The Role of Coaching

The Broken Covenant in US Healthcare

A covenant can be generally defined as an agreement that yields a relationship of commitment between two parties. In healthcare, the covenant was historically between physicians and society: by sacrificing their 20’s (in some cases, a good portion of their 30’s) and dedicating themselves to become proficient in the healing arts, physicians would be granted by society a better than average living, an independent career and a place of respect in their communities.  In the 90s with the shift to a managed care delivery system, physicians remained committed to sacrificing many hours to learn their trade, while salaries are now capped and their independence is curtailed. Now with healthcare reform physicians must make the transformation from independent autonomous providers with many solutions to collaborative partners willing to accept standardizations in healthcare.8

Coaching for physicians can drive improvements in business relationships (e.g. with patients and healthcare team co-workers), communication skills, interpersonal skills, and work performance. With coaching, physicians can shift from survival and fear-based mindsets to ones of self-awareness.  The coaching process facilitates physicians’ self-awareness as they recreate meaning in their lives and careers that have been redefined by governmental interventions.  They attain the emotional intelligence to reexamine and refocus on why they chose a career in healthcare: to connect with and help people.  Moreover coaching will improve physicians’ communication skill sets resulting in stronger relationships with their patients and coworkers, thereby enabling physicians to experience an improvement in career satisfaction.8

Other valuable benefits of stronger physician relationships with patients and coworkers have been well documented (see Table 1.)9,10 the benefits for patients include an improvement in satisfaction with their physicians, better adherence to physicians’ medical and therapeutic recommendations and an increase in medical outcome success. The positive outcomes for society are a decrease in preventable medical injuries and deaths with a reduction in healthcare costs.   Society also gains due to improved overall productivity from a decrease in lost workdays from illness. For physicians, the improved communication skills result in a decrease in medical liability exposure and improved career satisfaction.