by Lis Paice
What can a coaching approach teach doctors about listening and questioning they don’t already know?
It all started when a colleague – a GP and a passionate advocate for coaching – got the funding to set up a coaching service for doctors in my region. She talked me into attending the three-day training programme, if only to understand what coaching was all about. I didn’t think it would take that long to learn. After all, I had spent my whole career as a doctor listening, asking questions and sorting out what I needed to do for my patients. How different was coaching going to be from that?
In fact, of course, it was probably harder for a group of doctors to get our heads around the principles of coaching than for most. Gathering the facts, checking hypotheses, deciding what is wrong and deciding what should happen next, that’s what being a doctor is all about.
It was tough to understand why none of that is helpful in coaching, and the facilitators had a hard job getting us to experience first-hand why the coaching approach had advantages. It wasn’t until the third day of training that people started to come back with stories about how taking a coaching approach had transformed their consultations with patients, especially those whose lifestyle was aggravating their condition.
My own discovery of how coaching can change your practice happened in a different way. I was working with a group of patients on improving the co-ordination of services for frail, older people.
The group had met a few times, each time listening to what was being proposed and commenting, from their experiences, on whether the reforms were being helpful. The comments were mostly negative and there was a sense of, ‘Here we go again, nothing will actually change.’
And yet there they were, giving up their time to meet and talk about service redesign.
I decided to view the group from a coaching perspective. They were not in the group as patients looking for help, but as people keen to make change happen. We ought to be able to harness their resourcefulness more effectively.
One challenge was to get the group talking from shared, rather than individual, experience. I got them to help me gather examples of uncoordinated care.
One of the group turned out to be a writer and pulled themes from the examples into a single story – a patient journey gone horribly wrong. We found a big room suitable for people with mobility and hearing issues, gathered some props and some actors, and acted out the patient journey before a group of 40 or so older patients.
They discussed what they had seen within small groups, each with a facilitator who was instructed to listen, keep the discussion on track and ask open questions to explore how things could be done better.
The outcome of the exercise surpassed my wildest expectations.
Pages were filled with practical suggestions about how services could be better planned, health and social care staff could work more effectively together and with patients, and how patients could do more for themselves if only they had the support, tools and information they needed.
This experience convinced me that taking a coaching approach – listening rather than telling, and then harnessing the resourcefulness of patients – must be the way forward in involving patients in improving care.
Lis Paice OBE FRCP FInstLM is a doctor, executive coach and chair of two integrated care pilots in London. Her recent book New Coach: Reflections from a Learning Journey is published by McGraw-Hill
Coaching at Work, Volume 8, Issue 5