Balancing Leadership Styles: The Importance of Coaching and Managing in Healthcare

Let’s begin by stating the obvious: A healthcare leader, by definition, is an individual who leads or manages a healthcare organization. Does it make sense, then, that a healthcare leader is concerned with the organization’s day-to-day operations? Of course. That is as it should be. When it comes to scheduling, inventory control, equipment, facilities, finances, contracts, insurance, patient records, and so forth, managing daily operations is exactly what healthcare leaders need to do.

However, healthcare leaders also need to think strategically. And, the more human aspects of the healthcare organization sometimes call for a different approach. Managing alone will not always foster, nurture, and draw out the very best from healthcare employees.

Sometimes, employees will benefit much more if the healthcare leader functions less as a manager and more as a coach. As Holly Green(1) puts it, “We have to be both coaches and managers. To lead effectively, we need to know when to wear which hat.” Coaching can be helpful to healthcare leaders who are trying to improve the performance of their good employees because they can customize their approach to the people in their organization who may be the most receptive to the strategy.

MANAGING VERSUS COACHING

When we manage others, we generally tell them what to do to get a job done. Usually, managers act from more experience, knowledge, and/or training than those they manage. In some cases, the manager has done the very job of those they manage and manages from the strength of that experience. Nonetheless, managers manage from above and their primary tools are command and control. Managers get things done by directing and monitoring staff performance. They set the bar for their employees. They share their expectations and requirements through tasking, directives, and initiatives, and by measuring outcomes.

Certainly, it makes sense to manage in situations where immediate needs are paramount and when we need to achieve specific outcomes efficiently and quickly. Laura Stack(2) suggests, “Your team members look to you for answers, and rightly so in critical circumstances.” Managing can also be a useful approach when employees have never undertaken a task before and whenever they need a leader to tell them what to do and how to do it. Stack adds, “Sometimes a team just needs someone to coordinate while everyone else does their piece of the project.”

Coaching, on the other hand, is the more effective approach when we are trying to develop the best in others. A coach does not direct others. In fact, a coach doesn’t set an agenda for the coaching; the person being coached does. Green explains, “Coaching involves exploring, facilitating, partnership, long-term improvement, and many possible outcomes.”

The coaches’ position is beside their employees; their primary tools are active listening and powerful questions. Coaches get things done by guiding staff performance, by anticipating and clearing obstacles from their paths, and by supporting their employees’ immediate and long-term career goals. Stack explains that when you coach, “You teach your people the ropes as necessary, acting as a mentor rather than autocrat, and otherwise make suggestions in real time concerning what they can do to tweak their behavior toward an optimum.”

When employees don’t quite reach a standard or goal, coaches may praise what they did well, but they also shine a light on where employees showed weakness. They focus attention on what employees can improve, but they won’t tell them how to do it. Whenever possible, they draw next steps from the employees themselves rather than telling them what to do.

Healthcare leaders who use a coaching approach with their employees develop more effective teams in the long run. That’s because they develop better people. Coaches change people’s lives, often in profound ways. Clifton Harski(3) explains, “Good coaches show team members their potential, help them find confidence in their work, point out the value of what they do, and inspire them to be the best versions of themselves.” They help employees to feel that someone is in their corner and that with that needed support, they can improve and grow. Harski adds, “Every time we coach an individual, we as leaders have that opportunity to have an impact on him or her.”

There’s another slightly less obvious benefit of coaching employees: Coaching can help healthcare leaders engage their employees, foster employee loyalty, and improve employee retention. Most employees want to work in a place where they believe they can achieve their career goals and where they feel supported in their own development. A healthcare leader who coaches employees can help them to feel that way about the healthcare organization. According to Stack, “Coaches create the kind of engaged, empowered employees needed for survival today.” In the end, employees are more likely to stay with an employer who they feel brings out the best in them.

WHEN TO MANAGE, WHEN TO COACH

Knowing when to manage and when to coach your employees is critical to your effectiveness. Stack suggests that management is needed when:

• A crisis requires quick, positive results.

