Episode 12: Coaching Through the Chaos of Change

The very thought that physicians can benefit from executive coaching is an indication that the medical profession is shifting. Darelyn “DJ” Mitsch, an executive coach with The Pyramid Resource Group, works with healthcare professionals to take on leadership positions. It is a challenging task in an era where, starting in residency and training, clinicians are taught little to nothing about self-care. Learn how coaching physicians benefits everyone because, after all, they’re the ones treating illnesses.

Interested in healthcare coaching? DJ and Healthcare Coaching Institute are offering $500 off tuition for listeners who use the code P3 when signing up at HealthcareCoachingInstitute.com.

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Full Transcript

Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone, and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans, and many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together, and here’s some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.

Michael: Welcome to the “Paradigm Shift of Healthcare,” and thank you for listening. I’m Michael Roberts from P3 Inbound. On today’s episode I’m talking to DJ Mitsch, one of the pioneers in the coaching profession. She’s the Chief Coaching Officer and curriculum designer of the healthcare coaching Institute. DJ, thank you so much for being on today’s episode.

DJ: I’m grateful to be here. Michael. I’m thrilled that we have some time together to discuss what is becoming an increasingly important topic in healthcare.

Michael: Absolutely. Absolutely. So before we jump into questions about healthcare specifically, which is, you know, what this show is entirely about, I know that you and your group of coaches at The Pyramid Resource Group work with several different business sectors and I’m interested how you ended up working with health care specifically.

DJ: That’s a great question. We are based in The Research Triangle Park area in North Carolina, which is, you know, a hotbed if you will, for research, biotech, pharmaceuticals and has been over the years. So we’ve done, always done a lot of work, about 35% to 45% of our business, even in the early stages was in this space and increased every year as we began to produce white papers.

And we decided to stay in this space because of, you know, healthcare touches everybody and it was late adapting as an industry to coaching, and I guess, there’s sort of a mission minded aspect of the work that we do as coaches sometimes. And I put a stake in the ground around healthcare and it’s proven to be the smartest group of people I’ve ever been around. The hungriest when it comes to wanting to learn to coach and use the skills and leadership frameworks. And it’s, for me, it’s a heart-based conversation because we’re all touched by some health need as we grow and develop ourselves as professionals and leaders, right? So many dimensions to the healthcare conversation that it impacts us all.

Michael: It certainly does. I’m fascinated as we at P3, we work with a lot of physicians specifically in the orthopedic space and in a few other industries as well, a few other areas of medicine as well. And over the past few years I’ve really gotten to know some of those doctors and see just how focused they are and how dedicated they are to what they do. And I’m really interested as you’re talking about how they’re so receptive to this concept of leadership. And so one of the first things that we could start off with is, you know, how does coaching help leaders in the healthcare space? What is it that you particularly work with them to do?

DJ: Yeah, so part of what we’re doing is changing the narrative and the mindset in healthcare. And I think everybody agrees healthcare in this country, the U.S. primarily, but around the world is something that we need to pay attention to because it’s every dimension of who we are as families and communities and, you know, ourselves. And so, when we start coaching, we’re looking philosophically at, you know, what is the mindset shift that needs to happen with the individual who’s in front of us first? What is their growing edge for self-awareness and for executive presence?

So when you’re working with healthcare professionals, a lot of times that’s not an area they’ve paid attention to. A surgeon has had to become almost perfectionistic in what they do in the operating room, and many physicians and healthcare providers are in that space, right? And so how do you move them into the space of leadership? And we’ve seen such a gap there, but you know, if you’re in in surgery, if you are leading a team or a group of people who include some employees, some staff members who are on the payroll, some hospitalists who might be contractors and you know, how do you create the kind of environment that benefits not only the patient or the consumer of whatever the aspect of healthcare is, but the whole of the employee base and the physicians themselves? And so that became a big part of the conversation I think early on and coaching pushes on the edges of the shifts that people need to make or want to make.

