Coaching in the Upside Down World of Health Care

Over the course of the year we worked together, Jeff learned how to separate from his colleagues in order to lead them without losing his sense of connection. He also learned many basics of leadership from how to run an efficient meeting, to project management, delegating and empowering others, clarifying decision-making processes, and building rapport between the doctors and nurses. The docs stopped drinking at the computer stations and Richard was only late one more time. The ER quality metrics improved consistently. Jeff learned how to manage up and set realistic expectations for the C-suite and he became much more involved with the hospital at all levels.

I knew Jeff was really making progress in his understanding of his leadership when he said to me one day, “I think I finally get it. All this time you have been trying to show me that even though I am still a clinician, I am also running a multi-million dollar business.” “Yes,” I said, “That’s it.”

Being An Enterprise Leader

Another challenge for physician leaders is to understand how to wear both an enterprise and departmental or other functional hat. Providers and staff do expect their leaders to defend them against what are experienced as unrealistic demands by the administration. For physicians, these demands often get in the way of their time and ability to practice medicine. Yet, physician leaders who sit on the executive leadership team also see that executive level decisions may at times negatively impact their specific department. They know what it means to sit at the table, but they don’t always know how to lead in both roles simultaneously.

I was working with an executive team of 12 leaders, including many physicians. The group had lost trust and was adrift in a team culture of blame, polarization, and indecisiveness. In one of our first workshops, I and another coaching colleague began to explore what leadership meant to them. We asked them to take a walk outside and take a picture to send to us that represented “leadership.” We also asked them to think about the question “What does it mean to be an enterprise leader?”