Reflecting on the Power of Coaching

This past weekend SurgeonMasters hosted its inaugural coaching conference, Harnessing the Power of Surgeon Coaching. It was a great opportunity to further explore the untapped power of coaching in medicine. There are many reasons to engage in coaching. Maybe you want to improve your communication skills with patients. Perhaps you’re trying to advance your leadership abilities to exert greater influence in your hospital. No matter what your goals are, coaching can help. In this article, I will outline what coaching is, how it works, and where I see it going.

What Is Coaching

There are many models and styles of coaching - and they’re not all the same. However, in essence, coaching is a process that helps bring out the best in you. When defining something it’s often good to start by talking about what it is NOT.  Regardless of the challenges coaches work with, the same is true across the board - coaching is often misconstrued for something it is not, including:

  • Sports Coaching - Often this is where our mind goes first - the image of the sports coach on the sideline barking orders. Sports coaching is focused on win-lose scenarios, and less on individual progress toward self-define goals. When coaching is combined with many other skills, such as teaching, managing, and more, you can create a very successful leader. When you look at the portion of their leadership that helps athletes reach their maximum potential in competition and in life - that’s coaching.

  • Consulting - Consultants have an agenda and provide answers. They are experts in their field, just like many coaches. Consulting relationships usually end before implementing action plans, and rarely is there an ongoing relationship that allows for further adjustments to the plan. Coaching understands that the answers lie within the coachee and the longer relationship allows the process to be conveyed and practiced.

  • Mentoring - Having someone to lean on that has done it before and to model your behavior after is beneficial to your career. There is typically a hierarchy in this relationship skewed toward the mentor over the mentee. In coaching, there is more objectivity and detached involvement from the coach, and the understanding that the coachee will not necessarily do what you would have done in the same situation.

  • Therapy - A therapist functions to help clients fix problems and overcome issues. Coaches try to refocus “problems” as opportunities and don’t practice mental health without the proper training, credentials, and licensing. Therapy is often rooted in the past, whereas coaching focuses on the present and future.

It’s important to frame surgeon and physician coaching properly. Physician and surgeon coaching is more akin to executive coaching, and involves a process of reflection, goal setting, and incremental adjustments in behavior to accomplish self-defined goals.

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How It Works

Coaching moves ideas, plans, and steps forward. Atul Gawande has been advocating and observing this concept in action for several years. In describing the most effective coaches, he states "mainly, they observe, they judge, and they guide." "Good coaches speak with credibility, make a personal connection, and focus little on themselves... listen more than they talk...They are 100% present in the conversation....They parcel out their observations carefully." Coaching can help you reach your maximum potential in your career. Alternatively, you might want to learn coaching skills to apply in various aspects of your surgical practice or leadership position.

Where I see it Going

There are endless applications of coaching and coaching skills. In the future, I envision coaching skills being taught in medical school and training. Future leaders will rely on coaching skills to bring the best out of each member of their surgical team. Doctors will utilize coaching skills to instill a sense of resilience in their patients on the road to recovery. And surgeons will have an empathic peer listener to whom they can go for help processing a difficult outcome.

SurgeonMasters is building a community of surgeons and physicians interested in learning and applying coaching techniques to help surgeons and physicians manage the ups and downs of a successful career in medicine. A coaching mindset and skills are powerful tools. They enhance our ability for to help ourselves and others. If you would like to learn more about coaching and joining a peer support community of like-minded surgeons and physicians email Team@SurgeonMasters.com.

The Four Tendencies and the Power of Coaching

Note: this is part 3 of our ongoing series on Habits & the Power of Coaching. Read part 1 here and part 2 here.


In the third installment of this series, we examine The Four Tendencies, created by Gretchen Rubin, for creating habits. Gretchen is a four-time New York Times best selling author of The Happiness Project where she spent a year thinking about happiness and setting up networks of like-minded people pursuing happiness. Her work focuses on habits and what makes people happy.

The Four Tendencies

Before we get any further, let’s briefly outline The Four Tendencies framework. In this framework, Gretchen describes four types of people, broken down by how they respond to expectations (both inner and outer):

  1. Upholders. Upholders meet inner and outer expectations readily. They love rules, always have a clear plan, and are self-motivated and disciplined. They struggle in an environment that lacks structure.

  2. Questioners. As skeptics, questioners meet their own expectations, but resist outer ones. Questioners need to see purpose and reason in anything they do. Clarity as to why they should do something is all-important.

