While much of the business world is calling these times “The Great Resignation,” for family physicians “The Great Reprioritization” may be more accurate. There were already plenty of stressors in the profession prior to March 2020, and now two-plus years of the pandemic, economic upheaval, political polarization, and social unrest have provided more reasons for many in health care to step back and reassess their careers, priorities, and aspirations.1,2,3
Family physicians are like pluripotent stem cells, with many options for career and professional satisfaction. When the trajectory we’re on no longer works for us, or we find ourselves thinking “there must be something more,” coaching is a tool we can use to forge another path — not to abandon our profession, but to refresh its possibilities. The coaching process includes answering critical questions such as “Where have I been?” (insight), “Who am I now?” (information), and “What do I want/where am I going?” (inspiration/illumination).
This article explains the coaching process, including journal assignments to help family physicians begin to experience the coaching process for themselves. The aim is to help family physicians advance on their professional journey and improve their personal well-being.
Having a coach to provide objective observations, clarity, accountability, and encouragement can be invaluable, particularly for physicians who feel “stuck.”
The coaching process involves learning from past experiences, exploring how your identity and strengths can help you surmount present challenges, and building a vision for the future.
The journal assignments included in this article can help family physicians begin to experience the coaching process for themselves.
THE COACHING PROCESS
“Coaching is unlocking people’s potential to maximize their own performance.” — Sir John Whitmore, author of Coaching for Performance
The International Coaching Federation (ICF), a leading accrediting body for coaches, defines coaching as partnering with an individual in a “thought-provoking and creative process that inspires them to maximize their personal and professional potential.”4 Coaches employ keen listening skills, insightful questions, reflective dialogue, and a future-oriented mindset to help those they’re coaching explore possibilities, realize untapped potential, and optimally achieve in their present circumstances so they can become more effective, efficient, and engaged.5
The coaching process begins with perceptive questioning based on the Socratic method of inquiry. This spurs guided self-exploration in the person being coached. Coaching then provides a structure for translating this information into achievable goals and habits that drive professional and personal growth. Having a coach who can provide objective observations, clarity, accountability, and encouragement can be invaluable, particularly if the person being coached is feeling “stuck.” (See “Finding the right coach.”)
FINDING THE RIGHT COACH
While there are many qualified professional coaches, finding one whose personality fits with yours is also important. Here are a few tips:
Ask potential coaches for an initial coaching session (at no charge) as a sort of “interview” to see if you feel comfortable being open and honest with them.
Examine potential coaches’ qualifications and experience — such as training in an International Coaching Federation (ICF) accredited program or holding an ICF credential. The organization has a searchable directory of credentialed coaches.
Ask potential coaches about their coaching philosophy, how they structure their coaching process, and how they measure success.
Ask potential coaches for references.
Although there are numerous coaching models, one of the most popular is Whitmore’s GROW model:6
Goal — Where do you want to be?
Reality — Where are you now?
Options — What could you do to get there?
Will (or way forward) — What will you do?
One of the authors (Greenawald) has taken the GROW model and expanded it to GROOVE (goal, reality, options, obstacles, visualize/vocalize, and execute) for his coaching. (See “The GROOVE method.”)
With any model, the goal is to learn from the past and intentionally and thoughtfully close the gap between your present reality and the future you desire. The three sections that follow provide strategies, tools, and questions for you to begin to experience the coaching process for yourself. Recording your thoughts in a personal journal will make the process more effective.
THE GROOVE METHOD
Goal — Define it.
Reality — Recognize it.
Options — Explore them.
Obstacles — Identify them.
Visualize and vocalize — See and share your desired destination.
Execute — Define serial next steps.
LEARNING FROM THE PAST
“We all need 30 minutes a day for time to reflect, unless we are busy, then we need an hour.” — attributed to St. Francis de Sales
Challenging times call for purposeful pause to reflect on past experiences and observe our resulting emotions and actions. While it is helpful to look back on what went well in the past, it is also valuable to identify what did not work and where you may have gotten stuck.
Write in your journal about a recent challenge in your life — perhaps a trauma, a loss, a difficult interaction, a failed project, or a missed promotion. What occurred? How did you interpret the event? What did you think, say, do, and feel?
Next, consider what you did well and what you could have done better. How well did you care for yourself and for others during this challenge? What gaps might you need to overcome to enhance your professional performance and well-being?
Finally, what did you learn? As you reflect on this recent challenge, consider whether you have a fixed mindset (i.e., people don’t change) or a growth mindset (i.e., change is possible). The former will keep you stuck, while the latter will help you grow. Consider how you were changed by the experience. What growth did you see in your personal or professional life? What lessons did you learn? What insights might you take with you from the past into the next phase of your life, the next interaction, the next team project, or the next committee meeting?
Record your initial answers and then revisit them at a later date to consider what ongoing reflection might reveal. “Crucible” events from our past affect our present and future, but they can teach us about ourselves if we embrace them as opportunities and make time for reflection.
THRIVING IN THE PRESENT
“Yesterday is history, tomorrow is mystery, today is a gift.” — Eleanor Roosevelt
In stressful times, we may gravitate to external quick “fixes” such as junk food or alcohol in search of happiness, or at least numbness. But these can actually pull us further away from who we genuinely are and lessen our internal capacity to face challenges. Allowing ourselves instead to feel our unhappiness and recognize where it comes from helps us to ultimately rise above stressors and go deeper in a search for authentic meaning in our lives. Then, we can envision a new future.
