Toward the end of my clinical career, I didn’t feel like I had control over much at all. The patient safety issues loomed large. We used ridiculous workarounds for broken processes. The constant vigilance to provide excellent care in a suboptimal environment was exhausting. I didn’t see anything I could change. Based on my work with physicians as a coach, I think that the sense of powerlessness and being a “cog in a wheel” is now at an all-time high.

While on an uninspiring stretch of road on a recent family trip, a realization came to me: There are many, many system issues over which physicians have little control. But physicians do have control over three things:

• How they lead in both formal and informal leadership roles
• How effectively they advocate for change
• Who they show up as every day

Leading. Research has shown that the actions of physician leaders directly correlate with the risk of burnout in the physicians they lead. There’s a ripple effect with both negative and positive leadership behaviors. How you lead affects those on your team and across your organization.

Being a voice for change. Effectively advocating for change requires an understanding of the context and relevant needs. Physicians are perfectly situated to understand the downstream impact of organizational policies and culture on patients and colleagues. Yet seeing is not enough. Physicians also need sufficient bandwidth and energy to communicate and collaborate with decision-makers so that important changes are prioritized.

Showing up as your best self. If you went to climb a mountain without eating breakfast, you’d probably be irritable along the way and you might not make it very far. Eating first would increase your enjoyment and the chance that you’d be successful. Being at your best at home and at work is critical to how you lead and how effectively you advocate for change. And this is where coaching has a big impact.

People generally can’t just decide to show up in a different way and have that work long-term. Real, sustained change takes heightened awareness, relevant and important insights, goal-setting based on what really matters to the individual, practicing new ways, and accountability support. It takes a commitment to dig in, step out of your comfort zone, and make real change.

When is a good time to seek coaching? When you need things to be different and are not sure how to make a change. Or you don’t want to look back with regret. Or because life has delivered some lemons you didn’t expect or want.

Monitor yourself for a week. Are you presenting your best self to the world? Are you on your A-game most of the time? When you stumble, is it at work, at home, or both?

Coaching helped me see where I have agency and changed the trajectory of my life. If you’d like to see how it can change yours, let’s connect.

Diane W. Shannon is a physician, professional coach, author, and health care writer who helps women physicians build influential, sustainable careers without sacrificing their well-being. She can be found at dianeshannon.com.

She brings more than 20 years of expertise in physician burnout, women physician leadership, and building sustainable physician workplaces. After experiencing burnout early in her own primary care career, she dedicated her work to understanding why talented physicians struggle and what it takes for both individuals and organizations to thrive. Drawing on her experience as both a physician and award-winning health care writer, she helps women physicians expand their leadership, navigate career transitions, and avoid burnout, while partnering with health care organizations to retain physicians, develop women leaders, and strengthen workplace culture.

Dr. Shannon is coauthor of Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine, a TEDx speaker, and cofounder of Lead Your Way Academy. Her writing on burnout, cognitive load, and physician well-being has appeared in Massachusetts Medical Society publications, the American Medical Association’s STEPS Forward toolkit series, and on WBUR. She shares updates on LinkedIn and Instagram.

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