Should you have a coach? Greg Pawlson, Beth Griffiths, & Vicky Tang

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: Hi, this is Alex Smith.

Eric: Alex, is that your Halloween costume?

Alex: Aye. Indeed, matey. It’s Halloween.

Eric: For those who are not watching on YouTube, Alex has an ancient ax and some type of headgear on, like a Norse.

Alex: I don’t know if I have the accent right. [laughter]

Eric: What are you trying to be, Alex?

Alex: Maybe that’s a pirate accent. I don’t know.

Eric: You are a pirate, but you’re not a pirate. You’re not dressed as a pirate. Alex, maybe you need some coaching to figure out how to do Halloween costumes and accents correctly. But before we talk about that, who is on the Zoom with us right now?

Alex: Well, today, we’re delighted to welcome Beth Griffiths, who’s a Primary Care Internist and Associate Professor of Medicine at UCSF in Leeds, a coaching program for general internists, also at UCSF. Beth, welcome to GeriPal.

Beth: Thank you.

Alex: We’re delighted to also welcome Greg Pawlson, who’s Senior Faculty at Lodestar Consulting & Executive Coaching and former President of the American Geriatric Society. Greg, welcome to GeriPal.

Greg: Yep.

Alex: We’re delighted to welcome Vicky Tang, who’s a Geriatrician Researcher and Associate Professor of Medicine at UCSF and founded and leads the Junior Geriatrics Research Faculty wellness group. Vicky, welcome to GeriPal.

Vicky: Yay. Hi.

Eric: Well, we’re going to be talking about coaching and what it is. When do we need it? What’s the evidence behind it? Tons of other stuff. But before we get into that, who has a song request for Alex?

Vicky: I do. I have one.

Eric: Okay. Vicky, what is it?

Vicky: Don’t Stop Believin’.

Eric: Why did you pick this song?

Vicky: Because prior to coaching, I was starting to stop believing. It was after coaching that I reconnected with my why and my mission to help older people. Thank you.

Eric: Wonderful. Alex?

Alex: (singing)

Eric: I could tell Alex loved that song.

Alex: I love that song. It’s so fun.

Eric: Well, Vicky, thanks for the song, and thanks for the brief reason why you’re thinking about this, and maybe why the reason you’re also interested in coaching. Is that right?

Vicky: Yeah, that’s right. I have a coaching practice for geriatricians and those interested in increasing their impact in improving older life, older adult care.

Eric: Let me turn to you, Beth. Why did you get interested in coaching?

Beth: Yeah. Well, I was probably a couple of years into being on faculty, and I think I had a point at which one of the teaching roles that I was leading in the school of medicine went away. It was really a time where I think I was questioning what was next. I had the escape fantasies and on the weekends, my partner and I would go to the small town and think about being the small-town doctor and really was starting to re-question what was next.

I think I was very fortunate that one of my med school mentors and teachers, Dr. Sunny Smith, who runs a large coaching program now, Empowering Women Physicians, I think knowing her made me feel confident that it wasn’t a scam, that there might actually be some benefit to me to do some coaching. Through that process, I joined Empowering Women Physicians and it really changed my life. It made me feel purpose again in my work at UCSF, and also allowed me to pivot in some roles and see what was next.

I became a coach really because it had, like many people, an impact on me, and I wanted to be able to share that with some other people who I saw in my division and department, who are having similar issues.

Eric: That’s great.

Beth: Yeah.

Eric: Greg, I’m going to turn to you last. You’ve had a long, historic career as a geriatrician. Led the American Geriatric Society. Now, wait, you’re mostly doing coaching now? Is that right?

