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The Role of a Coach
One of the things that’s interesting to me is how different professions approach improving their skills over time. The common approach in a field like medicine is what I call the “pedagogical approach.” You are going to go to school forever. You’re going get your 10,000 hours of practice in internship and residency, and then you’re going to be set loose on the world. And part of being a professional is the expectation that you will improve yourself, that you own responsibility now for the fact that the technology will change, the skills will change, and you will go about the task of getting to better performance yourself.
I was midway through my surgical career. I had been assiduously tracking my surgical complications and other measures of how I was doing as a surgeon, and I’d seen year-on-year steady improvements. And at about 10 to 12 years into practice, I found that I’d flattened out. I’d reached a mid-career point where I wasn’t getting that much better. I wasn’t really getting better at all. It struck me that I might consider getting a coach. I asked one of my former professors to come to the operating room and observe me. I had done a couple thousand of these thyroid cancer procedures. It had gone extremely well, took about just over an hour. He’d been sitting in the corner taking some notes. He had 20 minutes of things to tell me about. “Did you notice that the light that was shining in the patient’s wound had drifted off course, and you were only getting indirect light?” “Did you notice that the anesthesiologist was struggling with the blood pressure for about 10 minutes during the operation?” “I noticed your elbow goes up in the air, and if you move your feet a little to the left, that allow you to keep it down on your side so you’re always in full control.” It was amazing.
That’s the difference between a teacher and a coach. A teacher is going to make deposits of knowledge or skill, but not necessarily see your performance in an ongoing way. And helping you walk through the process of change and improvement is the role of the coach.
Coaching Basics
We ended up introducing a surgical coaching program at all Harvard hospitals. It changed the culture and the mindset of surgeons themselves. You needed to have some humility to allow someone to come observe you and what you do. That you needed to recognize this isn’t just for beginners, but people at any level of the profession.
The training program took people through some of the important basics that the purpose of a coach is to first not be the one to set the goals for a surgeon, but instead to say, “Here are the kinds of goals we can work our way through. We can improve technique. We can improve teamwork. We can improve leadership. We can improve teaching. Where would you like to start? What would you like to accomplish over the next three months?” That gives you a shared basis for saying, “We now agree on what I’m going to observe and help you with.”
I have a executive coach as well. He’s asked me to record my meetings so that he could give me feedback. “Did you know you spent more than 70 percent of the time doing the talking in this meeting?” “No. There’s no way.” “Well, that is the reality. So what’s your goal on how much talking you want to be doing next time? How can you get to that point? Can you start the meeting with questions instead of statements? Can you make sure you set clear action steps at the end of your meeting?” That ability to have someone providing an external set of data on your reality is such an important part of changing your mindset.