“I know I blow up and get angry. I am protective about my patients and the physicians in my department and I can’t help myself.”

Dr. Leonard was one of my coaching clients, a surgeon who had left a trail of destruction by his combative style everywhere – the operating room, staff meetings and medical executive meetings.

“I’m a leader in my surgical specialty. People expect me to be forceful.”

I asked, “What do you look for in a good leader?”

“I want someone who listens to me, who looks at all options without stuffing his solution down my throat. I want someone who is calm, thoughtful and . . .”

After a long pause I heard “Oh.”

In medical school we are taught to take charge, consider data and then make decisions – a reductive way of thinking.  We consider diagnostic possibilities, eliminate those that aren’t relevant and then decide on the lab tests and imaging studies we need to narrow the field.

We are taught to give orders.

In my first large management job, at the US Department of Health and Human Services as a senior executive working with Dr. Donna Shalala, I gave an order to my staff.

Nothing happened.

I gave it again.

Nothing happened.

And so began my long journey to become a more effective manager and eventually leader.

Recently I delivered a presentation at the XX in Health Retreat on coaching as a leadership style. With a coaching approach we stay curious and calm, ask questions and actively listen.

Given our busy schedules we often listen to others’ words, and then jump in with our solutions without really using the information we just heard.  What would health care look like if we created true teams?  It turns out there are many articles in the medical journals about exactly that – evidenced based articles.  The conclusion?  With effective teams – TRULY effective teams – fewer patients die.

What might you do to develop a coaching culture in your office, in your organization? Start with Coaching Behavior:

  1. Practice active listening.
  2. Ask open-ended questions. Gently probe, ask for details.
  3. Summarize what you heard, paraphrasing and asking for confirmation or clarification.

Keep a journal to record your thoughts as you move from telling to asking. Your journal becomes your road map on your leadership journey.

You can do it!


Margaret (Maggi) Cary, MD, MBA, MPH (medleadership@gmail.com) works with executives in large, small and startup healthcare related companies to increase their effectiveness as leaders. She develops custom-designed programs for organizations on leadership development. She has spoken at the Mayo Clinic, Georgetown University School of Medicine, the Harvard Macy Institute and the American College of Healthcare Executives, among others, on coaching as a leadership style. She is adjunct faculty at Georgetown University’s School of Medicine and George Washington University’s School of Medicine and Health Sciences.


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3 Responses to “Develop a Coaching Culture”

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    One thought–how often did “nothing happen” when you gave an order because you were female?

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