Chandresh Shah

Everyone Needs a Coach – Even Doctors!

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Ted talks have become a phenomenon.I’m sure you all have heard at least one good Ted talk. One of my favorite authors and thinkers in the healthcare space is Dr. Atul Gawande. Many of you may have read one of his books on the checklist manifesto.

He gave a Ted talk on ‘Want to get great at something? Get a coach’

(Watch the video here)

As we know, Dr. Gawande has really been focusing on how to make things work better especially in the healthcare arena. In this talk, he says it is not just how good you are now, it is how good you are going to be or how good you can be that really matters.

He was talking about being a great physician, but I will take it further – physicians need a coach even for their other role as a business owner.

Who needs a coach?

Here is what he said, “You are never done, everybody needs a coach. Everyone. The greatest in the world needs a coach.” This view comes from the world of sports.

I am transcribing some of the things that he said here.

“So I tried to think about this as a surgeon. Pay someone to come into my operating room, observe me and critique me. That seems absurd. Expertise means not needing to be coached.

Turns out there are numerous problems in making it on your own. You don’t recognize the issues that are standing in your way or if you do, you don’t necessarily know how to fix them. And the result is that somewhere along the way, you stop improving. And I thought about that, and I realized that was exactly what had happened to me as a surgeon.

I’d entered practice in 2003, and for the first several years, it was just this steady, upward improvement in my learning curve. I watched my complication rates drop from one year to the next. And after about five years, they leveled out. And a few more years after that, I realized I wasn’t getting any better anymore. And I thought: “Is this as good as I’m going to get?”

So I thought a little more and I said … “OK, I’ll try a coach.” So I asked a former professor of mine who had retired, his name is Bob Osteen, and he agreed to come to my operating room and observe me.The case — I remember that first case. It went beautifully. I didn’t think there would be anything much he’d have to say when we were done. Instead, he had a whole page dense with notes.

“Just small things,” he said.

But it’s the small things that matter. “Did you notice that the light had swung out of the wound during the case? You spent about half an hour just operating off the light from reflected surfaces.” “Another thing I noticed,” he said, “Your elbow goes up in the air every once in a while. That means you’re not in full control. A surgeon’s elbows should be down at their sides resting comfortably. So that means if you feel your elbow going in the air, you should get a different instrument, or just move your feet.” It was a whole other level of awareness. And I had to think, you know, there was something fundamentally profound about this. He was describing what great coaches do, and what they do is they are your external eyes and ears, providing a more accurate picture of your reality. They’re recognizing the fundamentals. They’re breaking your actions down and then helping you build them back up again.After two months of coaching, I felt myself getting better again. And after a year, I saw my complications drop down even further. It was painful. I didn’t like being observed, and at times I didn’t want to have to work on things. I also felt there were periods where I would get worse before I got better. But it made me realize that the coaches were onto something profoundly important.

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