Reducing clinician inefficiency and restoring meaning in practice: A professional coaching approach for family medicine residents

Abstract

Burnout is widespread among primary care physicians (PCPs). Several key drivers of burnout in this specialty that have been increasingly recognized are the growing complexity and work demands placed on PCPs by outpatient clinical work environments. These high demands, from the perspective of the physician, detract from other valued tasks which provide meaning in daily work such as relationship-building and fellowship with the medical team. Given these trends, we believe that a viable means to address burnout can be found in utilizing a performance coaching approach to equip resident physicians for the practical and emotional demands of the primary care work environment into which they are entering. Specifically, we recommend a focus on clinical efficiency as an area for coaching development due to its potential impact on resident physician well-being. In this brief review article, we provide a summary of evidence for coaching interventions, along with evidence supporting an expansion to these approaches in clinical efficiency in outpatient settings based on the connection between workflow and engagement in meaningful medical practice. Lastly, we outline a prospective coaching approach which targets common sources of clinic inefficiency for resident practitioners.

Effect of a Novel Online Group-Coaching Program to Reduce Burnout in Female Resident Physicians

“…The coaches were certified by The Life Coach School, a thought-based coaching institution with training in both group and individual coaching. 18 , 19 , 20 The Better Together curriculum was housed on a members-only, password-protected website. Participants could participate in any or all of the following: (1) 2 group-coaching calls per week scheduled on weekdays at 7 pm on a video-conferencing platform where up to 5 participants could be coached live on any topic (these calls were recorded to allow for later asynchronous viewing), (2) unlimited anonymous written coaching in an “Ask for Coaching” forum where participants could submit a narrative reflection and receive a written coaching response published on the website, and (3) weekly self-study modules (videos and worksheets) on topics including goal setting, growth mindset, receiving critical feedback, impostor syndrome, and perfectionism.…”

“…Available literature shows that coaching may reduce burnout and improve well-being among physicians and trainees. 17 , 20 , 21 , 22 , 23 However, most studies rely on resource-intensive interventions and use variably trained coaches and in-person sessions that are challenging to incorporate and scale within graduate medical education. 20 , 21 , 22 , 23 , 24 We posited that a 6-month, web-based group-coaching program led by certified physician coaches would decrease burnout among resident physicians.…”

“… 17 , 20 , 21 , 22 , 23 However, most studies rely on resource-intensive interventions and use variably trained coaches and in-person sessions that are challenging to incorporate and scale within graduate medical education. 20 , 21 , 22 , 23 , 24 We posited that a 6-month, web-based group-coaching program led by certified physician coaches would decrease burnout among resident physicians. Here, we describe the results from a pilot randomized clinical trial of our coaching program, Better Together Physician Coaching (hereineafter referred to as Better Together).…”

“We’re all going through it”: impact of an online group coaching program for medical trainees: a qualitative analysis

“…Professional coaching is relatively new in academic medicine and has been shown to improve burnout and wellbeing among physicians and trainees [ 14 , 16 , 17 , 19 , 20 ]. Much of the existing coaching literature describes individual (1:1) coaching sessions and focuses on quantitative measures of wellbeing outcomes rather than understanding the facets that may contribute to their success [ 14 – 17 , 20 ]. Our findings add to the literature by identifying concrete mechanisms by which this coaching intervention supported wellbeing among participants.…”

“…Most previously described coaching interventions use variably trained coaches, and 1:1 in-person sessions which are logistically challenging and costly to incorporate and scale within GME programs [ 14 – 20 ]. A lesser explored alternative is group coaching [ 10 , 11 ].…”