As physicians of the next generation lose the continuous stream of small interactions that we benefited from, the risk of their depersonalization — and burnout — increases.
In their article, Three Keys for Effective Leadership, authors Marton, et al., provide an interesting analysis of three closely related but different facets of leadership — mentoring, coaching and managing — and how these roles relate to health care. Their analysis provides a thoughtful exploration of what all of us in health care have benefited from, some of us greatly, though perhaps not all of us may have understood the process or even recognized the experience when we were in the midst of it.
Whether we are cognizant of it or not, each of us, and at different times in our careers and to different degrees, has been affected by good and poor mentors. To extend this, regardless of our current strengths and successes, we might have developed as individuals less well and less rapidly because of the absence of great mentors in our lives.
Leadership training, such as in traditional business environments, has often focused more on leaders and managers, and distinguishing between these two roles. Leadership might be defined as the ability to envision and engage others to achieve meritorious group goals, where the participants view the influence as legitimate.
It is often said leaders choose the right things to do, and managers get the right things done. Management is perhaps seen as more confined to implementing strategy within an organization. This may appear less important than the envisioning role of leaders, but how managers perform greatly determines the organization’s culture. Though it may seem to be less consequential, managing is an important facet of leadership, albeit with greater opportunity for leading the tactical implementation — the how — of strategy.
More recently, business and health care have paid greater attention to mentoring and coaching as important roles to the success of organizations, by facilitating the success of the individuals who make up the organization. This obvious link is not always clearly recognized. When we speak about how “my hospital did that” or similar statements, we are trapped in a collective noun fallacy. Hospitals don’t “do” anything. The individuals who are agents of the hospital or organization — employees or others — are responsible for everything that the organization does.
Paying attention to individuals always has been important to successful organizations. For most health care organizations, the “human” talent is their most valuable strength. There has always been a need for leaders to sense others’ development needs, and nurture and enhance their knowledge, skills, abilities, attitudes and values through mentoring and coaching. Harvey S. Firestone said, "The growth and development of people is the highest calling of leadership." Effective mentoring and coaching are as much about leaders having insight of the heart as insight of the intellect.
Why is mentoring and coaching becoming even more critical today? It seems too simple just to say that it is because our health care systems and processes have become much more complex, and therefore greater abilities are needed. There are other factors. While some may say we are now more “connected” as individuals than ever before, those connections are different and are not the same as the primarily face-to-face direct connections of the past.
It is more and more through asynchronous, and less-personal, methods — emails, texts, tweets and social media — that we conduct business and communicate. Many of us default to an email or text rather than meeting or even phoning. This certainly brings some greater time efficiencies, but it also has other consequences. We are losing more and more of the consistent personal interactions where much of our mentoring and coaching has historically occurred, albeit informally.
Many of us may not have recognized how we were being mentored when we were supervised by senior physicians and leaders, and how we were being coached when we worked closely with a colleague on a project. Maybe not by grand design, and maybe not even intentionally, but many of us have been, and are still, coached and mentored during the many small and simple interactions we have with others.
There is much attention now about physician burnout, as well as burnout across the health care professions. A key contributor to the sense of burnout is depersonalization, the impersonal and dehumanized perception of one’s role, which leads to distancing and detachment. We can no longer expect that coaching and mentoring of learners and our junior colleagues will occur without purposeful, intentional and reflective practice on our part.
As the next generation loses some of the continuous stream of small personal interactions that we benefited from, the risk of their depersonalization — and burnout — increases. Since we will continue to use email and texting to communicate, we need to pay attention in other ways to mentoring and coaching.
All of us have opportunities to coach students, residents and junior colleagues, but also to mentor our peers and to “coach up.” The reward in seeing a colleague grow and excel from our personal attentiveness is quite comparable to the satisfaction that we experience by having our patients’ health and lives improve. Senior physicians have an obligation to mentor and coach the next generations of physicians, to give back to our profession and ensure that the future for our patients and for society is better because of us. We also have to mentor and coach our learners and junior colleagues on how to grow to be mentors and coaches themselves.
We can mentor and coach by example, by design, or by default. All of us influence those around us and, whether we acknowledge this or not, are mentors and coaches by our example. Purposeful, thoughtful mentoring and coaching done by design will be most effective. It is even necessary to ensure the personal interactions and attention that minimize the risk of career burnout.
To paraphrase author William Arthur Ward, “The mediocre teacher (mentor/coach) tells. The good teacher (mentor/coach) explains. The superior teacher (mentor/coach) demonstrates. The great teacher (mentor/coach) inspires.”
The challenge for each of us is to be the mentor and coach that we would have liked to have had.
Hal B. Jenson, MD, MBA, CPE, is a member of the Physician Leadership Journal editorial board. He is the founding dean, corporate president and CEO of the Homer Stryker M.D. School of Medicine at Western Michigan University.