Exceptional athletes and singers have a coach. Should a physician?

New Yorker Magazine. October 3, 2011

Surgeon Atul Gawande got real about his inability to lower his complication rate on his own when he realized that, like most surgeons, he worked in isolation and had “no outside ears and eyes”to help him improve. But he hadn’t arrived at a solution. Then, during a chance encounter with a tennis coach. Gawande was so impressed that a “kid just out of college” could dramatically improve his serve after only a few minutes observation that he began to investigate physician coaching and its effects. That led him to his own personal physician coach and a lower surgical complication rate.

Gawande, who is also a New Yorker Magazine staff writer, found that effective sports, educational, and personal or professional coaches use similar techniques to help clients. For example, most encourage dividing tasks into small steps and focusing effort. Overall, a coach supplies those “outside eyes and ears” that keep you alert to your opportunities to increase your competence. Regardless of how competent you become, Gawande writes, “few can sustain their best performance on their own.”

Finding the right coach can be “tricky” Gawande notes, because humans resist being critiqued. But effective coaches ease this discomfort by becoming your confidant with a high degree of integrity that thoughtfully collaborates with you on your own goals – most commonly through plain conversation, sometimes observations of performance, and occasionally reviewing videos.

Gawande found his own coach could distill hours of observations into a twenty-minute discussion that provided more strategies to consider than he’d had in five years. With his coach’s support, he began to look at the way he planned prior to surgery, he began to watch colleagues’ surgical techniques.

Just four hours of coaching per month had Gawande making smarter decisions and improving his techniques. He reasons that, if coaching helps him avoid a single complication–which typically results in fourteen thousand dollars in costs, as well as pain and suffering – it’s worth it.

If physicians who are competent and well-along in their careers can abandon the view that they are through with being observed, they can enjoy “the most effective intervention designed for human performance,” Gawande writes.

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