Greg: Yeah, coaching and leadership development. It’s funny. My wife, who’s a PhD nurse practitioner, who actually was a founding dean of the nursing school at GW, and I were thinking about, well, we’re not sure we want to work for somebody else all the time. We entered what we now call preferment. In other words, doing what we prefer to do, which is an absolutely wonderful place in life that few people are privileged to get to. The question was, what do we prefer? In thinking back through my career, mostly in academics, obviously about 15 years at NCQA as well, what I loved was working with bright people and seeing them develop and get smarter and better than me. And thinking, “How can I do that?” without being residency director or fellowship director or something, some grand pooh-bah title.

My wife had a coach at the time who asked her the question, “What do you want to do? Have you thought about being a coach?” We started talking about it, and coaching just seemed to have everything we ever loved about working with people who were bright, capable, and maybe just running against a wall, or up against some issue that they haven’t quite thought through. It’s so different from therapy. Because in therapy, you’re saying, “Well, here’s what I think you should do,” or, “You have depression,” or whatever. We make a diagnosis. In coaching, it’s, what do you want to do and how can I help you do that?” It really is totally different, because it really assumes that the person you’re working with has the answers and knows the questions better than you do.

Vicky: And it’s whole.

Eric: Let me go to the definition real quick. How would you define coaching? Alex, you play guitar, right? You’ve had a guitar teacher, right?

Alex: Mm-hmm.

Eric: Is Alex’s guitar teacher a coach, like a coach for a sports team? Is it a teacher? In some ways, maybe it’s like a therapist for Alex, too. How would you define a coach?

Beth: I think one of the things Vicky was talking about was, and also that Greg was talking about, too, is really assuming that the person is whole and has the answers for themselves. And that really coaching is much more about asking the questions, holding the space for people to consider for themselves what the answers to their questions are. First of all, I think it’s important to say that in my mind, there is not any kind of competition between coaching or therapy.

I think both are incredibly important, and often physicians struggle to ask for help, and clinicians more broadly struggle to ask for help. I think it’s really important to say that actually, oftentimes, people have both, and that both can be needed. But oftentimes, a therapist has deeper training and really history of trauma and specific diagnoses, versus a coach may be a little bit more future-focused and really works with people, regardless of whether they’re having any diagnosable challenge at the moment.

Eric: Vicky, anything you’d add to that? Also, I’m interested in how you think a coach differs from a mentor.

Vicky: Yeah. Also, getting back to what Eric’s question is. It’s like, is Alex’s guitar teacher a coach? Well, that guitar teacher could be a coach, depending on what their beliefs are and how they’re approaching the guitar practice. If they’re asking about, “Alex, how do you want to express yourself with your guitar playing?” that may be more of a coaching question than, “Let me just teach you the technical skills.” I think when you think about a coach, and plus everybody coaches differently, I think, we would say, and so they have different coaching philosophies.

Some folks may focus more on strategy and technique, so that would be more of a teacher, I would think, component. Whereas what Greg and Beth are saying with coaching is really helping that person come up with the answers for themselves, because they have it within themselves and we are just here to guide. Did that help, Alex? There was one other question.

Eric: What’s the difference between coaching and mentorship then? Because it sounds a lot like mentorship, like good mentorship.

Vicky: Exactly. Good mentorship, Eric. I think all good mentors need to have coaching skills. I do coach some clients that are mentors and I emphasize needing to learn coaching skills, but not every mentor has coaching skills. That’s the difference. A lot of, especially prior generations of mentors, that thinking of, “Well, I walk this path. I will show you how to walk down this path.” But a coach is really like Ken Covinsky stuff. “What do you want to do? What drives you?”

Alex does that, too. I know, because y’all are good mentors. Y’all have these coaching skills that you use, and so I think that’s the difference. You see a lot of mentorship where it’s just, “I walked down this path. I’m going to tell you how to do it. I’ll connect you with people.” But that’s not coaching. Coaching is really helping you figure out your why and how to get there, and give you that confidence to lead your own path.

Greg: Yeah. I’ll just add two things to that. One is, it’s the difference between me saying, “Eric, I know you want to be just like me and I’m going to do everything in my power so that you can just follow in my footsteps.” That’s mentoring and not very good mentoring. It doesn’t have the coaching elements. Coaching is like, “Eric, if your dream is to be an underwater basket weaver, what’s the barrier?” How do you get there?” It really is a very different focus.