When addressing present challenges, it’s helpful to look inward at who we are, declare what matters to us, and apply our strengths to the problem.
Make a list of the identities that are important to you in your family life (e.g., parent, child, spouse, or sibling), professional life (e.g., clinician, educator, researcher, administrator, or mentor), personal life (e.g., writer, artist, or musician), and community life (e.g., neighbor, board member, or community advocate). Our sense of identity is key to our happiness.
Next, prioritize activities that maintain those core identities. Author and speaker Stephen Covey calls these things our “big rocks”7 — our top priorities (spending time with family, improving our health, etc.) that we are most passionate about and should keep front of mind when evaluating any life change or challenge. Covey suggests imagining your life as a large empty jar. If you put the big rocks in first, you will be able to pour your lesser priorities in around them, like gravel or sand. But Covey’s warning to those of us who are busy is that if we first fill our jars with gravel or sand (things that are less important to us), it will be impossible for us to later fit in the “big rocks” that matter most. What matters to you now, at the present moment? Identify three “big rocks” in your life.
Finally, identify your top strengths and consider how you can leverage them to advance in what matters most to you. Research has shown that using personal strengths in times of adversity enhances personal and professional authenticity, engagement, and leadership.8–11 Understanding and applying your strengths can help you boost confidence, increase happiness, strengthen relationships, manage problems, reduce stress, accomplish goals, build meaning and purpose, and improve work performance. There are several tools available to help you recognize your strengths, including the VIA Institute on Character’s free, validated survey and Gallup’s CliftonStrengths Finder ($49.99). Post your strengths in a prominent place, such as the cover of your personal journal, to remind yourself of what you do well and how you can use these qualities to overcome the challenges of the present and realize your identities and priorities.
FLOURISHING INTO THE FUTURE
“You are always one decision away from a totally different life.” — attributed to many
The decisions you make in the present help determine what your personal and professional life will look like in one year, five years, 10 years, and beyond. The coaching process provides structure and space to make your future “by design” rather than “by default.”
Coaching is not simply for those who are looking for a change of circumstances. The process can often allow us to see our present circumstances in a new light and make small changes that can have significant impact on our future happiness. Coaching provides permission to dream and to imagine a new future. When we envision new possibilities, we can reconnect to our purpose and acquire skills to achieve it.
Use your journal to explore your vision. What do you want your future to look like? Where do you see yourself in one, five, and 10 years? If you could design your ideal work life or home life, what would it look like?
Next, explore what you need to do to get there. What are the first steps you must take? What changes must you make? What should you keep doing, stop doing, and start doing? Being intentional in your approach to the future and having a structure in place to help guide you substantially increases your chances of flourishing, rather than just surviving day-to-day.
A COACHING SUCCESS STORY
To pull together all of these ideas, consider the story of Margie, a primary care physician who has been in practice for 15 years but describes the last two as “lost years.” During this time, she got married but lost out on the wedding and honeymoon experiences because of the pandemic. She tried to prioritize her family but lost her mother and sister to COVID-19. She tried to focus on the needs of her patients and their families, but she was reassigned from her primary care clinic to urgent care, vaccine clinics, and a nursing home practice where nearly 60% of the patients she cared for died. She struggled to stay connected to colleagues and friends but lost many relationships and her sense of purpose. Margie, feeling isolated, fearful, and negative, sought help from a coach.
The past. With the help of her coach, Margie delved into her recent past. They reflected on how her losses over the last two years resulted in her feelings of isolation, fear, and negativity. By journaling and analyzing her responses, she was able to see that despite all the loss, she remained happily married, focused on her patients, and balanced in her self-care.
Margie saw how the pandemic, though a time of great challenge and loss, allowed her to slow down and spend more time with the people closest to her — particularly an intense, concentrated amount of time with her new husband. She acknowledged that although she lost a sense of control, she gained a greater acceptance of her humanness and the limitations that come with it, releasing some of her past desire for perfection.
The present. Margie and her coach next focused on her present circumstances. Margie identified herself as a family doctor, a wife, and a community servant. She named two “big rocks” that she wanted to prioritize: growing her family and easing the suffering of others. As she learned more about her strengths, she saw herself as a survivor and even a hero of the recent “lost” years. She began to see how curiosity, hope, and perseverance could redirect her losses and grief into self-compassion and compassion for others.
The future. Margie’s coach helped her map out a path to the future she envisioned. She imagined herself as a mother and wanted to expand her own practice to include more pediatric and obstetric patients over the next few years. Her ideal job balanced motherhood with patient care. As she began to define her future and articulate this vision to others, she found a group of like-minded colleagues. She became excited about the future as she participated in conversations about covering each other’s maternity leave and setting realistic goals for the practice. Margie learned through her coaching experience how exploring times of loss can open doors for future gains.
AAFP PROGRAMS INFORMED BY COACHING PRINCIPLES
The American Academy of Family Physicians and its Foundation are incorporating coaching principles into many professional development programs:
INVESTING IN YOURSELF
“If you don’t know where you’re going, any road will get you there.” — Lewis Carroll
Prioritizing time for regular professional and personal assessment is vital to keeping your career and life trajectory “on target” (or creating a target). The coaching process is a time-tested method to learn from past experiences, identify your strengths and priorities, and create a future vision to move toward purposefully. Carving out time for reflection with the help of a coach is an investment in yourself that can advance your career and well-being and help you live the life of your dreams.