  3. Obligers. This is the most common type. Obligers love satisfying other people’s expectations, but struggle in prioritizing their own. Being held accountable by a friend, coach, or boss helps them a lot.

  4. Rebels. This category defies both inner and outer expectations. Freedom to choose feels most compelling to rebels. They want to be challenged, but not pressured into doing things.

If you’re interested in seeing which category you fall into, take this short quiz.

When it comes to creating new habits or changes in old habits, it is helpful to know how we respond to inner and outer expectations. When you understand which category you fall into, you can adjust your environment to better suit your tendencies. This process of reflection bearing out awareness is the first step in creating any habit.

How Coaching Supports the Four Tendencies

Personality tests are often scrutinized because our personalities can change over time. I also believe our personalities might change depending upon the situation. Therefore, the reproducibility of the test can vary depending on the surrounding circumstances. Ultimately, the purpose of using a personality test for habit change is not to give someone a label. It is to create an opportunity to explore whether incorporating the strategy increases your likelihood of success. If it works for you, this is a powerful tool! If it doesn’t, we cross this off the list and try another resource.  

Let’s look at physicians as an example. Most physicians fit the tendency of Obligers. As an Obliger, habits that relate to better service to others tend to be much easier to implement. If it creates efficiency and better patient care, the rewards are fantastic. However, the Obliger struggles to meet internal expectations. Being held accountable from a close colleague or coach can increase the odds of success for creating those healthy habits that seem to impact the Obliger most. It can also be very helpful to show the Obliger why the seemingly selfish habits are in fact unselfish because they meet the outer expectations of their friends, family, and patients indirectly (especially over time).


Take this The Four Tendencies Quiz and then consider how this might impact the most effective way to end old habits and begin new habits that are positive and create sustainability. We invite you to mail us what you found out! What is YOUR tendency? Did you reinforce what you already thought? Or was it different than you expected? Let us know your habit change, motivations, situational factors, and how it is going for you. Our team will follow-up with coaching questions to aid your self-inquiry. Your comments in private or on social media will also add to the conversations that we all need to be having.


Harnessing the Power of Surgeon Coaching

Working hand-in-hand with a coach can significantly increase your ability to create and maintain healthy habits. At SurgeonMasters, we offer coaching services to surgeons in all specialties. Let us help you create healthier habits and a more lifestyle-friendly surgical practice.

Want to learn more about surgeon coaching, perhaps to do a little of this on the side? Sign up for our inaugural training program on January 20, 2019 at the Kona Kai Resort & Spa in San Diego.

Tiny Habits and the Power of Coaching

Note: this is part 2 of our ongoing series on Habits & the Power of Coaching. Read part 1 here (LINK).

In the first installment of this series, we examined Charles Duhigg’s model for creating habit loops. Here, we’d like to take a look at another model - The Fogg Behavior Model (FBM), developed by Stanford behavior scientist BJ Fogg. This model outlines triggers (similar to the cues in Duhigg’s habit loop model) that need the appropriate levels of ability and motivation in order to activate. Dr. Fogg now refers to these triggers as “prompts.”

Fogg uses his model to create an approach called “Tiny Habits.” These are habits which:

  • “you do at least once a day,”

  • “that take you less than 30 seconds,”

  • “that require little effort.”

Learn More:  behaviormodel.org

Learn More: behaviormodel.org

I would like to give you an example from my life. Before I begin each surgery, the scrub sink is the prompt for my boundary ritual. For the first 30 seconds while I’m washing my hands, I let go of ALL of my other roles and responsibilities in life and outside the OR. I remind myself of my purpose for this particular patient in the operating room.

This is just one example of a tiny habit that can have a huge benefit - especially when linked with other tiny habits throughout the day.

How Tiny Habits Compound

Here is a quick breakdown of the tiny habits I go through each morning.

When I unplug my phone each morning from the charger, I head to the bathroom. After that I play one or two games on my phone to get my brain awake. At that point, I go to my calendar for the day and assess what my day will look like. Is there a big event for one of my kids? What do I need to get done? This tiny habit triggers my next tiny habit to find my most important daily email - the priorities email that I receive from my team leader. What are the priorities for SurgeonMasters for the day and the next few days? Do I have emails requiring a response? If yes, then I will need my laptop, as I don't like writing emails on my phone. Do I have client calls? I will need to be in the right environment to provide my undivided attention and care. Do I have a podcast to record? I will need a quiet place. My days are complicated, and the tiny organizational habits I created build on each other to help me manage my day with less stress and frustration.