The other thing I differentiate between big C coaching and little c coaching. Big C coaching is the formal, “I’m an executive coach, I’m a life coach,” et cetera. Although, to me, that blurs together a little bit. The other piece of coaching, it’s an incredibly powerful set of tools. We’re doing a lot of interactive relationship building. Leaders who are really, really good coaches, I think are incredibly agile, effective, compassionate leaders.

Because they don’t have to say, “Eric, this is what I want you to do, do it,” or, “I don’t know, just go do it.” They can coach you. They can ask, “Eric, what do you think about this problem? How would you put this together? What are going to be the blocks in your solving this problem?” Instead of taking on the problem and think they have to solve it themselves. It makes leadership so much, not only easier, but more effective. Because the higher up you get, the less you know about what’s really going on.

Beth: Yeah. I think we’ve emphasized the differences. I think I’ll also say, I think there’s a lot of good overlap in good mentorship. As Vicky said, good mentorship oftentimes brings in a lot of the same coaching skills. Sometimes, a coach has not actually walked the same path, and maybe a mentor hasn’t always either. But I think, certainly, I have found benefit in people who are trained in the coaching skills, people who actually have a pretty different career trajectory than me. But because they have belief in me and they trust me, and they hold space for me and they know that I have my own answers, they can actually help me very effectively, even if they might be a pathologist, for example.

Greg: Exactly, Beth. You’re seeing, what do they need? It’s also a lot what stage of career they are. If they’re a beginning fellow, that’s a very different coaching situation than coaching the chief medical officer or the president of a medical center.

Beth: Yeah.

Eric: Well, Greg, are there themes? If you’re going to be talking to the brand new intern on the service, or the chief executive of the hospital, are there some themes or similarities to how you’d approach that in the mentoring, sorry, not the mentoring, the coaching process? I got to get my terms right.

Greg: Hmm. It comes down a lot to, where are you now and where do you want to be? What are the steps in between and what’s blocking you? How can I help you move in the direction you want to go? That sounds simple and easy, but most people don’t know where they want to go. They don’t know how to get there, necessarily. They haven’t thought through it, they haven’t given themselves the time, and they haven’t really looked at what the barriers are going to be.

Alex: This sounds very different from the coaching I had when I was in the soccer team in high school, where they would line us up to run behind the van that they drove around town in the rain and we had to run and keep up with the van.

Beth: Oh, my gosh.

Vicky: Well, that’s my kind of coaching, Alex, actually.

Alex: Vicky’s process. She drives them.

Eric: It’s because she’s clearly like, “What? How do I make them the best person?”

Vicky: My process is …

Greg: Yeah. I would label that skills development coaching. You can use a coaching, again, I think it was Vicky that pointed out, you can use a coaching approach in almost anything, including guitar playing. You can ask questions. “What kind of soccer player do you want to be? What position do you want to play? How much are you willing to devote to this? How much drive do you have? What does it mean to you?”

Eric: It strikes me that there also seems to be a difference between coaching a team, like many of us are familiar with, and this individual coaching, although there may be group coaching as well. I don’t know, maybe you could comment on that.

Greg: Yeah, there is.

Vicky: I just wanted to answer Eric’s question. Because I do want to say, I gave a talk recently to the K Scholars, which is a junior faculty research group at UCSF. I showed them, basically, thoughts that senior research faculty at prestigious universities have that I coach, and one of them is, “I don’t have time.” And they feel overwhelmed. I point out to them that I’m not trying to scare them into coaching, but basically saying, “Hey, these thoughts that you’re having now, they don’t change. You can still succeed to professorship level at high-ranked institutions, but that experience is awful. This is a great opportunity as a junior faculty to address this now, during your upbringing, I guess, into the faculty world, so that you can avoid that in the future.”

