Dr Andrew Wilner (Host):

Welcome to Children's Mercy Transformational Pediatrics podcast. I'm your host, Dr. Andrew Wilner. Today I have the pleasure of speaking with Dr. Alyssa Stephanie, associate Professor of Pediatrics, university of Missouri, Kansas City School of Medicine and Education Associate Professor of Pediatrics, university of Kansas School of Medicine.

Our topic today is professional coaching and medicine and health care. The health care sector has begun to embrace coaching, to promote resilience and innovation during a time of massive disruption, while also cultivating healthier workplace cultures. In this podcast, Alyssa Stephanie shares how professional and peer coaching can help replace burnout, increase job satisfaction, and improve the overall provider experience of health care, while also having a positive effect on patient care.

Welcome, Dr. Stephanie.

Dr Alyssa Stephany: Oh, thank you for having me today.

Dr Andrew Wilner (Host): Yeah, our pleasure, and I'm really looking forward to learning more about physician leadership and coaching. Let's start by talking about the Physician Leadership Center at Children's Mercy. Tell me about the center and its purpose.

Dr Alyssa Stephany: Oh, excellent. Well, the Leadership Center for Physicians is specifically designed by physicians and really tries to close that gap of our education. So, we are, I think, well-educated to take care of patients. But our taking care of patients, really our education was missing some things. We often aren't taught the business of health care and we're often not taught about the health care landscape, and how it's evolving and what factors impact the change of health care.

And we also aren't often privy to things like billing and coding, things outside of patient care, direct patient care and so talking about how to lead, how to come to the table and discuss important issues that affect health care, and how we deliver health care, are things that aren't necessarily taught in medical school or residency.

So oftentimes we get into our faculty days and we then function in a health care system that we don't necessarily understand. So, the Leadership Center for Physicians was actually brainstormed about by physicians that really saw the need to come to the table to participate in decision making, and to participate in being able to, solve some of the problems in health care.

So not only is it a development process, for those of us that are on the front line, cause on the front line, we can also lead, we can lead teams,. but also for those of us who are actually in leadership positions that are making some of these active decisions. So really the Leadership Center for Physicians, really is multifold, in the sense that whether or not you are a formal leader or an informal leader as a physician, really trying to give you those tools and skills, that we really didn't get during our training.

Dr Andrew Wilner (Host): Yeah. Well, that's great. I would agree because I remember when I was in medical school, I had, you know, all I could do a hundred hours a week, just to learn medicine. and, really no bandwidth for, business, or billing or, leadership. So, I think it's great that there's this postgraduate center now to help physicians because, we're kind of at the mercy of all of those things in our daily jobs. Now, one question I had, it's not all that clear to me, is what is the difference between, coaching and mentoring?

Dr Alyssa Stephany: So, I think, growing up in medical school, in residency, we're a little bit more familiar with mentors. Mentors are usually people who are ahead of us in our career. Sometimes they can be peers, but they are people who have walked the path often before us and can share back their learning.

And it is often, more of a telling relationship and an advice giving relationship and more a directional kind of partnership that you develop. It's often that you need something from them that they can offer you. They often can offer advice. They can offer their wisdom to you, and often you are seeking something from them. A coach on the other hand, really, does not give advice. A coach really seeks out the person's own insight…and so it is a much different relationship. A coach will actually ask questions in a thought-provoking and creative process to inspire and maximize the person's own insights.

In fact, in a coaching relationship, both the coachee and the coach believe that the person in front of them holds all the answers and that by  asking questions, the coach will actually elicit, the person's own insights for the direction that they will go. So, a mentor more directs and a coachee or a coach in a coaching relationship will actually allow the coachee to direct the direction of the discussion and direct the answers.

Dr Andrew Wilner (Host): Would you say also that a coach kind of has more, uh, ownership of the problem? You know, a mentorship might be more casual, but the coach is kind of committed to the relationship. Is that a difference?

Dr Alyssa Stephany: Yes. I think also, it can be, a mentor can come in even just one time. A coach,  a coaching relationship, is really meant to be a very, longer term, more, longitudinal, kind of relationship. You know, sometimes you could, just get mentored one or two times for something.

A coach really wants to develop that relationship with that person, and really help in that discovery process.

Dr Andrew Wilner (Host): Now coaching can be one-on-one, but what about, teams? Do you have coach for teams within health care?

Dr Alyssa Stephany: Yes, actually, we do. And very recently, there has even been a certification process for even team coaching, so that, as the coaching profession has gotten, more professionalized, and there's now, credentialing and certification to it, and as the profession has really grown as a career, now there's even real criteria to what team coaching should even be and what really is a team coaching engagement. And how team coaching can really be used is not only for kind of those team dynamics and team cohesiveness together. you can do it on a small scale. You can do it on a large scale. But you can really, drill down to like, can you help a team find even their purpose? Can you help a team grow together to become functional? Could you help a team in a merger process?

So, there are so many different ways that team coaching could be used. In so many different ways, even in the health care system, that you can really, use team coaching to really gain, either team effectiveness or to really help them explore more in depth how they can achieve alignment, achieve goals, and really achieve things together as a functional unit.

