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

Developing Physician Leaders as Coaches

Although physicians and hospitals are stakeholder partners in the new landscape of healthcare reform, they operate from significantly different structural bases. Physicians operate as an independent heterogeneous group that tends not to function in a cohesive integrative manner, whereas hospitals represent business entities that are cohesive. This contrast presents two major challenges to their future relationship. The first challenge, poor communication, stems from the disparate nature of physicians. A poorly organized group is much more prone to miscommunication and poor data exchange than one which is well organized. Effective communication is absolutely necessary to obtain the high levels of successful patient outcomes mandated in a value-based purchasing model that seeks to maximize reimbursement and profits.

The second challenge is the capability of physicians to accept the standardized treatment modalities necessary to have system-wide cost efficiencies in healthcare. Physicians must transition from a group of independent practitioners with many solutions to the same problem, to unified stakeholder partners willing to accept standardizations in healthcare. Consequently, a new communication skill set is required for physicians to be successful in the future. Physicians must not only maintain competent clinical skills. They must now add the competency of working well with benchmark treatment modalities.

The Physician Leadership Development Program

We wish to illustrate the nature of these challenges that physicians confront and the way in which coaching can be of assistance to these physicians by offering a case study. We describe a program that has been created to develop hospital-based physicians into physician leaders. This program was initiated at a large full-service hospital that is part of a $2 billion public and private healthcare system in the Midwest region of the United States. Ten physicians participated in the three month program. They were all members of a larger 21-member hospital physician team. The ten member team (representative of the larger group) consisted of seven hospital physicians, a nurse practitioner, a clinic manager and the hospital’s Chief Medical Officer.