Creating tiny habits can make a huge difference in the ease of accomplishing tasks throughout the day.

How Coaching Supports Tiny Habits

Creating tiny habits is a great way to incrementally improve our physical health and mental well-being. Over time the benefits compound, and tiny habits can produce deep results. How does coaching support our ability to create tiny habits? A great example is when we are first beginning to take action. Sure, it would be great to “just do it.” Chances are it is not that easy. In an iterative, give-and-take process, coaches ask driving questions that address underlying motivations and situational factors. By answering these questions, coachees benefit from thinking critically about their process, how it can be improved, and what additional steps are required to make the desired incremental changes.    

What tiny habits will you create this next week? Tell us here, along with your motivations, situational factors and how it is going. Our team will follow-up with coaching questions to aid your self-inquiry. Working hand-in-hand with a coach can significantly increase your ability to create and maintain healthy habits. At SurgeonMasters, we offer coaching services to surgeons in all specialties. Let us help you create healthier habits and a more lifestyle-friendly surgical practice.

Want to learn more about surgeon coaching? Sign up for our inaugural training program on January 20, 2019 at the Kona Kai Resort & Spa in San Diego.


Source: BJ Fogg, PhD, http://behaviormodel.org/

You can sign-up for a free, 5 day session of the Tiny Habits program at TinyHabits.com.

Creating Habits and the Power of Coaching

We all have habits - some negative, some positive - that influence our daily lives. All habits have a purpose and reason. Often, these habits form naturally based on our daily activities and environments. And, whether we like it not, these habits can influence the trajectory of our careers and personal lives. Early in my career, I never thought much about this. By default, I created some really good habits. However, I also created some that I now know had a lasting negative impact.

My hope is that you will be much more conscious of your habits. Periodic reflection and conscious adjustments over the past several years has created amazing growth for me.

I often think about questions like:

  • What is a current negative habit that needs to be replaced with a positive one?

  • How can I better control my habits?

  • When is the best time to start the change?

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While I know that I have made many self-adjustments over recent years, the most significant impact has come from working with coaches and the use of coaching skills. This article is the first in a series on Surgeon Coaching and the Power of Habit, in which I share how we can create amazing surgeons with a more healthy and sustainable model than our current methods in surgery.

How Are Habits Formed?

There are quite a few habit researchers that have published on the science of habit formation. In this article, I will highlight the habit loop, outlined by Charles Duhigg and discuss how it applies to surgeons.

In his book The Power of Habit, Charles Duhigg outlines the “habit loop” which consists of three basic parts of the loop:

  • Cue - The signal that triggers your habit. For example, your alarm in the morning, signaling that it’s time to start your day.

  • Routine - The behavior that follows the cue. For example, taking a shower, brushing your teeth, getting dressed, and getting something to eat.

  • Reward - The source of satisfaction that makes the habit so easy to repeat. For example, the efficiency of my time to get out of the house and getting productive as early as I can.

This particular habit loop is an example of a positive and negative habit. Quick doesn’t always mean healthy. This can also apply to my bad habits. For example, eating junk food when I am on-call to sustain my energy. The best way to break bad habit loops is to first identify each of these three components and then replace them. Typically, this starts with changing the routine, which leads to a different reward. For example, my morning routine often includes granola or yogurt because I adjusted my routine to get this at the hospital where it is available. The reward is healthy, and I am either rounding early or getting the pre-op work done so the patient will roll back to surgery while I am nourished with something healthy.

Making these changes requires effort and adjustments over time. We can create our own habit loops - focusing on maintaining our positive habits, while decreasing our negative habits. And with training, support and leverage from a coach, our chances of success are greatly improved. So how does a coach help with habit loops?

How Coaching Supports the Habit Loop

Coaches play an important role in personal and professional development. In a cyclical process of self-reflection, goal development, and intentional adjustment, you and your coach create a process and culture that fosters performance improvement and bolsters goal attainment. Likewise, we can apply this process to create habit loops. When we involve a coach, we decrease the learning curve and energy invested. A coach is there to guide self-reflection, analyze the cues, routine and rewards, share best practices, provide tools and resources, and provide feedback and additional inquiry as we round out the cycle and start fresh.

Looking for help creating a new habit? Habit loops are a great way to improve your performance inside and outside of the OR. SurgeonMasters has the tools and resources to assist. We also offer an advanced method to analyze your habit  - The 8 PRACTICEs Performance Improvement Tool. The 8 PRACTICEs is a methodology designed to bring awareness, intention and purpose to your actions. Check it out here and let us know how it helped you.