Dr Andrew Wilner (Host): Well, in fact, you wrote a recent article, Professional Coaching in Medicine and Healthcare. So how do you get an organization to sort of, accept coaching, how does it become part of the culture?

Dr Alyssa Stephany: So really an institution can really become an organization that promotes a culture of coaching. And I think, you know, it can happen many different ways. So you can, little by little, have kind of an investment in a coaching culture, you can have it come top down, you can have it come bottom up.

But I believe that really when an organization really truly reaches being a coaching culture, it is when everybody is able to have conversations in a very authentic way that seek out people's insights and it is more of a tell less, ask more type of culture, where people are asking empowering questions in order to find other people's insights and solutions to things.

And this is especially true for leadership asking the people under them that are coming in and having conversations with them. So when you really see kind of the leaders empowering the individuals, you will start to really see increased productivity. You'll see increased wellbeing. You'll see increased accountability. And you'll really see this kind of increased growth mindset that then spreads and relays into increased psychological safety.

Then you see really increased retention and engagement. You see, more innovation, you see increased positive culture, and you really see an organization propelling forward, to be, moving in this almost unstoppable way despite challenges and crises that happened.

And so in that manner, that ultimately is really where you see a coaching culture coming into play. You also then, often will see communication being better. You'll see conflict management, being handled more effectively. You'll see more effective feedback and you'll see, often, more active listening.

And that comes from not necessarily having tons of coaches in the institution, but teaching leaders to have coach conversations. So not necessarily the noun of coaches, but the verb of coach-like conversations.

Dr Andrew Wilner (Host): Well, I think you, were answering my next question, at least, in part, but I want you to fill in the blanks a little bit. How does coaching impact patient care? Because that's really what it's all about, right? That's why we're there in the first place.

Dr Alyssa Stephany: Right. So I think there's both direct and indirect impact. So when you have then, your organization, a health care organization, reallyexemplifying a coaching culture, you then have a lot of the things that I just spoke of, like increased productivity. You have people innovating and then you have people innovating about patient care delivery and about how to do things in a way that makes sense.

But, you also then have people, when they are directly touching patients also. asking instead of telling patients, you have them also asking and empowering patients and asking them their insights, and asking them and then having coach-like conversations with patients. Now we talk a lot about the patient experience and we talk a lot about patient-centric care.

And so, although we have definitely already started down that road, we know that everybody has great opportunity to even improve that. And so just imagine if you are continually improving your skills on having coach-like conversations, how you can even,  translate that even better to the bedside too.

And so, as we continue to become more and more patient-centric, being able to take some of these very authentic coach-like questions, even to the bedside and being able to gain patients’ and families’ perspective how to innovate together, just becomes even more empowering there too.

Dr Andrew Wilner (Host): Would you say that Children's Mercy has a coaching culture?

Dr Alyssa Stephany: I would say we have a large dedication to having a coaching culture at Children's Mercy. Not only are people taking up on the investment of coming and getting an internal coach, we also have so many of our leaders partaking of the opportunity to come get education on having coach-like conversations.

There is many development opportunities to learn how to have these types of conversations. And there is such a hunger from the leadersto partake in these development opportunities. You can feel it palpably, around the institution --  this dedication towards really continuing to grow the coaching culture here.

Dr Andrew Wilner (Host): Oh, thanks for that. Well, we're just about ready to wrap up for those physicians and health care providers who are listening and who are interested in sort of partaking of this, coaching. Do you have any, advice?

Dr Alyssa Stephany: When we survey each year, I think that the comments that come out speak the loudest. And so I'd love to give the advice from the comments that have been allowed to be shared. And one of the comments is, if you haven't done it yet, go find an internal coach.

And so I would say that if you haven't partaken in coaching yet, and if you have an opportunity, go try it out. Go see what it is all about. And so I would say that that is one of the takeaways. Number two, I would say think about investing, in an internal, coaching program.

Our institution has on average saved $2.1 million retention costs savings per year. And in a time when there is a lot of turnover and, when there is a lot of burnout, being able to say that 98% have experienced greater wellbeing as a result of coaching is wonderful.

Knowing that you're able to make a difference in that. And so if an institution is able, look into what it would be to have internal coaches. I think that would be another takeaway, think about what you're able to do and invest in for your people in terms of  wellbeing and in terms of helping

invest in retaining people. I think those are some of the two biggest takeaways that I would say. It's about the people. It's about the people that then see the patients and can really do very good work for the patients.

Dr Andrew Wilner (Host): Oh, I agree. I think less burnout and happier physicians and other health care providers, it can't help but translate into, better patient care.

Dr Alyssa Stephany: Well said.

Dr Andrew Wilner (Host): Well, Dr. Alyssa Stephanie, this has been a very informative discussion, and I'd like to thank you very much for joining me on Transformational Pediatrics.

Dr Alyssa Stephany: Thank you again for having me.

Dr Andrew Wilner (Host): For more information on Children's Mercy Kansas City visit Childrensmercy.org. I'm Dr. Andrew Wilner. Thanks for listening.