10 reflections on coaching and what makes it work

I am a family medicine physician who had every intention of seeing patients all day, every day for 35 years and call it a day. As you know… life sometimes pivots in pretty compelling ways and it did for me when I got the call from the president of our medical group to coach and develop our clinicians. Twenty years later, I founded a company, Practicing Excellencewith an amazing group of people, who is now coaching tens of thousands of clinicians, team members and leaders to make life better for patients, those providing care, the leaders who lead and the groups they are part of. 

I want to share what we have learned about the power of coaching, what makes it work and why it is the most important thing we can do as leaders. These are the essence of our learnings that now fuel a coaching approach to build an organizational mastery culture that is constantly growing the skills to connect to patients, collaborate across teams and lead to bring the best of others. 

My top 10 reflections on coaching:

1. The most important question to ask those who are coached is, “tell me the kind of clinician you want to become?” Having asked this question hundreds of times, there are remarkably consistent themes with most every clinician about being a trusted difference maker who partners with patients to advance their clinical care. They have a vision and hope for themselves which is often different from where they are when they begin to be coached. The coaching process is simply helping them become who they aspire to be.
2. You cannot hold people accountable for an outcome or metric without the tools and development to deliver on that outcome. Data provision and attributable to individuals must come with adaptive data response with the knowledge and skills to improve. 
3. Coaching and development are not remediation interventions. Coaching and development work for everyone at every level and using simply for the “challenged” is a radical underutilization of a development strategy.
4. Leaders should go first in the coaching process to advance their effectiveness as leaders, brought with vulnerability, curiosity and self-awareness to lead a coaching culture by example and going first to advance their abilities to bring the best of others. Nothing builds authenticity and trust more than doing what you ask others to do.
5. Coaching of skills to create outcomes must map to organizational “North Star” priorities. Coaching is not random or ad hoc. It is a highly disciplined provision of skills and behaviors to manifest your vision in witnessable and measurable ways. 
6. The key to coaching success is the provision of simple actions that create moments of impact with those who are coached. The process of learning a skill, trying a skill, and experiencing meaningful benefit perpetuates the skill as worth doing, sustains the behavior and often creates ambassadors for learning as they share their story.
7. Coaching does not have to take large investments of time. We have found a micro-learning approach, powered by app-based video coaching tips of 5 minutes per week with immediate application of new skills is consistently creating improvement for individuals and organizations. The on-the-fly coaching is preferrable for clinicians, care teams and leaders who have no spare time.
8. Coaching leadership skills at the clinical micro-system level are essential for culture, talent retention, safety, patient experience and everything else we want from our health system. Coaching the skills of running small teams, creating influence and encouraging others and how to bring the best from teammates is both critical, and almost totally undeveloped in most clinicians.
9. Authentic recognition of the display of a coached skill is a powerful replicator of that new behavior. Appreciation of what others do can change how they see themselves, the pride they have in their work, and the revitalizing of a tired care team member.
10. The consistency of leader skills to engage care teams through mindset, listening, modeling, influence, gratitude, approachability, team intelligence is highly variant in most organizations and coaching for all leaders is essential to care for and effectively those who care for others.

Coaching works in extraordinary ways to help clinicians, teams and leaders soar, be who they aspire to be and to create tremendous pride in who they are. Our real job as leaders is to simply help those we lead be their best, and coaching may just be the most powerful way to make that happen.