News & Insight
October 2011

Case Study: High Impact Coaching for Derailing Head of Surgery

WJM Healthcare CoachingSituation: A teaching hospital had a highly valued oncology surgeon and department head with an excellent rapport with patients and a widely recognized track record of excellence in his work, but who was also known to bring residents to tears and even to play a part in their early departure from medical school. He was known to be intolerant of anything he considered “stupidity” and would publicly and on rounds humiliate his students and colleagues. The hospital was considering him for a higher level position in the future but was having enough trouble keeping staff from leaving due to his performance in his current role.

Decision: To engage the client in High Impact Coaching with the goal of a radical and sustainable change in the Doctor’s behavior while on rounds, in case reviews and in teaching sessions. A secondary goal, defined by the lead executive coach and agreed to by all was to work on a pronounced “bigotry” towards all who did not think and reason the way the client did.

Process: After discussing the challenges with the head of Human Resources and the CEO, an initial meeting was set up with the Doctor to discuss his perspective and the process of High Impact Coaching.

The first phase of the coaching work included the following:

  • Interview of key stakeholders to determine criteria for success for the Doctor given his track record and reputation. Gathering data on the organization’s culture, current perceptions of the senior team including the CEO and the factors that would define a successful start in terms of repairing existing relationship with each of the stakeholders. Impressions from the interviews were used to begin to assess the communications style and needs of each of the key stakeholders as well as behavioral change goals.
  • Custom design a three-day offsite to rapidly develop skills and abilities to move from functional head to a multifunctional senior role.

Through this first phase, it was determined that a great deal of fear and resentment had built up in recent years and that his reputation extended beyond the immediate hospital environment. It was also found that his outbursts were somewhat unpredictable which added to the apprehension of all who regularly worked with him. His abilities and value as a surgeon were not disputed by anyone and he was held in high esteem professionally, but he was either feared or loathed on a personal level by many.

There was a fair amount of understandable skepticism on the hospital leadership’s part as to whether he could change behaviors and whether or not he was willing.

The second phase consisted of a three day offsite with the client and two executive coaches.

Three-day offsite process:

The offsite portion of the High Impact Coaching program involved an intensive process which began with an in-depth career/life history. It was discovered that the client grew up in a very demanding environment in which success was quickly rewarded and anything less than excellence was quickly punished. This added to the client’s natural tendencies to seek tangible measures of success and an ability to take blunt criticism as a useful part of his growth as a person and a professional.

The assessment process identified both manifest and latent talents as well as potential weaknesses that the client could fall into. The assessment model used also looked at which talents were most prevalent in each of the roles of individual contributor, team member, colleague, leader, follower and decision maker. It further identified strategies to optimize the client’s ability to operate in his strengths and to be aware early on if weaknesses were starting to manifest. Beyond this level of awareness, the assessment process also identified personal styles of others that the client would inherently have difficulty with and began to build an awareness and appreciation of styles different from his own. In his case, this was particularly important as a number of his residents were likely to be of a temperament for which he inherently had no respect.

The next step was to draw from the interview process to identify potential gaps in the client’s behaviors and to create role plays which would give the him an opportunity to try out several approaches and test them for viability with the styles of key stakeholders. A discussion ensued which further refined the understanding of the stylistic needs of each of the stakeholders and the coaches proposed a list of attributes for each stakeholder to confirm their style and needs.

After completing a sufficient number of role plays the Doctor felt prepared and had a strategy for dealing with each of his key stakeholders in a more adaptive style tailored to the needs of the stakeholder.

The last step in the process was to create a return strategy which covered first contacts with stakeholders, including his residents and close colleagues, as well as one-month and three-month goals for building the kind of working relationships that were identified as key goals for the process.

The third phase of the coaching consisted of bi-weekly meetings to assess progress and attendance by the lead coach or his colleague at several of the Doctor’s classroom sessions and case reviews. This part of the process allowed for real-time fine tuning of strategies and an opportunity to coach the client as new challenges arose.

Final result: Both the CEO and surveyed stakeholders felt that the goal of enhanced interpersonal effectiveness had been attained and sustained over time.

WJM Faculty Member, Dr. Robert Patraw has over twenty years experience assisting organizations and individuals to enhance their success by applying his skills and background to significant leadership and organizational challenges. He is renowned in the areas of executive coaching, assessment, leading change, mission/vision statements, business strategy development and evaluation, team building, communications effectiveness, and organizational design

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