Coaching has been utilized in the business world and other professions for years, but is just now gaining traction in medicine. The rising popularity of physician coaching has led many institutions to develop internal physician coaching programs as a benefit to their employees. This can be attractive for a number of reasons—namely that it takes a lot of the leg work out of starting a coaching relationship independently. Minimal effort is required to research, identify, and retain a coach. Time may be provided to meet with the coach during “business hours.” And, of course, the cost is likely covered by the employer.
But all of these conveniences for the employee beg the question, “what’s in it for the employer?”
In order for an employer to provide coaching (or any other program for that matter), there is likely some business case for them. What is the tangible return they expect from investing in coaching for their employees? This expectation may conflict with many of the major tenets of coaching, starting with neutrality. Traditionally, a coach is a neutral party who has no personally vested interest in the choices that the client makes. This neutrality prevents them from bringing any outside influence into the coaching relationship. While the coach may work to challenge their client’s assumptions, they do not do so in anyone else’s favor. They don’t take sides in any conflict. Their responsibility is to support their client. But in an internal coaching program, the coach can easily be seen as an agent of the employer. Regardless of whether the coach is actually employed by the same employer, if they are retained and/or compensated by that employer, the allegiance can easily shift from the client to the institution. Any influence of the employer on the coach’s view of the client, their challenges, or their goals can interfere with the relationship.
Another core principle of coaching that can be challenged in internal programs is trust. A successful engagement requires psychological safety, so that the client can be vulnerable and transparent with their coach. In a traditional coaching relationship where the coach is retained directly by the client, there is an explicit expectation of confidentiality. Prior to engaging in an internal coaching program, expectations around confidentiality should be discussed.
With an external coach who is hired by the client, there is no risk for retaliation, as the coach has no power over the client. But when the coach has been retained by and/or is being compensated by the employer, there is potentially another master. Because of this financial interest, the employer may expect, or even mandate, that they are kept abreast of what is discussed in coaching. Any information that the client shares about the institution or specific individuals could conceivably be shared with the employer, which is a risk to the client.
Internal coaching programs also limit the number of potentially available coaches to work with. The coaching space is filled with coaches from all backgrounds with various types of training and expertise. This allows the client to identify a coach based on the characteristics that are most important to them. But most internal programs have limited pools to choose from, and it’s possible that the perspective the client is searching for is not available.
With all of these risks and limitations, is it even possible to get real value out of an internal coaching program? Potentially. Here’s what you’ll need to understand:
- Do you actually want coaching? If so, why? If not, why are you being asked to participate?
- Who gets to set the goals of the engagement? Are there institutional goals that could influence the direction of coaching?
- What are the expectations regarding confidentiality? Who will be granted access to what is shared in coaching?
- Who gets to define success?
- What is the structure of the coaching program? Is it an individual or group coaching model? Is it longitudinal or single, one-off meetings? If longitudinal, how many sessions are allowed?
Only you can determine whether you can get the intended benefits of coaching in an internal program. You’ll have to decide whether the conveniences of internal coaching—pre-identification of potential coaches, cost coverage, etc.—are more valuable to you than the advantages of external coaching. While pursuing external coaching would require you to take the time to find a coach on your own and pay for their services, it does mitigate the potential conflict of interest that internal coaching programs are at risk for.
Coaching should be viewed as an investment in yourself. The setup determines what kind of return you can get. Before engaging in an internal coaching program, do your research to figure out if you can truly get what you need from it, or if you are better off pursuing coaching independently.
Muyibat Adelani, MD
Muyibat is a board-certified orthopaedic surgeon in Saint Louis, Missouri whose clinical interests include primary and revision hip and knee arthroplasty. Outside of work, she enjoys sports, photography, and interior design.
Muyibat is a physician coach with SurgeonMasters.