Michael: Absolutely. As you were describing those terms, being more aware of themselves, that sort of thing, so much of when I think of like what surgeons are about, when I think about like what healthcare is about is almost that macho, you know, or you know, really tough persona of I’m not gonna let the fatigue set in. I’m not gonna make mistakes. Just like you were saying. And so I can imagine this is a really different way for people to think in general.

DJ: Well, yeah, in general because they’ve not been taught. The residents that we’ve worked with that have not been taught self-care. And so, you know, there’s almost this superhero and put my cape on kind of conversation. One of my nieces is a physician. She’s a pediatric dentist and she is married to a surgeon who’s going into plastic surgery. He’s doing his rotation now out in Oklahoma city. And right before their wedding I watched, you know, all the prep for the wedding and everything and there was a day, there was part of the parties that we attended, I think he was awake for three days in rotation as a resident.

Michael: Oh my goodness.

DJ: And I was like, that’s insane. So time away he needed for getting married, and I think there’s something that’s really wholly wrong with that picture and it is a common practice.

Michael: Absolutely.

DJ: Yeah. So, you know, so how do you create the shifts? And it’s gotta be one conversation, one system at a time. There are some systems that are getting it righter. We’ve trained coaches at Moffitt Cancer Center and I know Mayo clinics has a coaching culture, Banner Health systems. There’s some places where coaching is taking hold and it’s producing, you know, a different level of synergy and leadership development and a framework for self-care, mindfulness training. There’s a lot that’s going into this space of culture. So, and I think it’s system by system now, but how do you get it to a place where there’s a tipping point, right?

Michael: Why would you think that anybody might be apprehensive about approaching some sort of coaching or trying to make some sort of culture shift? Like what are the barriers that health care systems have to face in order to overcome that and start down this pathway?

DJ: Oh, I think there’s, you know, a lot of it’s that when you practice medicine there’s an identification with perfectionism and there’s an identification with the profession, right? And you are expected to be almost, like I said before, godlike. There is a, that you come from a space of science and knowledge and what we’re inviting people into is a space of behaviors, looking at behaviors, looking at patterns of energy and why they show up the way they do.

And that can feel therapeutic, but I think sometimes it gets collapsed with therapy that I’m gonna be sitting on the couch and really navel gazing with somebody for a period of time. And therapy is a healing model and it’s deserved by a lot of people in the space but that’s not what this is. What this is, is about, you know, really finding yourself present and future focused. What’s true for me now and asking the questions about what’s true for me today and beginning to notice what works and what doesn’t.

Medicine’s too hard. The practice of life sciences, whether you’re a researcher or whether you’re actually a practicing physician. All this is too hard for people not to be called to it. It’s like there was a joke about attorneys where guys who went to medical school and didn’t make it. And not to make fun of attorneys. God knows I have a batch of those in my life and I love them and they would say that’s not true. But you know what I’m saying is that there is a real calling to this and so it’s something they cannot not do. It’s just too hard.

So going back to the, so why should they have a coach, right? There are some barriers. Like I should already know this and so why would I work with a coach if I’m a health care professional? And I think you know more than the spouse relationships they have or more than the friendships they have or even colleague relationships, the peer relationships. A coach is a sounding board to have them work through some of the heart-wrenching things that they go through. Some of the aspirations they have.

Michael: The professional environment, whether it’s health care or anywhere else, it’s just how’s my performance? Did I come in on time? Did I deliver the results we hope for? And that’s it. That’s where it ends.

DJ: Yeah, and so let’s just take it through to the performance category. So what is performance? If we step in and look at what the expectations are around performance, we’re looking at someone bringing their highest and best contributions. And if you look at the leadership competencies, if you look at anybody’s competencies and what they’re expected to deliver, they have to be animated. They have to bring, again who they are fully into the game. If they are going through divorce, if they are going through something going on at home that impacts their mental state, do you want them operating on you?

My father had some brain trauma. He’s 87 years old and the surgeon that was gonna do brain surgery for him in this hospital I think he had been for two days in surgeries and he’d had like, I don’t remember but enormous amounts and they were gonna pull my dad and all the Thursday night. And I said no, I’d like a fresh doctor in the morning. He’s got great insurance. We’re gonna stay here until somebody can see him tomorrow morning who hasn’t done any other surgeries. And so you know, so it’s like what is that aspect of who we are that drives us to the point that we do things that could harm other people.