Greg: Absolutely.

Vicky: I’ll just say there are themes. If you’re talking to an intern versus a CEO of some sort, there are themes. There’s fear of failure, needing to impress people. This is what Greg was talking about, life coaching blurs with executive coaching. These are all things that human beings find suffering in. Yeah.

Beth: I think that’s so important, Vicky. I think in medicine, in particular and probably in all clinical specialties, there is this sense of a rival fallacy of, “When I finish residency, I’ll be happy. When I become full professor, I’ll be happy.” I think one of the things we talk about in coaching is that, it’s not your external circumstances that create your feelings, it’s really how you think about them, similar to the cognitive behavioral therapy model. There’s a variety of coaching and not all schools of coaching teach in that way, but I know the one that Vicky and I have trained in does, and many others as well. I think that’s really important is actually in-group coaching.

To get to your question, Alex, in-group coaching, I think one of the things that can be powerful is that people can see, for example, we don’t always do this, but if you have a group and the intern is there and the division chief is there, and you can see that the division chief has … if they feel comfortable sharing. You have to create that in a group model. But if they are comfortable sharing that they are struggling with feeling like they’re not enough in some way, then the intern can actually see, “Well, it’s not going to be necessarily that if I become division chief that I’m suddenly going to feel confident about everything.” We have to do the underlying thought more in coaching.

Greg: Absolutely agree.

Eric: Beth, so you do this, right, with a group?

Beth: Right now, I’m actually just doing individual coaching, but we are writing a grant to start group coaching next year. One of our colleagues, Dr. Ilse Larson, in pediatrics, she is doing group coaching with pediatricians and OBGYNs at UCSF. I haven’t actually done group coaching as a coach yet, but I have certainly been a participant in group coaching.

Vicky: I have done group coaching with the geriatrics researchers in our group. It’s really great because they start modeling coaching skills with each other. It’s beautiful to see because you can hear them learn from each other, and they can better, I think, empathize with themselves when they see the issues that come up for other people. They can empathize with others and show compassion for others. Therefore, then they learn to show compassion for themselves when they see the same issues come up. Group coaching is really powerful in that way, I think.

Greg: Yeah. I think we want to make sure that there’s a difference between group coaching, which is coaching a group of people, and everything that Vicky and Beth said. They can resonate with each other and it actually builds momentum. Very little of our learning is totally isolated often. We learn in context. We learn with other people, so that can be very powerful.

Team coaching is different. That’s focused on helping a team develop, and you often coach each individual, as well as the overall team, group, which hangs together. Whereas a group may come together just for the coaching. There’s a difference in focus and even the way that the coaching is conducted.

Eric: Just so I can get my head around it, I’m going to turn to you, Beth again, what does your process look like for coaching? If you could summarize it briefly?

Beth: Beautiful. The program I currently have, people do six hour-long, one-on-one coaching sessions with us. You can do this many different ways, but the first one is a little bit more structured, like an assessment that we’re all familiar with clinically. But some of the questions that Greg was talking about, about basically, where are you at? They’ll look at a number of different domains in their life and rate them from zero to 10. And then, actually imagining, what would a 10 look like? Where do you want to get to? What’s your ideal state? And then, really, what’s in the way? What are the barriers? As I mentioned, oftentimes people think those barriers are external circumstances, but it’s also often partly related to how they’re thinking about it.

And then, in the five additional sessions, it’s really open to, what do they want to talk about? I often give them the prompts of, what’s on your mind? What keeps you up at night? What are the things from work that you’re still thinking about when you go home? Oftentimes, once people have been in coaching for a period of time, they already know what they want to get coached on as soon as they jump in. But at the beginning, people don’t really know what should I bring here? If they don’t have something that’s on their mind or that’s bothering them, then we go back to, what are their goals and how would we get them to that 10? What’s in the way?

