The Transition
Clinical
Administration
leaders are at risk of interpreting the
time it takes to get feedback from
others and implement change as “slow,”
“bureaucratic,” and inefficient. This
attitude can interfere with their ability
to influence and collaborate with
individuals whose support is needed to
impact change.
Problem focus
Solution focus
Rapid assessment and
intervention
Complex problems
requiring collaboration
The Coaching Model
Solo expert
Many experts
Immediate feedback
and gratitude
Slower feedback cycle
and more frequent
complaints than
appreciation
Strive for perfection
Strive for “good
enough” and dynamic
response
Dr. F.’s story illustrates some common
issues faced by clinician leaders
adjusting to their new roles.
Leadership Transitions:
Clinician to Administration
“All about my success”
All about the
organization’s success
The above table illustrates some
of the more common transitions
physicians experience as they move
into leadership roles. In a 2011 O’Brien
Group whitepaper, Gordon Barnhart
terms this phenomenon “physician
whiplash.” Although quick assessment
(judgment) and intervention work
when caring for patients who have
life and death issues, the world of
administration requires a big-picture
view and the involvement of many
stakeholders and experts. Physician
In working with physician leaders,
the coaching model that I have found
effective is AGPE, which stands for
“Awareness, Goals, Practice, and
Evaluate and Sustain.” The model
works from the inside out, recognizing
that our beliefs, emotions and
subsequent behaviors impact results.
As Alexander Caillet describes in his
Thinking Path model, our thoughts
impact our emotions, and our emotions
impact our behavior. Our behavior
determines our results.
As coaches, we create awareness through
behavioral and motivational assessments
as well as through 360-degree feedback
surveys. Tools that I have used to great
effect include the Strength Deployment
Inventory and Portrait of Personal
Strengths, which allow for a memorable
and quick understanding of differences
in motivations and ways to communicate
and manage conflict. As my clients
learn how to better influence others, it is
critical that they learn to make it about
Physician Leadership Effectiveness Model
Motivations
Defined, observable,
measurable goals
Values
Behavior
Strategic alignment
Perceptions
(360-degree assessment)
Stakeholder feedback
Noticing
Evaluate impact
Strategic partners
Cueing
Structural support
Reinforcement
12 Coaching World
Awareness
Evaluate &
Sustain
Goals
Practice
(Behaviors)
Strategic impact
Taking action
Learning new skills
Persevering
Consistent application
the other person as
opposed to focusing
on their own agenda.
In working with
physicians, I have
found interviewbased 360-degree
feedback surveys
rich in the stories
they provide, as well
as indisputable from
a “data” perspective.
Clients are less likely
to question the
validity of data when
it comes directly from
their peers.
Phase two looks at
the client’s goals
and is often the first
time that someone
has provided a safe
space that is “all
about them.” For
many physicians,
this is the first
time that someone
expresses interest
in knowing who
they are in totality,
without any other
agenda. For clients
who have dedicated
most of their lives
to being perfect and
“getting it right,”
coaching provides
the opportunity to
be vulnerable and
imperfect. Goals
are established that
are measurable
and meaningful
to the client and,
if applicable,
the sponsoring
organization.
Once goals are
identified, a plan is
created that includes
the rehearsal of new
skills and behaviors.
Using client
language, we call
these “small tests of
change” to encourage
experimentation