Scouting a career coach: When it's time for a change
■ Physicians are turning to advisers to help them decide where to go in their professional life. But with so many coaches -- and with charges at $130 per hour -- physicians need to tread carefully before hiring one.
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A few months ago, Lee Slavin, MD, MPH, wondered why he'd gone into clinical medicine -- and if he should find an exit. "I thought I could do more," says the Cleveland trauma surgeon. "I thought I wasn't performing [to potential] and I didn't understand why."
Dr. Slavin was finishing his MBA and thought vaguely about venturing into business. After hearing that some physicians use career coaches to clarify goals, he met with a Washington-based coach. For nearly six months he's had telephone coaching sessions -- each costing a few hundred dollars -- about once every two weeks, an hour to 90 minutes each. Dr. Slavin talks with his coach about his personal and professional strengths and weaknesses, and about options he might have inside and outside of medicine.
Physicians, in apparently growing numbers, are seeking advice from career coaches who can offer services from job-hunting guidance to improving life skills.
Career coaching as an industry has mushroomed over the past five years, and for some coaches, physicians disgruntled over declining reimbursements, climbing liability insurance premiums, and other hassles of medicine have become a lucrative clientele.
But although many physicians say they've benefited from being coached, it's a wholly unregulated field. That's why experts say physicians need to check out carefully any coach they consider retaining.
Why a coach?
Some doctors hire career coaches because they're unhappy with professional relationships in their practices and want to hone interpersonal skills. Others are curious about other fields within medicine. Some are dismayed with health care and want to leave it, but aren't sure how. Others long to chase a lifelong dream.
Timothy McNichols, MD, an internist at a multispecialty clinic in Springfield, Mo., has been coached at various stages of his career. He first consulted a career coach when he was a medical resident and had "no clue" about the job interviews he faced or what office setting he preferred. The coach, he says, "asked a lot of good [probing] questions about what kinds of problems you could live with, and what kinds of problems would drive you crazy."
Coaching helped him decide to join a large group. A couple of years later, when he got frustrated by issues such as a lack of autonomy, the quality of the practice staff and a series of conflicts with hospital administrators, he went back to the same coach for more sessions, first in person and then on the phone.
"She helped me work through the issues so I didn't have to leave my practice," Dr. McNichols says. He now thinks of his coach as being akin to a lawyer hired on retainer, someone he can call up for pointers when the need arises.
Richard Faciana, MD, a psychiatrist in Solvang, Calif., began seeing a coach five years ago when he felt himself sinking into the morass of a frustrating health care system.
"I was buried in managed care insurance," he says. The coach came up with ways to "disentangle" his practice from third-party contracts and convert gradually to a cash-only basis without an income loss.
Dr. Faciana, who now spends about $150 for a coaching session by phone every few months, says his coach also pushes him to add balance to his life, whether that's spending more time with his wife and four children, reading and exercising more, or engaging in hobbies.
The line between coaching and psychotherapy is an important one, though it's not always clear-cut. While some psychologists or other licensed therapists are increasingly taking courses in coaching to supplement their skills, most coaches in business are probably ill-equipped to aid doctors with serious psychological problems such as depression, alcoholism or other addictions, says Peter S. Moskowitz, MD, a pediatric radiologist at Stanford University in Palo Alto, Calif., who since 1998 has worked half-time coaching other physicians.
"Coaching accepts [physician clients] for who they are," Dr. Moskowitz says. "Coaching is not therapy and it is not counseling. It does not look at family-of-origin issues. It is forward-looking."
Coaches' fees vary. Some coaches charge per hour, and others by the month for a certain number of bundled sessions. Physicians also might have informal opportunities to get feedback in between sessions, often via e-mail.
A survey of 300 coaches by Stephen Fairley, a Chicago business coach and author, found the average hourly fee to be $130, with a range of $40 to $300.
Identifying a good career coach can be difficult. For starters, there are so many coaches. There are at least 10,000 full-time personal and career coaches practicing nationwide, according to numbers cited by Y. Barry Chung, PhD, in a December 2003 article for Career Development Quarterly. That's a tenfold increase from the mid-1990s.
But no one keeps an official count, in part because many coaches practice informally or as a sideline. In his article, Dr. Chung also cited research showing that many coaches don't have a graduate degree. A significant minority haven't finished college.
"As long as you have a Web site and can convince people to take business from you, you can be a career coach," says Dr. Chung, an associate professor of counseling psychology at Georgia State University.
Finding a coach
Unlike psychiatry or psychology, coaching requires no license and no formal training. A few national coaching associations exist, but their standards aren't universally accepted by the traditional professional counseling field. Only a minority of coaches belong to them.
Evidence-based criteria for evaluating a particular coach's skills and success rate also are not established, making it especially important for a physician to tread carefully before hiring a coach.
"The practice [of coaching] is, in many ways, ahead of the science of it, compared to psychotherapy and counseling," says Rodney L. Lowman, PhD, a professor of organizational studies at Alliant International University in San Francisco. He has studied how people choose and change careers.
"[Coaching] has been burgeoning from nothing to something in a hurry," says Dr. Lowman, who has worked as a coach.
There is no general, objective repository of information of all career coaches, their skill levels and training, nor are there centralized records of complaints filed against them. An array of designations is associated with coaches, depending on their training, including job and career transition coach, credentialed career master, and certified career coach.
Organizations that provide such recognitions include the International Coach Federation, the Professional Assn. of Resume Writers and Career Coaches, and the Professional Resume Writing and Research Assn. Web sites for these groups can be a starting point for finding a coach, although a coach outside those groups might be no better or worse than a coach who belongs to one of them.
Most coaches offer a free, brief, introductory session. A coach may ask a physician to sign a contract for a certain number of sessions spaced over several months. But others say their "contract" is more a list of mutually satisfactory goals than a binding agreement. The key, experts say, is that physicians should beware of being locked into a costly arrangement that precludes terminating the relationship easily.
Aside from money matters, key things to watch for in hiring a coach include length of experience, an eagerness to provide you with references, a good rapport and comfort level, a solid professional background and college education, and a familiarity with the complexities of the U.S. health care system. Although they certainly don't have to be physicians themselves, experts say, it's good to look for coaches with some previous experience with physicians.
"Doctors are absolutely unlike other mid-career professionals," says Francine Gaillour, MD, an internist in Bellevue, Wash., who has been a coach for five years. "Doctors are almost naive about surviving in the business world outside of medicine. They're fearful. But they are good students, and they're resourceful."
Dr. Slavin, who is one of Dr. Gaillour's clients, has felt especially resourceful recently -- though some of his coaching homework hasn't been about career exploration. Although he started his coaching pondering what to do with his MBA, he soon began looking inside himself to examine his real passions, he says.
An opera buff, he's being encouraged by Dr. Gaillour to write his own libretto for an original, humorous opera about a malpractice trial.
The hero of the opera, Dr. Slavin says, is a surgeon who is a "poor soul caught in a system that doesn't allow him to act properly."
If his coaching fulfills its potential, he says, he'll find a job that permits just the opposite.