And then, the process of actually then what it looks like is really, I think, the most important thing, which actually sounds very simple, but takes a lot of practice, is really holding space for them to come to their own answers. And asking them the questions that help them to uncover. Oftentimes, yes, people will want your advice. I was coaching someone this morning, who really wanted to know, what does your clinic template look like, and how do you respond to patient messages? Who gets a visit and who gets a MyChart message? Really, a lot of coaching is coming back to, there’s not a right way. There are many wonderful options and what actually feels right to her, and working through that process. The topics are many, but that’s part of the process.

Greg: I think that’s a really wonderful description of formal coaching or big C coaching. There’s two other kinds of coaching I do as well. One is, using coaching as learning facilitation. How do you facilitate learning? I can’t make you learn something. You have to figure it out. You have to incorporate it. I can either tell you, “Here’s what I want you to do and know,” or I can just give you a book and say, “Go read it.” Or I can use coaching. Coaching often asks, what’s your take on this? What for this is a difficult concept? What’s most challenging about this? What else do we need to know? What can we go look up together? It can be a technique there.

And then, the whole Lodestar thing that I’m doing now is just one of about seven or eight different groups I work with, is around trauma recovery and trauma mitigation. Because all of us understand how much the healthcare professions, and especially public health, just got whacked big time by a whole bunch of stuff, including COVID. But beyond that. Understanding and recovering from that and then building on it, to being able to be a really effective, positive-building leader is also another way you can use coaching. Without going into therapy, without digging deep into your past trauma. It’s just acknowledging-

Eric: It sounds like it’s a little bit blurring the line as we’re talking about trauma when we’re thinking about therapy.

Greg: Of course. Yeah, all these are blurring lines. When somebody is not able to function, they need deep therapy, and probably maybe even hospitalization. Who knows? It’s when they’re just not performing at their best on an ongoing basis, and sometimes that’s because of trauma. They haven’t recognized it and said, “You know what? COVID sucked. Here’s all the things that I had to do that I didn’t want to do that were really painful.” Acknowledging that and then moving past it. Focusing on the future, Beth said that before. It’s really future-focused. If they’re so deep and so scarring and so on, they need therapy.

Vicky: I know a lot of coaches will then refer to a therapist.

Greg: I do that all the time.

Vicky: Or, “Hey, I recommend going to therapy.” In a way, that’s beautiful. Because then, people that otherwise would not have reached out for therapy, but they would feel more comfortable reaching out to a coach because there’s “nothing wrong with you” when you reach out to a coach and a coach telling you, “Hey, you may need therapy.”

Greg: Yep. I’ve done at the same time, I don’t often do that, but I’ve coached people that are in therapy. We’re careful to talk about it and keep the boundaries clear.

Eric: I guess, if I’m going to turn to you, Greg, again, did you just use your life skills that you’ve had over time to become a coach, or did you do any training to become a coach?

Greg: No, I did a two-year formal coaching program at the Hudson Institute in Santa Barbara. It’s like, can you practice geriatrics without having been a geriatric fellow? Sort of, maybe, but it’s much better if you have the formal training. You can be more sure that what you’re doing is more evidence-based and cutting-edge and so on. I certainly wouldn’t want to coach and do what I do without having had that training.

I think I forget whether it’s Vicky or Beth said about a really, truly good mentor is doing some coaching. It’s not like you can’t do some of it, or that there isn’t some natural or some learned skills where you’ve had a person who coached you and you learned how to do that. Yes, there really is a pretty well-defined set of core skills that you need if you’re really going to do coaching in the most effective way.

Eric: Yeah.

Beth: I like that analogy, Greg. It’s like, for sure, I do a lot of geriatrics in my primary care practice, but do you guys do it better? Yeah, for sure.

Greg: Yeah. Yeah. Yeah. Well, it’s like early on in geriatrics, there were no [inaudible] fellowships when I started. I never did fellowship.

Eric: I guess, –

Greg: I wish I had.

