Coaching in Health Care: The Patient-Physician Relationship and the Role of the Physician Leader

Perhaps the best area to illustrate the importance of the physician-provider relationship is in medical liability claims. Here, the physician’s communication skills are paramount to whether or not he or she will be sued. In a study of malpractice settlements, awards and costs, 75-85 % were attributed to only 2–8 % of the internists, surgeons and obstetricians.  Why are a small minority of practitioners receiving such a large majority of malpractice suits?  Numerous studies demonstrate that a physician’s lack of communication skills, not involving a patient in his or her healthcare decisions, and lack of interpersonal care of the patient are all characteristics of the physicians who repeatedly suffer multiple claims. The less satisfied the patient is with the physician’s interpersonal care, the more likely the patient is to initiate a suit.  In a review of plaintiff’s depositions, Beckman and associates showed that 71% of malpractice claims were due to a break down in patient-physician communication.  Clearly, physicians who communicate and have an effective rapport with their patients are less likely to be involved in a malpractice suit.  Similarly, trust is another patient determinant as to whether or not they will initiate a malpractice suit.

Professional Business Coaching and the Physician

For purposes of this discussion, professional business coaching is a dialogue between a client and a coach, focused on the client, in order to address gaps in performance and improve outcomes. Using active listening, a coach is trained to listen and observe a client, allowing the coach to ask thought provoking questions of the client. These questions help clients “see” a situation or dilemma from a different perspective, a process called reframing. In reframing, not only is the situation viewed from different perspectives, the different emotions associated with each of those perspectives is discerned. Thus, the client’s emotional awareness, often called emotional intelligence, is reframed. It is in this process that the coach helps the client elicit solutions and strategies for confronting a situation or problem.

Individual Coaching in Health Care

Due to the recent explosion of coaching in the business community, much has been written about the benefits of coaching. While not specific to physicians, a study commissioned by the International Coach Federation detailing the benefits of business coaching. In this 2009 study performed by Price Waterhouse, a total of 2,200 clients from 64 countries were surveyed. Four benefits were consistently noted to have a direct bearing on the new skill set physicians must master: relationships, communication skills, interpersonal skills, and work performance.