Three Reasons Physicians Executives May Prefer a Different Kind of Coaching

Published on November 19, 2019

Michael Brown, Chief Medical Officer at Acesis, Inc. and executive coach to physician leaders

When I became an executive coach, I wanted to become the best coach I could possibly be, and I found there is much to learn from the trainings and writings of those with more experience. I felt this was true even if very little of the training was specifically focused on coaching specifically for physician executives. People are people, and the dynamics of personal interaction are similar across industries and disciplines.

However, I also noticed that some of the assumptions from what I was studying did not seem to apply to the people I was seeing. I do not know if my clients, as physician executives, are different from others or if there is another explanation. Perhaps, those who have chosen to be coached by me are different. No matter the reason, this posting discusses my observations and describes how I have responded.

1. Procrastination vs Readily accepting pains.

We all struggle to get ourselves to do things that we know we should do. For many people, that is one of the main reasons they decide to work with a coach. 

However, I have noticed that my clients are not generally asking for help overcoming procrastination. When they describe unpleasant parts of their job, they often do so in passing. For example, someone might mention a difficult upcoming conversation. However, they usually do not ask me for help with this challenge since they believe that “it is just part of the job, and I know I just have to do it.” They then proceed to the next topic. 

Instead, I find that my clients are more likely to commit to an unpleasant action and not adequately consider alternatives. Perhaps, as a group, physicians are good at pushing themselves to do what they intellectually have decided to do. Throughout their life and medical training, they have had to delay gratification and perform many unpleasant acts in their busy schedules. 

Therefore, I do not spend much time helping my clients overcome procrastination. Instead, I listen carefully for the frustrations about which they do not know to ask for help. When I direct the coaching to explore a frustration and its alternatives, they recognize new opportunities that they then enjoy considering.

2. Confident natural leader vs Hesitant to lead

I once lived on the campus of a well-known business school, and I was overwhelmed with the level of confidence displayed by some business school students. Even before graduation, they seemed like they felt ready to take charge. Marshal Goldsmith’s book “What Got You Here, Won’t Get You There” has some wonderful ideas for helping executives to change, but one of the undercurrents of the book is that an individual’s confidence (and possibly arrogant) style, that worked early in their career, will not work as a manager advances into leadership. Thriving in a top position requires leaders to learn to better collaborate rather than simply commanding orders.

Doctors have a reputation for great confidence as well, but many of the people whom I have coached have not expressed this same level of confidence. Instead, they focus on the leadership gaps in their resume rather than their unique strengths. Also, some are ambivalent about exercising their full authority. They did not go into medicine to become leaders; they went into medicine to care for patients. They seem to want to maintain that physician’s identity with their colleagues and those they supervise.

Of course, new leaders can lack skills and experience, but since they now aspire to make systemic changes beyond their practice, they need to take on challenging roles for which nobody is ever fully qualified. For those undergoing career transitions, I often find myself regularly giving pep talks focusing on the skills they already have that will enable them to achieve their goals. If they seem hesitant to step up to a leadership challenge, I remind them that the alternative may be that they end up reporting to someone who is more confident, but actually less qualified.

3. Wanting just classical coaching vs expert advice as well

Some successful people who become coaches without any training might instruct their clients on how to address their problems. In my training as an executive coach, I learned that this is not coaching; it is advising. It is generally better to let clients have the space they need to come to their own conclusions. The job of a coach is to help clients think through their ideas but avoid providing answers. Besides, since clients are already experts in their life/work, clients will inevitably not appreciate a coach’s advice.  

From my training, I greatly benefited from learning how to develop a questioning style of coaching. This change in style is likely the single biggest benefit of my training. However, I have also found that my clients often ask for and enthusiastically accept my advice when I do provide it. In particular, clients like when I point out assumptions that they had not appreciated they were making. I can then also provide them with new options that they had not yet considered. They want more than a sounding board for their ideas. They want a peer collaborator with domain expertise who can provide ideas of his or her own. 

Even though some coaches might disapprove of my style, I now see the practice of quickly alternating between what some call coaching and advising as being a critical part of how I serve my clients.   My clients now expect me to regularly contribute my ideas during our coaching session, and I have enjoyed seeing my clients accept and follow through on the ideas I have proposed.


The benefits of executive coaching are clear, but coaching styles vary.  Some readers will relate to what I have written while others will not.  That is good. My hope is that this posting helps physician leaders think about what they might prefer from a coaching relationship so they can find what works best for them.  

Michael E. Brown MD, MS, MCHM, CHCIO is a certified executive coach (Center For Executive Coaching) and Chief Medical Officer at Acesis, Inc. He was an instructor at HSPH for 8 years after graduating from HSPH in 2007. For the 12 years prior to joining Acesis in 2014, Michael was the Chief Information Officer for Harvard University Health Services.  He can be contacted at mbrown (at)