Physician Coaching and Burn-out, part 3
Myron Yaster MD, Lynne Maxwell MD, and Rebecca Margolis DO, FAOCA
Today’s PAAD will again focus on an article from Anesthesiology Clinics (Volume 40 issue 2) which was entirely devoted to physician well-being, quality of life, and gender inequities. In today’s PAAD we’ll look at how coaching can address work-life balance, ameliorate burnout, and improve individualized faculty development.
Before getting under way, I’d like to share a story. Several years ago, I read an article by Dr. Atul Gawande in the New Yorker magazine that was an “AHA!” moment for me. He asked “if top athletes like Tiger Woods and Rafael Nadal and opera singers like Renee Fleming have coaches, why shouldn’t I as a surgeon (just substitute anesthesiologist) have one too?”1 In Gawande’s article the goal of the coach was to focus attention on technical performance improvement. Today’s PAAD picks up this idea but seeks to solve a more pressing problem: physician burnout is causing an exodus from medicine and coaching may improve job satisfaction and retention.
And of course, first a word from Dr. Glaucomflecken
Myron Yaster MD
Original article
Laura K. Berenstain MD, FASA, ACC, Scott D. Markowitz MD and Stephanie I. Byerly MD. Physician Coaching. Anesthesiology Clinics, 2022-06-01, Volume 40, Issue 2, Pages 337-348 PMID: 35659405
“The practice of anesthesiology requires comprehensive medical knowledge, a robust clinical skill set, and the ability to navigate complex social situations on a daily basis. While medical school and residency training serve as preparation for the first two, training in emotional intelligence, conflict management, negotiation skills, and leadership is often deficient or nonexistent”.2 “Coaching has been successfully used for both personal and leadership development in the business world for several decades, and now a growing body of evidence is demonstrating its applicability in medicine”.2-4
Coaching, Mentoring and Sponsoring? (Who’s on first?) The first and perhaps most important question is how is coaching different than say mentoring or sponsorship? Traditional mentorship is familiar to most of us in medicine: Advice is dispensed by a senior faculty usually in the same field regarding specific topics or needs, with the mentor acting as a content expert or facilitator: the mentor leads, and the mentee “follows.”2 Sponsorship is when an influential individual vouches for a junior faculty or passes on an opportunity such as a speaking engagement or article authorship (e.g,: I (MY) sponsor junior faculty to write a PAAD or speak at national meetings). Coaching, which has been used in the past for remediation, is now frequently used to maximize career development. Coaching does not center on dispensing advice, rather “a coach listens intently, explores with the client (or “coachee”), and asks questions meant to spark insight and facilitate growth. Most importantly, coaching allows the coachee to identify and discard limiting beliefs or assumptions that are often holding them back, allowing them to initiate desired changes and shift their mindset”.2 Coaching is designed to be a time limited relationship particularly beneficial for those in a career transition, planning for promotion, in need of developing leadership skills, or those who suffer from imposter syndrome. Importantly a coach is impartial, they are often unconnected to the coachee’s institution and sometimes to medicine, although not surprisingly physicians prefer physician coaches. Further, “coaching views all aspects of the coachee’s life and creates space for the exploration of both personal and professional aspirations. Coaching is also a partnership of equals whereby the coachee is regarded as resourceful and able to solve their own problems; they do not need to be “fixed.”2,3
There are many types of coaching, individual or one-on-one coaching, team or group coaching, executive coaching, leadership coaching, and life coaching.
Fundamentally, does coaching work? Based on the article and our personal experiences YES! I (MY) was extremely fortunate that my former Hopkins Department chair, Dr. Colleen Koch, made leadership and team coaching a requirement for her upper and middle management and spent an enormous amount of capital (time and money) to make it happen. It dramatically improved how we worked and thought about ourselves and our team. The Society for Pediatric Anesthesia, under the leadership of Drs. Jenny Lee, Jamie Schwartz, and Nina Deutch, pioneered the Women’s Empowerment and Leadership Initiative (WELI), a coaching program to empower women to achieve promotion, leadership, and equity in pediatric anesthesiology. All 3 of us have participated in WELI and the program has achieved remarkable success.3-5 Although the coachees are all women, the coaches are both men and women. Finally, what if any, is the role of coaching in burnout? Several studies investigating coaching interventions for physicians have demonstrated efficacy in mitigating burnout.6
So again, lot’s stop the BS of mandatory seminars and resilience training and try things that work! Would love to hear your thoughts.
PS: I don’t want to end this PAAD leaving you depressed, so one more video from Dr. Glaucomflecken
References
1. Gawande AA: Personal best: top athletes and singers have coaches. Should you?, The New Yorker, October 3, 2011 issue
2. Berenstain LK, Markowitz SD, Byerly SI: Physician Coaching. Anesthesiol Clin 2022; 40: 337-348
3. Schwartz JM, Wittkugel E, Markowitz SD, Lee JK, Deutsch N: Coaching for the pediatric anesthesiologist: Becoming our best selves. Paediatr Anaesth 2021; 31: 85-91
4. Schwartz JM, Markowitz SD, Yanofsky SD, Tackett S, Berenstain LK, Schwartz LI, Flick R, Heitmiller E, Fiadjoe J, Lee HH, Honkanen A, Malviya S, Cladis FP, Lee JK, Deutsch N: Empowering Women as Leaders in Pediatric Anesthesiology: Methodology, Lessons, and Early Outcomes of a National Initiative. Anesth Analg 2021; 133: 1497-1509
5. Margolis RD, Berenstain LK, Janosy N, Yanofsky S, Tackett S, Schwartz JM, Lee JK, Deutsch N, Sinskey JL: Grow and Advance through Intentional Networking: A pilot program to foster connections within the Women's Empowerment and Leadership Initiative in the Society for Pediatric Anesthesia. Paediatr Anaesth 2021; 31: 944-952
6. Dyrbye LN, Shanafelt TD, Gill PR, Satele DV, West CP: Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA Intern Med 2019; 179: 1406-1414