So when you look at performance, you can categorically look at, you know, again, what energizes us? How do we perform when we’re at our best? Can you check off accountability? What is my peer accountability if I am in a room of a lot of other people and I’m not fully engaged? And you know what all the engagement scores look like if you’ve studied any leadership development in the Gallup, in the Sierra Togo reports and research. It’s 80% of people on the planet are not engaged in their work. They stay where they are, a lot of them because they need benefits, they need health care.

And so, you know, if we’re looking at in that room talking about engagement, really bringing people’s hearts and minds to their work and having them contribute their best, what would it be like to be in an environment where everybody felt they could, that they were there for the right reasons? And I think that’s a conversation worth having. And so what’s the question you want to ask if you were in that room? Well, I’m serious. What’s a question you’d want to ask?

Michael: You want to ask to the other providers or other leaders or ask to you?

DJ: What would the question be that you’d want to ask to a group of leaders who are seated in the room, who are looking at how to solve this bigger problem and they’re thinking about performance. They’re thinking about, you know, how to get more revenue to the bottom line. It’s profits. They’re thinking about the things that you know, most of us talk about in business. What’s the bigger question you think?

Michael: How do we bring our best? What’s holding us back from being able to engage and treat people on a one-on-one basis the way that we want to be treated?

DJ: Yeah. And that requires a level of curiosity most people don’t take time for. From some of the research we’ve seen and experienced, you know, physicians basically will listen for about three seconds, if that, before they start diagnosing symptoms. And if active listening is something that we teach everybody to do, you know, in this coaching framework, then you become wholly curious. You begin to hear a lot more, and when I say spirituality sense or intuit is really what I’m saying, a lot more that could be going on that would help you get to a deeper source. So you begin to treat the sources instead of the symptoms. And that’s true whether we’re talking about a leadership problem, a culture problem, or a physical problem, you know, how do we get at the source?

So there’s some questions I’d love to see organizations asking some that we see and one of them is, what’s the truth here everybody’s sitting on? What would happen if you told the truth. You’re not speaking right now. And so you know, just to take a look at that is something that you can do with a coach who’s gonna help you sort through what that means, what kind of agreements that you need to be making with your team so that there is a different level of presence and movement. I think every organization should be asking a coaching question about what makes our employees, our communities, consumers, patients crazy in our daily practices and what can we do about that now? What’s in our control that we can really address now. So if you go back to that room that depicted, I really think it’s about having the deeper, richer, more meaningful conversations.

Michael: One of the things that you sent over before we talked today was this progress that you have of kind of moving from chaos to change, from complexity to creativity, and we’re gonna include this in the show notes so everybody can see because it’s a funny line of just how straight or not at all that line is to making it to progress. I’d love to know a little bit more about how you feel, I guess, what’s that tipping point that gets people from that line of chaos all the way across the board because I know obviously from this depiction here, it’s not a very steady line. It’s not just a straight forward progress. Like, how much time is spent in that sort of first third of that illustration where man, we’re just trying to get all these things out. How do we get to all the things that we haven’t said yet and actually start addressing these things?

DJ: That’s a great question. I don’t know that there’s a standard quantifiable amount of time, percentage of time. Where we find people who are confused or who are dealing with the chaos of change, and that’s what I call it. It’s chaos of change. And they’re discouraged or I sense this futility, just why am I doing this? I want to go start a farm kind of conversations. It’s really to let them sort through it. But most of us, when we put all that stuff out there, it’s almost like I give them a big container to dump out a story in first and then we sort through that. Once they’ve said that, they’re usually ready to move on because remember they’re problem solvers. They have tapped into that executive brain a long time ago. It’s just that they’re sliding back through into a space of fear sometimes that they’re functioning from. So getting them to articulate or give language to the things that are challenging is so important. And that’s one of the gifts of coaching is people say things and then they begin to look at it with you going, “Oh, that sounds like I’m a victim here and I don’t want to be bad.” So they immediately look at what’s better than that, right?