• You are handling new, inexperienced employees, especially those tackling a task for the first time.

• Your team needs to complete (and may be resisting) low-level or unpopular tasks.

• You are meeting difficult deadlines when every minute counts.

Coaching is needed when you wish to:

• Support your employees while guiding them in their career goals.

• Work with your employees to define and facilitate the best strategies for them and for your healthcare organization.

• Share your mission, vision, and goals with your employees in a transparent way and invite them to join you in your quest for success.

• Facilitate everyone’s progress toward the goals you’ve mutually set, as well as toward organizational goals.

ACTIVE LISTENING IN COACHING

Active listening is an essential skill in coaching. Yet, listening is probably the most overlooked, misunderstood, and undervalued communication skill. Laura Hills(4) suggests, “Most of us take listening for granted and don’t think much about our listening skills.” Unfortunately, we can fall into passive, uncritical, distracted listening all too easily. When that happens, our listening becomes short and shallow.

On the surface, active listening seems to be a simple skill. We listen all the time, so how hard can it be to listen actively? However, we listen actively only when we’re paying very close attention. That means that our minds can’t wander, even for a little while. We can’t drift into our own memories. We can’t start generating solutions for the issue at hand. And we can’t mentally argue with the speaker. When we listen actively, we fully concentrate to absorb all of what the speaker is saying, even if the speaker is dull or illogical or all over the place. We pay careful attention to the speaker’s body language and how the speaker uses the space they occupy. We also consider what the speaker is not saying.

Active listening is challenging for a couple of reasons. First, many of us assume that we listen well enough and therefore don’t try to improve our listening skills. Second, most of us have had little or no training in active listening. Hills suggests, “Listening is rarely taught or intentionally practiced and it is almost always assumed.”

Another reason active listening can be difficult is that listening is the easiest communication skill for us to fake. Hills explains, “Some of us have become masterful at pretending that we’re listening when we aren’t.” For these reasons, many people find it difficult to stay engaged in active listening even when they want to. Old habits do indeed die hard. For most of us, listening actively requires new habits, care, and consistent effort.

Although active listening is challenging, it is essential whenever a healthcare leader steps into the role of coach. In fact, Elena Aguilar(5) argues, “Active listening is the highest priority skill for a coach to master and it must be mastered prior to success using any other strategy.” This is so, Aguilar says, because the core of active listening is empathy. “It’s not so much about the exact words that you use as the listener, it’s about the feeling behind them. It’s about who you are being when you use them — are you being a caring, compassionate coach? Or are you being someone who is trying to be right . . . ?”

Active listening is an essential foundation for building trust and connection between you and your employee. Coaches who use active listening effectively can guide their employees into personally challenging coaching explorations, even into “the scary realm,” Aguilar says. From there, employees may be able to experience deep insights and make big changes that ultimately will lead to their personal growth.

Excerpted from Next-Level Healthcare Employees: Improving the Performance of a Good Team by Laura Hills, DA.

References

1. Green H. Know When to Manage and When to Coach. Forbes, May 1, 2012. www.forbes.com/sites/work-in-progress/2012/05/01/know-when-to-manage-and-when-to-coach/#5806995223be .

2. Stack L. Managing vs. Coaching: In Today’s Workplace, You Really Need Both. TLNT blog, July 7, 2014. www.tlnt.com/managing-vs-coaching-in-todays-workplace-you-really-need-both/ .

3. Harski C. Why the Coach Approach Beats the Manager Mentality. Entrepreneur, February 18, 2014. www.entrepreneur.com/article/231568 .

4. Hills L. They’ll Eat Out of Your Hand If You Know What To Feed Them: The 30 Essential Communication Skills That Give Highly Successful Career Professionals Their Edge. Fairfax, Virginia: Blue Pencil Publishing; 2014.

5. Aguilar E. Active Listening: The Key To Transforming Your Coaching. Education Week Teacher blog, April 27, 2014. https://www.edweek.org/education/opinion-active-listening-the-key-to-transforming-your-coaching/2014/04 .