Eric: … the acknowledgement more, do you want to specialize in geriatrics and be that your focus, or do you want to just have really good skills-

Greg: Yes, absolutely. Yep.

Eric: … in geriatrics as a primary care doctor?

Greg: Yeah. I teach coaching skills to leaders. I’ve been doing that, actually, at UCSF in the nursing school and with Kaiser. I do them also-

Eric: At the end of this podcast, I’m going to give you some time to think about it, I’m going to ask each of you one or two things that, as mentors, you can give us a coaching skill that we can use as our mentees. But I’m going to let that sit in for a second before we get to the end, because I got some more questions about this, too.

Greg: Oops.

Eric: Because, I guess, the question is, if I want a coach and I’m going to look for a coach, how do I know, oh, there’s Greg Pawlson, who did a two-year fellowship and there’s Joe Schmo, who just hung up his shingle that he’s a coach and he may not even finished high school? Again, that doesn’t mean he’s a bad coach, but he’s not done any training on it. How do you find a good coach? You don’t go to college or grad school to become a coach, right?

Greg: You can. There are master’s degrees in coaching.

Eric: Oh, yeah?

Greg: Yeah. Yep, and I certainly considered that as part of it. I felt like I didn’t need another one. I’ll use a coaching flip-back.

Eric: Oh, darn it.

Greg: How can I find a good geriatrician?

Vicky: Ooh.

Eric: Yeah, you come to UCSF.

Greg: I do, frequently. That’s where I got this raspy chest cold.

Eric: I’ll tell you how you find a good geriatrician. I think the very first thing is that there are standards for a geriatrician. You have to, A, have done a geriatrics fellowship and, B, had some ongoing and passed the geri board. There is a national standard. And there is no national standard in coaching, right?

Vicky: Well? Well?

Greg: There is in coaching.

Eric: Vicky, jump in here.

Vicky: Well, I’m going to jump in. Eric, come on now, you know not every geriatrician is of quality. There are specific geriatricians I have listed-

Eric: Well, that random person on the street can’t just say, “I’m a geriatrician.”

Vicky: But it’s true.

Eric: “I’m going to prescribe you a medicine.”

Vicky: That is true. That is true. But there are difference, right? There are differences between geriatricians.

Eric: Differences, yeah, but at least there’s some standard.

Greg: There is a standard. There is a standard and there’s a certifying agency, the International …

Vicky: Coaching Federation, I think. Yeah.

Greg: International Coaching Federation, ICF.

Vicky: Not that I’m part of it, but yeah.

Greg: If I were going to pick one, just like I’d pick a geriatrician who would board-certified, which, incidentally, I’m not. Never took the boards because I was on the writing committee, which was really weird.

Vicky: Whoa, AGS president here.

Greg: Anyway, different story.

Vicky: Just saying.

Greg: But the ICF does have three different levels of credentialing, actually, in coaching, and you actually have to pass a test. You have to have so many hours of instruction, 150 hours or something like that. You have to then coach a certain number of people in practice settings, like an internship, and then you have to pass a fairly rigorous exam that I had to study for. There are standards. There’s also a lot of people walking around that have never had any training at all, and some of them, I think, honestly are dangerous.

Eric: Greg, would that be your recommendation to look for a coach?

Greg: Yeah. I would certainly look for somebody who’s ICF-certified, or at least has gone through, and that’s much harder, a reasonable training program. The ICF has lists of certified training programs.

Beth: Yeah. I think maybe this is one of the ways of similar to how do you find a good geriatrician is, I think that there’s a lot of value in being coached before you go down, getting into the world of coaching. But I think you may, similar to a therapist, it’s not just about their credentials. I think that’s part of it. But I think it’s also important how you connect with the person.

Greg: Yep, absolutely.

Beth: I do think that many coaches, particularly if you’re willing to explore group programs, have more affordable options, or even free options for open house for a week or something like that, where you can actually go and see their coaching style before you pay them many thousands of dollars. I think that’s important. Similar to how we often will say to patients, “A good therapist should potentially offer you an hour, in which you can see whether it’s a good fit.” I think many of the best coaches will do that as well.

