Leading like a coach: How physician executives can transform their leadership effectiveness

Who needs a coach? Everyone who wants to optimize their professional performance or the performance of their teams. In today’s world, if you are a physician executive leading a team, it is imperative you help your teams adapt, make decisions, mitigate risks and communicate effectively. You need to not only retain talent, but you also need to help them reduce their stress. You must help them to think, plan and act strategically. The environment you and your teams are functioning in is commonly known as VUCA: volatile, uncertain, complex and ambiguous. It’s your job to counteract that with vision, understanding, clarity and agility. By being a leader with a coach’s mindset, you can get there.

Physicians in leadership positions work side-by-side with other members of the health care team including nurses. In those peer-to-peer relationships, they must adopt a coach’s mindset and leave behind the mentality of “doing,” moving toward the role of a conductor – helping the musicians to create the best music. Physicians are not the only members of the team who benefit from adopting a coach’s mind set; according to O’Grady, Johnson and Hassmiller (2024), leading through chaos and complexity involves nurses adopting coaching roles to build high-performing teams. The case for coaching was made stronger by a recent study delving into physician and nurse well-being in 60 Magnet hospitals across the United States confirmed a workforce in distress.

Coaching is a fundamental leadership skill and a foundational shift away from the manager of old.  Becoming a leader with a coach’s mindset all begins with self-awareness.  Take a minute to reflect on your own leadership style.  What kind of leader would you say you are?  Are you a values-based leader?  Or do you put people first?  Do you focus on the strengths of your teams or are results the most important outcome you are driving toward?  Do you have an open-door policy or are you more laissez faire?  Have you been described as a micromanager?  In a post-pandemic world and a workforce populated by GenX, millennials, GenZs and today’s GenAlpha, we need a major mind shift.  Leaders must move left to right.

From the Manager of “Old”	To Generation “Now”
Selling and telling	Joining with employees, being a partner
Testing employees	Being supportive
Consulting (giving the answers)	Practicing curiosity and inquiry
Being directive	Advocacy, candor and compassion
Performance management	Performance development

Coaching skills also help with another critical leadership competency: motivating others. A study from 2012 “What Workers Want” published by Net Impact is relevant today. The top three things that employees want from their employer are: appreciation, a voice and sense of belonging and a boss who cares about them.  When you demonstrate coaching skills, you have an opportunity to deliver on all three.

The demands of the workplace have been changing for decades. In Gallup’s 2019 publication It’s the Manager: Moving from Boss to Coach, the global advisory and research firm concluded that people don’t leave jobs, they leave managers, offering a compelling paradigm shift based on 30 years of research with CEOs, CHROs and others in the C-Suite.

The workplace of yesterday	The workplace of the future
My paycheck	My purpose
My satisfaction	My development
My boss	My coach
My annual review	My ongoing conversations
My weaknesses	My strengths
My job	My life

Because words matter, let’s be crystal clear on what coaching means versus other terms we often use interchangeably such as consulting, teaching, mentoring, instructing and facilitating. For ease of discussion, we’ll distinguish three terms: teacher, mentor and manager.  A teacher would say to their student “I want to show you how to organize your work”.  A mentor would remark “In my experience, it’s helpful to check with your colleagues.”  A manager would direct “Please send me your finished product by 4pm.”  Contrast those statements with what a coach would ask rather than say “What are the pros and cons of asking your coworkers for help?” An adage about coaching vs. consulting as a helpful reminder is: Consultants have all the answers and coaches have all the questions.

When you use a coach’s mindset you will:

• Ask questions rather than fix a problem or give answers
• Support self-discovery through new insights and perspectives
• Help colleagues or direct reports reach their goals of being the employee they want to be

Of the many competencies leadership coaches gain through education and certification, four are highlighted here. We’ll refer to them as the 4 Ps. Staying present and focused on the other person. Practice active listening at Level II. Using powerful questions to create awareness, breakthroughs and mind shifts. Partnering to establish new behaviors.

Being present means centering yourself with a clear mind, free from distractions and intently focused on the other person who you are engaging with in a one-on-one conversation… not dissimilar to the way you would listen to a patient.

Listening at Level II is also focused on the other person. It’s thinking about what they are saying, why they are telling you what they are telling you, what they are feeling and thinking. This level is contrasted with Level I when you listen to respond and are pre-occupied with how you will reply. There is another level – Level III – which considers, in addition to the other person’s thoughts and feelings, the environment and any patterns and connections you can make from what the person is saying.

What are the benefits of listening at Level II? There are many you will realize such as the ability to:

• Broaden perspectives
• Dispel assumptions
• Uncover bias
• Understand the challenge
• Gain clarity

Once you have listened at Level II, you can begin asking powerful questions. Powerful questions can create learning, knowledge and introspection. By asking open ended questions (e.g., how/what, not why), you will notice that it: 

• Brings clarity
• Evokes “self-discovery”
• Offers new learning
• Explores what the desired outcome is
• Doesn’t use leading questions… not concluding or steering in a specific direction

Some examples of open-ended powerful questions:

• What do you think?
• What matters to you about this?
• How do you know this? What else might be true?
• When you look back, what do you want to see, feel, be?
• What did you learn about yourself? About the situation?
• How will you hold yourself accountable to your learning?

Probably one of the hardest adjustments leaders will make as they enter the coaching realm, especially physicians, is not jumping to solutions, judgments or assumptions.  Most of us have achieved career success by fixing problems, knowing what and how to take the next step. That’s territory coach’s need to avoid.

You’ll know you’re engaged in a coaching conversation when the topics are not about someone’s to-do list or the status of a particular project. Rather, together you are exploring challenges associated with:

Collaboration	Emotional intelligence	Leadership development
Communication	Executive presence	Leading change
Conflict management	Feedback	Strategic thinking
Core values	Goal setting	Team building
Delegation	Impostor syndrome	Time management

When we look at what thought leaders say about coaching, we can examine or refer to fellow physicians, record-breaking athletic coaches and professional associations:

“Coaching done well may be the most effective intervention designed for human performance. 

                                             Atul Gawande “Personal Best” The New Yorker, 2011. 

Partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.  
                                                                             International Coaching Federation

“Take me where I couldn’t get to by myself. That’s what a great coach does.”
                                           Tara VanDerveer, Stanford Women’s Basketball Coach

How can you apply this in your everyday work with direct reports, your team, your colleagues?  What resources do you need to put this new practice into play?  What will it take for you to Lead with A Coach’s Mindset?

Citations:

O’Grady, Eileen PhD, RN, NP, PCC; Johnson, Jean PhD, RN, FAAN, ACC; Hassmiller, Susan RN, PhD, FAAN, ACC. “Leading Through Chaos and Complexity: The Nurse as Coach – Building High Performing Teams.” Nursing Administration Quarterly, vol. 48, no. 3, July/September 2024, pp. 218-224. DOI: 10.1097/NAQ.0000000000000649.

Net Impact. What Workers Want. Net Impact, 2021, www.netimpact.org/research/what-workers-want.