One of the tools of language that we give people is to see, you know, where we labeled victimization, you know, where is it that you feel victimized in the situation or like you’re not in control and what would be better or different than that? And they can look at a future state or cast a vision and then we look at the gap between where they are now and where they’d ultimately like to end up and what are the top two or three things they need to do to resolve, you know, at least the first step to get into action.

Michael: And how long does your group typically work with somebody? So you talk about, let’s get all this stuff on the table, let’s sort through it and figure out what are the things that we can do about it. So once we start identifying those things, then is your coaching group there with them through that entire process or are you just starting them down the pathway or how does that work with you?

DJ: Yeah, and that’s also a great question and it varies depending on the needs of an organization. I’m working with a biotech company that’s in discovery clinical trials level three right now in Cambridge and we’re working with three individuals who are the top leaders in the company. And we started with a six-month contract. They’ve all re upped that for another six months and they’re doing other things, but for themselves it was about that. And so, I would say we’re probably going to see more of the executive team come through the coaching and we assign that based on good fit, a good match.

So I think there’s more work and more lift to do there and probably some team coaching. And then in large systems, a lot of times we will work with the learning and development or HR team and we’ll map out a process, a journey map if you will for, you know, what happens first, where are you going to get the most lift in the organization?

So taking this outside of healthcare for a minute and going into just other industry, you know, we might say for a sales organization, for example, where are those top performing teams that need to stretch who are really going to give you lift in the sort of middle of the pack that, you know, if you could just get everybody to focus on the right thing. And a lot of times they’ll take those folks into group or team coaching in support of the programs or in a pool through of other programs they’re doing so that everything gets, it really gets focused and people become playful with each other and make different agreements. And so, there’s a whole lift there. And those initiatives can sometimes take about two, two and a half years.

And then there’s the one-on-one coaching, just you know, somebody who says who calls us up and says I really need to address something for myself at this point in my life. I need to, you know, revitalize my career or what I’m doing. I have been offered some of the things I want to look at. And so, there’s that and those are typically six month contracts. And then beyond that, people come through our coach training program for the Healthcare Coaching Institute and that is a 10 month long educational process with three intensives, live intensives with the cohort of 10 to 15 people. And then there are virtual classes that are mushed between there that happen in support of the building blocks that we have there. So that’s a little bit about how they can work with us or how we’ve worked with the organizations.

Michael: When you talk about working with other coaches, is that something where our businesses, and again, in healthcare, out of healthcare, are certain businesses getting their own coaches that they keep on staff or is this somebody that would be like an independent coach that would just work with a lot of different types of businesses?

DJ: Yes and yes. So there’s a lot of different ways that we see this being played out. A lot of healthcare systems, hospital systems are looking at developing internal coaching cadres and this is usually a job plus role and that’s something we can help them refine, define. And sometimes they name change agents, so people they want to develop as leaders in the organization and that will help drive the changes that need to happen after these big conversations about what’s the truth you’re sitting on. And so those change agents are trained in coaching skills and they are on call and in support of others inside the organization at every level because they’re sort of the eyes and ears of the organization and they are usually trusted peer level with individuals, and so that gives some lift.

And then, you know, externals typically partner with internals either in the training role or to have us come in to work with executive team members where they might be limited. Now if you get somebody who is a frontline leader working as support of a senior executive, sometimes it can be career limiting if you tell them the things they need to hear, you know. So I think it’s a good idea to sort of map a plan for our coaching culture. I’ve done that and one of the things we can actually give your audience is the journey map through association of talent development.  So we’ll do that at the end of this in the transcript. We’ll give them an access to purchasing that through ATD, but it’s a full sort of white paper document on how to create a culture of coaching.

Michael: Nice. That’s really great. You know, as you’re talking through all this, I keep thinking about, I went through some classes around this sort of business leadership and getting my MBA and so much of what human resources departments are trying to do is trying to move into this kind of role, not just administering the paycheck and keeping up with everybody’s benefits, but actually helping provide that sort of like leadership and training. So I see a lot of opportunity for businesses, again, in all areas to be able to embrace this and provide that kind of training that everybody says that they want to and maybe aren’t yet able to do yet.