I think, to my view, it’s not just about the particular licensure that they have or certification that they have. But I think it’s also to do with, does it feel like the right fit? I would encourage people to also explore options to be able to briefly work with a coach for free or for a small amount and see whether it feels like a good fit before you invest.

Eric: Try it out. Yeah.

Vicky: I have two things to add. One, full disclosure, I am not certified by ICF. I was like, “Cut me off, cut me out of this podcast. I’m not qualified.”

Greg: Can we block her video right now? Hey, I said I wasn’t board-certified in geriatrics, so it happens.

Vicky: Yeah. Exactly. Greg Pawlson was AGS president, so let me just say that certification can go only so far. Second thing to say is that I think referrals are really important. I have hired coaches based on referrals. Beth is like, “Hey, my coach has an opening. She’s amazing. You should try her out.”

I think that speaks a lot when you have a colleague that you trust, or a friend that you trust, that has had this experience with a coach for you to go and try out. For me, I personally prefer folks that have walked in my shoes, or are specialized in, for example, academic life or something like that. But it doesn’t necessarily need to be…

Eric: Really quick … we’re running out of time here. I know we only got like eight minutes left. I just want to make sure we cover a few other topics.

Beth, I know you mentioned that you primarily mentor women faculty, and it does seem to me that there may be a gender story here. I know there was this recent paper we’ll link to in the show notes about coaching for, I think it was … Was it women residents?

Beth: And fellows.

Eric: Do you think there’s a gender story here, and what is that about?

Beth: Yeah. Our coaching program is actually open to people of all genders, but it is true that I think we do have more women that have signed up. Also, women are, if you look at the statistics, at higher risk for burnout in medicine, and that’s one of the goals of our coaching program. Certainly, we have prioritized women and people from groups underrepresented in medicine in our coaching program just because of the higher risk of burnout.

But to answer your question about the randomized controlled trial that was in JAMA, the initial pilot study was for women a couple of years ago, for residents. Now, most recently, hot off the presses in the last couple of weeks, there is a randomized controlled trial of resident physicians, women resident physicians at 26 sites. It includes anyone who self-identifies as a woman.

That coaching improved all of the different markers of burnout and moral injury, imposter syndrome, self-compassion, and the measure of flourishing, which, when I heard the study authors interviewed, they talked about that as thriving in every domain of your life. I think this is really incredible because it’s across many sites. It is based primarily on a group coaching model, which I think is important in terms of the feasibility of being able to reach a number of different people.

Greg: Yeah, I would agree. I think, obviously, it’s like anything else. Being the same race, the same gender, the same background and so on, sometimes adds something that you can identify more quickly and more easily. On the other hand, I would say, at least half my clients are very different from me.

The other thing. I think, clearly, people of color, women as a group, et cetera, have a lot more to overcome. Medicine’s a tough road for everybody, and we put all kinds of barriers in the way in addition. Coaching, perhaps, is really important. The other quick point I want to make is,-

Eric: Vicky, anything to add to that?

Greg: … this is an internal medicine audience ultimately. Where’s the evidence? Where’s the proof of this stuff? Does it really work? It’s interesting because I came into quality about 30 years ago, 40 years ago, quality research, and that was going on in business and there was no proof for it. It came into medicine and immediately, we started doing all kinds of randomized controlled trials and so on and show that it works, not perfectly, but it works. The same thing has happened in coaching. Every Fortune 500 CEO has a coach.

Eric: Yeah. Vicky, anything to add?

Alex: Well, I want to make sure, we’re running out of time.

Greg: We’re just getting the evidence now in some really good randomized controlled trial. I forget her. There’s a woman at Harvard, faculty member, who has done some really beautiful studies with residents, and I believe fellows, showing real impact.

