How Cleveland Clinic has saved $133M in physician retention

In 2008, Cleveland Clinic instituted a peer-based coaching and mentoring program for physicians and scientists to promote a proactive approach to clinician well-being for allcomers, which officials estimate has saved the health system at least $133 million in physician retention alone in 2020. 

The Center for Excellence in Coaching and Mentoring runs two physician and scientist peer coaching programs, and the Mandel Global Leadership & Learning Institute provides coaching opportunities to all caregivers at the Cleveland Clinic Foundation. The two groups partner closely to ensure programming is complementary. 

"We actually created our own coaching framework at the Cleveland Clinic, founded on the International Coaching Federation's competencies," said Andrea Sikon, MD, executive director at Cleveland Clinic's Center for Excellence in Coaching and Mentoring. "We teach our physicians and scientists in our programs to use this framework in their peer coaching and mentoring relationships." 

Dr. Sikon runs the programs alongside Elaine Schulte, MD, senior associate partner at the center and an executive team. Both have their graduate certificates in executive and professional coaching with additional certification historically through the International Coaching Federation and later as Board-Certified Coaches through the Center for Credentialing and Education. 

The pair works closely with Ashley Villani, senior organization development consultant and International Coaching Federation-credentialed coach who leads the other "arm" of coaching programming through Cleveland Clinic's Mandel Global Leadership & Learning Institute.

The Cleveland Clinic Center offers general and advanced coach training programs. Both programs are offered multiple times throughout the year and are open to physicians and scientists willing to meet the minimum requirements set forth by the programs.

"We intentionally are a little bit different," Ms. Villani said. "Our coaches are not physicians or scientists, so the different coaching program offerings complement one another and provide choice to participants.

All three programs, however, take a developmental approach to coaching, as outlined in an Oct. 10, 2019 report in Psychiatric Annals. 

"The beauty of this approach is it’s very coachee driven and empowering, 'teaching them to fish' vs. offering specific advice, which can be biased," Dr. Sikon said. "The other benefit of this approach is that many can be taught to use this developmental approach in that they don’t need to be an expert across many domains of a coachee’s goals; the approach works whatever the issue at hand may be."

Ms. Villani said the coaching provided by The Mandel Global Leadership and Learning Institute covers a broad spectrum including: on-boarding, leaders transitioning to new roles, career coaching, executive coaching, and talent and leadership development.

Dr. Sikon said at any given time there are approximately 350 coaches in the Clinic's Center for Excellence in Coaching and Mentoring general program and 200 coaches and coachees in the advanced peer program while Ms. Villani has 40 to 45 coaches made up of organizational development experts and enterprise leaders.

While the goals of the program predated the pandemic, Dr. Sikon said additional measures, such as monthly community calls, have been instituted to ensure physician well-being and prevent burnout. 

"The calls started as a way to really just bring people together because the pandemic was so isolating, especially initially when everything went remote," Dr. Sikon said. "And was just a way to bring all that emotion and have a place for sharing. They did evolve to people wanting to use and practice the coaching skills to adapt and help others adapt." 

The benefits of the program have been measured through retention rates at the system.

A 2020 end-of-year survey asking physicians, "To what degree has your participation in the Center for Excellence in Coaching and Mentoring programming contributed to your decision to stay at Cleveland Clinic?" used a Likert scale to measure satisfaction.

Dr. Sikon said 197 physicians stated participation in the coaching program influenced their decision to stay. With the cost of turnover estimated to be up to three times an employee's annual salary, they have calculated a potential cost savings of more than $133 million attributed to program participation.

Aside from retention, physicians said the program outcomes include increased engagement, resilience and fulfillment.  

"We know that when physician leaders are engaged, feel resilient and have professional satisfaction, the likelihood is that their reports are also engaged and less burned out," Dr. Schulte said.

Aside from the coaching program's impact on Cleveland Clinic, all three officials agreed additional benefits go beyond the workplace.

"It’s an incredible life experience when it comes to either being a coach or receiving coaching," Ms.Villani said. "Regardless if in the role as coach or coachee, one is more likely to see situations from a different lens, and therefore motivating themselves in new and unique ways. This may not be the primary reason they were attracted to coaching, however, it’s likely that they’ll walk away with additional or improved coaching skills from their meaningful connections with their coach. Whether they realize it or not, one is more likely to start incorporating coaching techniques into their day-to-day lives."

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