DJ: We kind of skipped over the edge of complexity and how much time is spent there into the so what would be available for these folks to actually look at. When you get to the creative edge, again you’re creating a gap. So you get to a sense of order where people are sharing a vision, where everybody’s focused, where there’s meaning and teaming and innovation and all the things in HR, learning and development organization, executive team wants for an organization. And it’s like nobody really knows how to facilitate the conversations from the chaos edge of complexity, like in mass anyway, to this space where everybody’s on the same page and there’s a minimum and a readiness for change. And so exacting change is one of the things that I think all leaders are gonna need to be able to do and that’s gonna require high level communication skill sets, which are the competencies of a coach.

Michael: There’s definitely areas here where I feel like a lot of courage is required to go in and have some of these conversations with folks. Like this isn’t something for the faint of heart to go into.

DJ: No, it isn’t. Well, you have to stand in the space. Even when we’re teaching, you know, because I have 4 physicians in the current cohort of 10 people that are going through the current class in the Healthcare Coaching Institute, and you know, what I’m seeing is talk about discomfort zone is that you move into the space where there is so much discomfort in articulating what you need and want for yourself first before you can go out and actually hold other people in that whole resourceful, creative space where they’re problem solving for themselves.

And so, you know, as I’m watching this, it’s like we get blow back. We get a lot of, you know, I can’t do that. Who do you think you are, I mean, walking into an organization and asking that question? So there’s a lot of judgment and bias that we all bring to this conversation. And if all we did at the end of the day was to get people to be aware of that and be courageous to go back to your point, to be courageous in what people are willing to step into with each other and to learn that, you know, you’re not losing friends if you say what you see, if you communicate directly, which is one of the 11 core competencies of the great coach is direct communication. And where was the last time you signed up for that course?

Michael: Absolutely. I think we’re getting to a point of wrapping up DJ, but I wanted to just open the open the floor here. Is there something else that maybe we haven’t covered yet that you think that healthcare professionals, healthcare organizations should be hearing?

DJ: I mean, we put a stake in the ground. We’re the only company doing this in country, in the U.S. and we’ve had people exploring with us in other countries for training coach competencies in the healthcare space. Now it doesn’t mean we’re the only provider who will do that and so I would recommend people do research on what they want. But if you look at the model on our website, you’ll see that it’s built on three building blocks and these were designed in part by physician leaders, thought leaders, academic medicine people and master coaches.

And so, the three rungs or ranges in our model begin with humanity is the base level, who am I and who are we together to really look at what we’re bringing to the game when we learn to coach or when we become coaches. And we map that back to the expected competencies for coaching and to really distinguish what coaching is versus therapy or versus training or consulting or some of the other things that, you know, people are expected to do every day. And so we have a full intensive around that.

Then we move into the exploration around what is true for people and really begin to ask questions like what’s the truth everybody’s saying? And in the exploration, there we’re looking at active listening and powerful questions and direct communications, looking at the systems management pieces and building awareness so that people catch themselves just in time to really calibrate or move in a different way. And then the top level, which is another full intensive, it’s been around innovation on what’s possible and really creating, shifting, designing actions together and looking at scaling, coaching and following a journey map.

I spoke yesterday with someone who was new to coaching, just getting a certification but wanting to partner with a company who could help drive this through a partial state-wide organization in the South. And so, you know, being able to really hear the needs, I think it’s good for us practitioners, right? To be able to go in and support people who are really wanting to create a new environment that will change the conversation for healthcare.

Michael: That’s fantastic, DJ. Thank you so much for your time today. I’ve learned a ton, so I really appreciate all your time with us today.

DJ: Oh, Michael, it was my pleasure and good luck to you with this podcast and the work that you’re up to in the world. Hopefully, there will be synergies and I just invite anybody who is interested in pursuing this to get in contact with us. We’re available for conversations.

Michael: That’s great. Thanks so much.

DJ: Thank you.

Announcer: Thanks again for tuning in to the Paradigm Shift of Healthcare. This program is brought to you by P3 Inbound, marketing for ortho, spine, and neuro practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.