Eric: We’ll have a link to one of those articles. I want to get to a couple last questions. Alex, did you have another question?

Alex: I want to hear your reaction to the Guardian article, if we have time for that.

Eric: Real quick, the Guardian article, the title was, I think we covered a little bit,-

Vicky: For the coach.

Eric: … “I’m a coach, you’re a coach: the rise of an unregulated industry,” about how a lot of this is trying to get people learn how to be a coach. But there’s also a push from industry of, how do we make money on teaching people how to be a coach? Vicky, your thoughts on that?

Vicky: I see Alex with his guitar. I do want to make sure we cover your request, Eric.

Eric: Oh, we will get there. Just one second.

Vicky: Okay. Good. Good.

Eric: You got 30 seconds on this.

Vicky: Wait, what was the question?

Eric: The Guardian article. We’ll have a link to it. I’m a coach, you’re a coach, everybody’s a coach. Let’s make money on teaching people to be a coach through these industries about teaching people how to be coaches, where you spend $20,000 and maybe there’s variable outcomes on what it means to be a coach.

Vicky: Yeah. I’ve thought about this, because I did read that Guardian article. And I would say, you could say that about college. We dropped tons of money with goals of, “Oh, you can go to med school. Oh, you can become the CEO of XYZ.” Variable outcome. Variable outcome.

Even [inaudible] fellowship, right? Geri Fellowship, all the fellowships.

Greg: That’s right.

Alex: What? [laughter]

Vicky: I’m sorry. I thought about it. It was like, you’ll get an NIH grant. Do you? Can you? That’s an outcome that only the person can decide to do, not the program. It’s a co-creation. I’ll stop now.

Eric: Isn’t there some need for some quality control, though?

Greg: There absolutely is, and it’s like early geriatrics. Any, at least, physician could put up and say they’re a geriatrician. It takes time and it takes refinement, and it takes doing studies that show what’s really important. We don’t know that yet. The evidence is pointing to certain things.

Eric: Okay. Real quick, lightning round, because I preempted this thought. Beth, I’m going to turn to you first, if you have one tip for me. I work with a lot of residents and fellows. I consider myself more of a mentor and a teacher, but is there one skill, thing I can do to practice on being more of a coach?

Beth: Well, I think the most important thing is, really turning the questions back to your mentee or your client, or whoever you’re coaching, of practicing the belief that they know what’s best for them. And then, holding the space. Meaning, really allowing silence and asking the questions that when they’re asking you to tell them what to do, don’t tell them right away. Really, try to turn it back to them and see in their mind what feels like the right next step for them.

Eric: A lot of it inquiry, really trying to-

Beth: Curiosity is such a great emotion to bring to training.

Eric: Curiosity. Wonderful.

Beth: To mention.

Eric: Greg, one thing?

Greg: Stop being the expert.

Eric: Wonderful. You don’t have to know everything. Vicky?

Vicky: More of a mindset. You do not control the outcome. Do not control the outcome.

Eric: Tell me what that means.

Vicky: I think especially as a mentor, you want so badly for your mentee to get what they want, or to get them that NIH grant or that XYZ. But the thing is, it is in the hands of the operator, not the operator, that mentee. And to trust that their path that they’re walking on is a path they’re meant to walk.

Eric: I love that, too. I think as a parent, I struggle with that, too. I think that’s really good parenting advice, too, is, I don’t control the outcome.

Vicky: You can’t control their emotions either. That’s another lesson in coaching.

Eric: Well, thank you for coaching me on how to be a parent there, Vicky. Appreciate that. I am not going to stop believing that one day, I’ll figure out how to be a parent, which goes to Alex.

Greg: When you become a grandparent.

Alex: (singing)

Eric: Oh, sad. Alex must have something at two o’clock, because he usually will sing that song forever. With that, Beth, Vicky, Greg, thank you for joining on this coaching podcast.

Vicky: Thank you guys so much.

Eric: And for all of our listeners, thank you for your continued support.