Setting Standards for Physician Coaching May Help with Burnout

Professor Angela Passarelli said the coaching industry can impact health care, but needs tailored guidelines for physicians

May 22, 2024
Health Care, Management
Angela Passarelli_Standards for Physician Coaching_Duke University's Fuqua School of Business

The coaching industry has often catered to physicians holding leadership positions within their organizations. But with many doctors considering quitting their jobs, coaching has also emerged as a tool to address the burnout that seems to be afflicting the medical profession.

“During the pandemic, we found that physician burnout was skyrocketing,” said Angela Passarelli, a professor in the area of management and organizations at Duke University’s Fuqua School of Business.

Passarelli said it is no surprise that health organizations tapped into coaching to help alleviate the issue of burnout, since several studies have already shown coaching’s effectiveness in improving the wellness of health care workers and even preventing turnover.

However, the current market of physician coaching is marred by a lack of standardized expertise, Passarelli said.

A lack of regulation

There are a number of credentialing bodies, Passarelli said, but none target the specific subfield of physician coaching.

“And some coaches don’t have any certification at all,” Passarelli said. “It's not like accountants who have the CPA exam. Someone could have zero coaching training and still market themselves as a coach. It's just a highly unregulated industry, and it is booming.”

Even if one were to hold a general coach credential, Passarelli and her colleagues realized additional specialization was needed, and a broad “health care certification” wouldn’t address the specific needs of physician coaching.

“The needs of physicians are different from the needs of nurses or other health care professionals,” she said. “So, we started with physicians.”

Determining key competencies for physician coaches

In the paper, “Competencies for Those Who Coach Physicians: A Modified Delphi Study”, published in the journal Mayo Clinic Proceedings, Passarelli and co-authors start the process of gathering stakeholder consensus around a baseline of standards for physician coaches.

“The goal was to create a scientific foundation for the practice of physician coaching,” Passarelli said.

The researchers adopted the “Delphi technique,” a common method “to establish competencies in medicine” through expert opinions from stakeholders.

First, the Institute of Coaching selected a group of 11 experts who agreed on a list of “thematic areas” and “competencies” for physician coaches. The researchers then designed a survey to collect responses from a wide sample of stakeholders representative of the United States and Canada physician coaching industry.

“We involved not just people who are physician coaches, but also physicians who have been coached,” Passarelli said.

Nearly 100 stakeholders commented on and rated the expert suggestions, and determined a final list of 129 specific competencies under six general themes that reflect the most in-demand areas for physician coach expertise and training: 1) Physician-specific coaching; 2) Understanding physician and health care context, culture and career span; 3) Coaching theory and science; 4) DEI and other social dynamics; 5) Well-being and burnout; 6) Physician leadership.

The agreement around the responses ranged from 80.5% to 95.6%, the study shows.

“And what surprised me was that when we asked people to rank the six key areas in order of importance, what came out on top was ‘coaching theory and science,’” Passarelli said. “It shows that the field is very hungry for evidence-based competencies.”

The applications in health care

Passarelli said health care organizations running internal coaching programs could use the study as a basis for their educational material. And if they are hiring coaches, they will be able to select them based on knowledge of the key areas that emerged from the survey.

But she said these are only standards for entry into the field, not predictors of what makes an effective coach.

“What we created is a baseline of what you need to understand in order to work effectively with this particular population,” Passarelli said. “What we did not do is to create standards that distinguish the best coaches. For that, we will need more behavioral trials.”

Maybe some well recognized medical organization, such as the National Board of Medical Examiners, can use these guidelines to certify physician coaching, Passarelli added.

“Coaching is like a band aid to a bigger systemic issue,” she said. “Burnout needs to be addressed at a system level. But until those system-level changes can happen, coaching is one way to alleviate the suffering that's happening for some of these health care professionals. When they are functioning at their best, the quality of care improves.”

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