Summary:
Knowing how to recognize and take advantage of these impromptu conversations is a worthwhile skill for physician leaders.
Knowing how to recognize and take advantage of these impromptu conversations is a worthwhile skill for physician leaders.
Coaching is the art and science of facilitating an individual's self-directed discovery and change. It's a collaborative activity designed to help a person think through a situation with greater depth and clarity than they could do on their own, and come up with actionable goals to which they are willing to commit.
Described this way, it suggests that successful coaching involves multiple in-depth conversations over an extended period. To the contrary, however, effective coaching often occurs in brief encounters that are referred to as "popcorn coaching" opportunities, e.g., hallway conversations.
These last only a few minutes, but by using the right coaching techniques a lot can be accomplished. Knowing how to recognize and take advantage of these popcorn coaching opportunities is a worthwhile skill for a physician leader.
The first thing you must do when a popcorn coaching opportunity presents is to recognize whether your colleague needs mentoring or coaching. Mentoring is appropriate when the individual asks for the benefit of your experience or advice on what course of action she should take.
A problem focus is necessarily on the past, on mistakes and causes that have already happened. A solution focus is on the future, on actions that can be taken to begin making progress toward a resolution.
Alternatively, a coaching response is called for when your colleague would be best served by arriving at her own conclusions about what she should do. If coaching is what is needed, your advice is not what is called for, and can even get in the way.
The default response for most highly trained professionals is to mentor, i.e., offer their advice and counsel. It requires some thought (and practice) to recognize the appropriate track to take, but don't worry if you get it wrong, as you occasionally will; it might be an opportunity lost, but no damage will be done. Our recommendation is that you default to a coaching response. If mentoring is needed, you can always come back later to offer your advice.
Most popcorn coaching opportunities involve helping your colleague create an actionable goal and switching her from a problem focus to a solution focus.
Create an Actionable Goal
A popcorn coaching opportunity presents when a colleague volunteers − sometimes emphatically − what they don't want, e.g., "I'm sick and tired of Dr. Smith condescending to me," or "I don't want to have to keep dealing with an intransigent hospital administration."
That type of opening statement is a clear signal that coaching is required. Your job as a coach is to ask a few short questions that will turn the colleague’s frustration into an actionable goal in only a couple of minutes. During a popcorn coaching moment, that's all the time you have, but it's all the time you need.
What someone doesn't want is not an actionable goal.
That's particularly true if it requires change or action on the part of someone else. An actionable goal must be stated in the positive, and it has to be under the person's control. Using tone of voice and body language that convey understanding and support, your question should be "OK, I understand what you don't want; but what is it that you do want instead?"
Often the person will simply restate what they don't want as an affirmative statement, e.g., "I want Dr. Smith to show me more consideration," or "I want the hospital administration to be less difficult to deal with."
It's quite common for people to define their objective purely in terms of someone else's actions or behavior. It's also nonproductive. Here, you should resist the urge to volunteer to talk with Dr. Smith or the hospital administration to see what the problem is, or to offer your advice on what your colleague might do to improve the situation. Remain in a coaching mode.
During a popcorn coaching opportunity, ask your colleague what she thinks she might do to improve her working relationship with the object of her frustration.
This question might meet some resistance − reiteration of the problem, for instance − but keep up your line of inquiry.
Tell your colleague you're not asking what the other person must do to fix the problem, but rather what she can do that might result in some small improvement. You're redirecting her focus from what the other person needs to do to what she can do to create movement − however small − toward a solution.
Your objective is to help your colleague self-discover one or more manageable first steps that can be taken toward improving the situation.
You're not trying to help solve the whole problem at once. All you're attempting to do is use inquiry to help her discover what action she can take to create forward momentum.
This might require some persistence on your part, but stay focused on your line of inquiry. This is essential to creating an actionable goal.
Note that this entire “popcorn” conversation can take place in only a few minutes.
With a few well-directed questions, you can convert a complaint or frustration about someone else's behavior into one or more actionable steps that can be taken by the complainant.
Moreover, they will probably never realize that they have been coached. However, this type of coaching response doesn't come naturally to most physicians. The common reaction is to listen patiently then offer your advice or assistance. The downside of mentoring, however, is that because your advice wasn't independently arrived at by your colleague, it is more likely to go unheeded.
Move toward solutions
A second type of popcorn coaching opportunity presents when a colleague begins to describe a problem, frequently an organizational or behavioral problem, e.g., "The physicians aren't dictating their patient encounter notes on a timely basis," or "Dr. Jones isn't treating his nursing staff with enough respect."
As a trained physician, your immediate reaction is to diagnose the problem, or if you are already familiar with it, to restate what you think the problem is and offer a solution. This is not a coaching response.
Unlike medicine, you don't have to diagnose the problem to help your colleague find a solution, which is counterintuitive to most physicians. Your objective is not to offer a solution, but to help your colleague identify the outcome they want to move toward and what steps he can take to begin making progress toward that outcome.
A problem focus is necessarily on the past, on mistakes and causes that have already happened.
A solution focus is on the future, on actions that can be taken to begin making progress toward a resolution.
Sometimes it will be challenging to divert your colleague from further discussion of the problem, particularly if it's a group discussion, such as a practice board meeting. Everyone will want to explain his or her idea of what the real problem is and what caused it. This invariably is a waste of time.
You can break the logjam by saying, "OK, what is the goal or outcome we want to move toward?"
Once the group's attention has shifted, it must be followed up by, "What actions can we take that are under our control that will begin making progress toward that goal?"
Refocusing your colleagues on the outcome they want and what steps are necessary to begin making progress toward it (the future) is much more productive than allowing the discussion to remain on the problem (the past).
Reframing this way is not easy, and sometimes you must persist to be successful. People invariably are more comfortable returning to a discussion of the problem, so you may well have to restate your question. However, once you have been successful in creating a forward focus, you have laid the groundwork for a productive discussion.
This is a good example of popcorn coaching. You don't need to present an elegant defense of your line of inquiry; rather, simply shift the group's focus from the past to the future. It can be achieved in only a few moments, and it's one of the most productive coaching techniques.
Remain in an Adult Ego State
During these popcorn coaching moments, it is essential for you to remain in an adult ego state, one which conveys an attitude of collegiality and power equalization.
An adult ego state contains statements that are exploratory rather than judgmental, solution-oriented in an emotionally neutral tone that promotes nondefensiveness. It is not always easy to do, especially when the issue is emotionally charged or when the other party lapses into a deferential or compliant ego state, but it is nevertheless essential.
By asking the right questions in the right communication style, you can make significant progress in a short, popcorn coaching encounter. You're likely to be presented with several such opportunities each week. Make a personal resolution to take advantage of them, becoming a more accomplished coach each time you do.
Robert Hicks is a licensed psychologist and a clinical professor of organizational behavior and founding director of the Executive and Professional Coaching Program at the University of Texas at Dallas. He also is a faculty associate at UT Southwestern Medical Center.
John McCracken is a clinical professor of health care management at t__he University of Texas at Dallas Jindal School of Management and adjunct professor of Family and Community Medicine at UT Southwestern Medical Center.
The authors wrote this article for the American Association for Physician Leadership in 2013.
Topics
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Develop Relationships
Action Orientation
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