Working with a coach can decrease the time and energy it takes to create a habit and greatly improve your chances of maintaining it. SurgeonMasters also offers surgeon coaching and coach training. If you want to learn more about Surgeon Coaching or if you want to become a surgeon coach, our inaugural training program will be on January 20, 2018 at the Kona Kai Resort & Spa in San Diego.


Confronting Burnout In Our Communities

An article published early this year in the New England Journal of Medicine titled, “To Care Is Human — Collectively Confronting the Clinician-Burnout Crisis” lays out an argument for why burnout is an industry-wide problem and proposes options to start addressing these system-level issues. We may be tired of hearing the word “Burnout” or prefer a different word. More likely, we are tired of not moving forward. In this article, I propose three steps we can take today to confront burnout in our communities and move the ball forward.

Confronting Burnout

What can we do to stop the progression of burnout in our industry? Progress begins with working together.

According to the article: “The problem is not lack of concern, disagreement about the severity or urgency of the crisis, or absence of will to act. Rather, there is a need to coordinate and synthesize the many ongoing efforts within the health care community and to generate momentum and collective action to accelerate progress.” There is no doubt we need to address burnout at the system level. WE can take steps together at a local level today to make changes immediately.

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Steps We Can Take in Our Communities

Step 1 - Raise Awareness

We need to continue to raise awareness around burnout, its causes, the symptoms, and how it affects each of us.  One of the many misconceptions surrounding burnout is that you’re either burned out, or you’re not. That’s simply not true.  

Burnout operates on a wide spectrum and it affects each of us differently in similar situations and circumstances. That is what makes burnout so difficult to “diagnose” -  we can’t order a biopsy to find out if the symptoms are benign. The feelings associated with burnout can crop up at times when we least expect and manifest in behaviors we never thought possible.  

Simply being aware that burnout is fluid and presents itself in each of us differently is an important first step. Let’s continue to have important, intelligent conversations around burnout to raise our collective awareness.

Step 2 - Act

Raising awareness is only the first step and amounts to little more than cheap talk if we do not follow through. We must follow-up our talk with action.

Here are examples of three actions we can take starting tomorrow in our hospitals, institutions, and practices:

  • Peer-to-Peer Connection - Make connections with colleagues who are going through the same experiences you are. Sharing stories builds camaraderie and discussing solutions to similar problems can produce greater results with less stress and frustration. Find a group you trust and schedule regular meetings outside of the hospital to introduce a new environment.

  • Wellness Day - Incorporate a “Wellness Afternoon” or morning, or whole day! Give your resident, fellow, or colleagues an afternoon off at least once a month to see the doctor, dentist or go for that long bike ride they’ve been craving. This builds in time for self health and takes a major source of frustration off our plate, with relatively low cost to the hospital. If you think it will hurt productivity or the bottom line, the data argues that productivity actually increases. Very few physicians actually take personal or sick time off, and this contributes to burnout, unless we encourage “wellness” days rather than “sick” days.

  • Mindfulness Practices - Practice a form of mindfulness. Before you skewer this suggestion as just another lame meditation or yoga suggestion, hear me out. I encourage all of us to start looking at mindfulness with broader perspective. Mindfulness can be something as simple as a breathing technique before surgery, to something as elaborate as finding a creative outlet that improves active mindfulness. A great example is SurgeonMasters collaborator and orthopaedic surgeon, Jonathan Swindle, who described his love of car restoration as his creative outlet.

Step 3 - Support

The final step we must take is to truly support these activities at a leadership and institutional level. It’s not enough to simply offer encouragement or pay lip service to burnout prevention efforts. It is critical we devote the necessary resources to improving the health and well-being of our healthcare providers, and then provide support and encouragement. Let’s start working in our hospitals and communities at a grassroots levels to turn the tide on burnout.

SurgeonMasters delivers burnout prevention resources and wellness programs to educate, support, empower healthcare providers. Our signature program, WellnessEdge™, provides a strong foundation, including progressive strategies and forward-thinking action plans, to help surgeons thrive in their careers and personal lives. Contact the Team@SurgeonMasters for assistance starting a burnout prevention effort in your community.

 

Source: To Care Is Human — Collectively Confronting the Clinician-Burnout Crisis - The New England Journal of Medicine, Massachusetts Medical Society, Jan 25, 2018.