome barriers to change. The coach may also use tools such as multisource feedback and personality inventories, such as the Myers-Briggs type indicator.
The coach’s role is to keep sessions on track, to bring awareness to strengths, and to highlight and explore inconsistencies between what the coachee says, feels, and does. Coaches contain the anxieties of the coachee in the same way as a psychotherapist might, but they also ensure that the coachee is accountable for his or her actions. The coach acts as a guide, cheerleader, and challenger.
The coaching I undertook as part of a coaching course led me to re-examine my values and how they aligned with my career, family, and life. I realised that I was burnt out and that I had lost confidence as a doctor.
Through coaching, I was able to identify, reflect on, and challenge the assumptions I held that if I didn’t work as a front line clinician I would lose my identity and that my skills were too narrow to do anything else. I now have a flexible and more interesting career and have regained my confidence, motivation, and love of psychiatry.
I have extended my therapeutic skill set and I am a better active listener, unafraid to let a patient lead an interview. I am more alert to language that can be perceived as judgmental and realise how using the “why” question makes others defensive. I have learnt that reflecting exactly what a person has said, and exploring the inconsistencies in this, is far more powerful than giving advice. Coaching has helped me to be a better appraiser, and when I return to front line psychiatry I will be a more skilled clinician, better able to develop and maintain a therapeutic relationship.
I believe that coaching should be made available to doctors at all levels who wish to undertake it. This will produce a happier, more productive, self reflective, and resilient workforce and could even lead to a reduction in the number of complaints about doctors—surely a win-win for the NHS and its staff.
FY2 doctor’s experience of coaching
“On completion of my foundation programme 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 really valued.
“Working with a coach I’ve gained a deeper understanding into my values and beliefs, and adapted my behaviour 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 by the need to make a significant change in my work life. I was sceptical 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-energised 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.”
Competing interests: I have read and understood BMJ policy on declaration of interests and declare: I am a consultant psychiatrist working as a medical member of the first tier tribunals and am an International Coach Federation approved coach. I have a website that offers coaching for doctors: coachingandappraisalfordoctors.co.uk.