Nov 9, 2023
Coaching is in. During the later stages of the pandemic, it seemed every other person, and particularly the junior faculty in our Division, were either being coached, in training to coach, or coaching others. When I was a junior faculty, coaching wasn’t a thing. Sure, Atul Gawande wrote about coaching in surgery - having someone observe you and coach you on your technical skills- but that’s a far cry from the coaching programs focused on empowerment that are exploding around the country today.
Today we learn more about coaching from 3 coaches: Greg Pawlson, coach and former president of the American Geriatrics Society, Vicky Tang, geriatrician-researcher at UCSF and coach, and Beth Griffiths, primary care internist at UCSF and coach. We address:
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What is coaching? How does it differ from therapy? How does it differ from mentoring
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What is typically covered in coaching sessions?
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What is the evidence (see many links below, sent by Beth)
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What are the standards for becoming a coach?
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Who is coaching for?
My take: coaching has tremendous potential. There
seems to be a gender story here as well - coaching may be of
particular benefit to women who are at higher risk for
burnout. Note, for example, the hot off the press
JAMA Network Open trial which demonstrated modest benefits
across a range of outcomes was conducted exclusively in female
resident physicians. Kemi
Doll, a physician-researcher and coach, has a terrific podcast
I highly recommend everyone listen to, though it is targeted at
women of color in academic medicine. On the other hand, there
is a concerning side, described in this Guardian article titled,
I’m a life coach, you’re a life coach: rise of an unregulated
industry. See also the long list of disclosures in the
JAMA Network Open study. Our guests note, rightly, that
the same profit motive and concerns are true about colleges.
Still, I remain concerned when I see that the Life Coach School
costs $21K; when the founder of the Life Coach School’s goal is
to
grow a $100 million/year business; and when my spidey sense
tells me there’s something cultish about the empowerment
industry. So, I see the potential of coaching, particularly
for groups that face challenges in academic medicine; and I worry
about the injection of profit-motives and the goals of industry
leaders pushing the meteoric rise of the life coach industry.
-@AlexSmithMD
1. Hot off the presses RCT in JAMA October 2023: Study that
looks at 1000 female resident physicians at 26 sites that showed
that coaching improved each outcome assessed (burnout, moral
injury, imposter syndrome, self-compassion, and
flourishing).
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2810135
2. An RCT for female residents published in JAMA May 2022:
This was the initial pilot single institution study by the same
team as above. Their findings concluded that it was feasible to
implement an online coaching program for female residents and that
coaching improved emotional exhaustion, imposter syndrome and
self-compassion.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2791968?fbclid=IwAR0taY5CGpUa5eyfleNIl7RfXLT7qVt0GakKPGlT9ESIPLn0yCKWG9obrZo
3. A March 2022 study of Stanford offering coaching as a
benefit to their physicians and finding improved self-compassion
and burnout. https://www.mayoclinicproceedings.org/article/S0025-6196(22)00038-6/fulltext
4. The initial RCT published on physician coaching in JAMA
in 2019 showing that coaching improves quality of life. This is the
first RCT that was available for coaching in physicians.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2740206
5. A 2020 RCT of coaching for primary care physicians shows that
coaching improves burnout well-being during the intervention and
has a sustained duration at 6 months of follow up. From Beth
Israel and UNC. https://pubmed.ncbi.nlm.nih.gov/32297776/
6. The Business Case for Investing in Physician Wellness,
again in JAMA. This paper includes coaching as a sign of a more
mature physician wellness program and states it has a positive
return on investment.
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2653912