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Family physician and certified executive leadership coach Lisa Herbert discusses her article, “From burnout to breakthrough: How a coaching culture transforms health care.” Lisa shares her personal journey with physician burnout, a crisis affecting 54 percent of physicians, and how discovering coaching revolutionized her approach to leadership and her career. She explains that a coaching culture, which emphasizes curiosity, continuous growth, and collaborative problem-solving over traditional command-and-control management, is a powerful antidote to burnout. Lisa outlines a roadmap for physician leaders to build this culture, starting with self-awareness, mastering fundamental coaching skills, and institutionalizing coaching practices. The conversation highlights the ripple effect of coaching, extending beyond physician well-being to improve patient interactions, medical training, and even personal relationships, ultimately benefiting health care organizations through better retention and patient experience. Physician leaders are encouraged to explore coaching, while executives should assess how organizational systems can support this transformative shift.

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Transcript

Kevin Pho: Hi and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Lisa Herbert; she’s a family physician and a certified executive leadership coach. Today’s KevinMD article is “From burnout to breakthrough: how a coaching culture transforms health care.” Lisa, welcome to the show.

Lisa Herbert: Thank you so much, Kevin, for having me. I’m excited to be here.

Kevin Pho: All right, so let’s briefly share your story and then talk about what led you to write this KevinMD article.

Lisa Herbert: I’ll try to be brief, but my story goes back to growing up as a little girl in Brooklyn, New York. That’s where my roots started and where my interest in medicine started as well. Coming from a community where there were not many physicians in my area, there was one who was a great mentor and a family physician who served in my community for as long as I can remember. He encouraged me to go to medical school, and when I went to medical school, I obviously chose family medicine because of the experience that I had growing up in that environment and from having him as a mentor. He served as a family physician for my entire family: myself, my mom, and my grandmother. So I saw myself in that role, doing that as well.

So I went on to medical school and chose family medicine as my career choice. When I first got out of residency, my first job was as a medical director, which is unheard of, getting a leadership role right out of residency. It was a great experience, but there was a lot that I had to learn and a lot that I realized that I didn’t know or didn’t receive in my training going through medical school and residency—all those leadership skills that we tend to talk about now.

Fast forward, after having spent seven years in that organization doing some really great things as a medical director, I wanted to get back to my roots of being a family physician. I took over a retired physician’s practice and practiced medicine for about 22 years, which is a long time in private practice. Back then, EHRs were just starting to develop, so insurance companies, HMOs, all those things were really just starting to develop. I was in the thick of it, in the throes of this change that was happening.

About 15 or so years into my practice, I went through burnout, which many physicians, even 20 years later, are still going through. Going through that burnout process was a struggle. I had a friend who was not in health care who recommended that I get a coach to help me figure out my next steps and work through some of the obstacles I was facing. It transformed my life; it was the best decision I had ever made. That began my transition into coaching and my coaching career.

Kevin Pho: All right. So I’ve been practicing primary care similar to you; I’m in my 23rd year now doing internal medicine primary care, and I can’t imagine a private practice family physician doing primary care. It’s very difficult in this day and age, and we’ve both certainly seen the evolution of primary care through all the different changes. So when you said that you felt burnt out after 20-plus years, what were you feeling? What did that feel like?

Lisa Herbert: It was an exhaustion that I couldn’t explain, and it wasn’t resolved with rest, going on vacation, or taking a break from medicine. It was not so much physical but a mental, draining exhaustion. I was pulling away from things that I loved, sometimes becoming a little cynical, even thinking, “This is just how things are,” losing a bit of that optimism for the things we look forward to when it comes to being in primary care and taking care of patients. And just doing this daily grind of feeling like I had to work harder to make things better. Those were some of the early signs that I had, definitely burnout.

Kevin Pho: OK. So you mentioned how coaching was a turning point for your burnout, and you talk a little bit about that in your KevinMD article, “From burnout to breakthrough: how a coaching culture transforms health care.” For those who get a chance to read your article, tell us what it’s about.

Lisa Herbert: I share a little bit about my own experience with coaching, how it transformed my life and career, and why I decided to go into coaching and take it on to help my colleagues and fellow physicians deal with challenges, burnout, and all the things we have to go through in medicine. What I realized is that I was doing this one-on-one coaching and getting really good results with many of my colleagues. They were benefiting from the coaching, sometimes going into organizations doing that one-on-one coaching.

But what was missing was the organization adopting what I call a coaching culture, where everybody takes on the mindset of, “If I can coach someone, whether that’s a person on my team, my colleague, or just someone in a different department.” Think about how we can transform the entire system and maybe not just do it as a one-on-one, almost transactional, service. That was the whole impetus behind my article: to get health care organizations to understand that we need to move past the traditional methods that we were using in the past and what we would consider professional development to help physicians and to take it on as a culture. We can create the psychological safety that’s necessary to help people sustain within organizations, improve patient outcomes, and hopefully reduce the number of physicians and health care professionals leaving medicine.

Kevin Pho: In your article, you cite that 54 percent of physicians report burnout symptoms and the majority of physicians practice in employed settings. A lot of times, they don’t have that culture of coaching. What specific things need to happen for that culture of coaching to take place? What would that look like?

Lisa Herbert: Health care organizations first of all need to understand what coaching is and what it does. There are still many organizations that, unfortunately, use coaching as a performative measure. If someone’s having a hard time or not doing well, they bring in a coach to try to fix it. Whereas coaching should be used to help an individual improve upon the skills they have, almost as a preventive measure to start in the beginning, not when someone is having problems or issues.

It’s to help bring teams together. It’s to help develop early career leaders who are taking on leadership roles, or to help someone transitioning into a different role within the organization. It’s not so much to use it as a performative measure but to use it to help grow an entire organization, help individuals grow, and help teams work together more collaboratively.

So, first, organizations need to understand what coaching is and how to use it. Second, they must ensure that those in leadership roles understand what it means to be a leader and that coaching is a skill they should have to help their team do the best job they can.

Kevin Pho: Is the coaching you’re talking about different from, say, mentorship?

Lisa Herbert: Absolutely. Coaching is much different from mentorship. A mentor is typically someone you look up to who is on the career path you would like to have. You may go to that person and ask questions about what it’s like to be in that position or what steps they took to get there. A coach, on the other hand, will do a deep dive into the skills needed for that position and how they can help you develop those skills that may be helpful for you along the way.

Kevin Pho: So how do institutions, a lot of them under time and financial pressure, take the first steps to implement the coaching culture you’re talking about?

Lisa Herbert: That’s a great question. First and foremost, they can bring someone in who has the credentials, who might be a certified coach who has worked within the health care industry because I do think that is important for someone to understand the industry and all the intricacies of health care. They can start by bringing someone in to introduce the organization to what coaching is, what it looks like, and what conversations we can have on a day-to-day basis with our team members using that coaching mindset to help us communicate better. You can start by bringing someone in to help teams understand how to communicate better. That’s one way an organization could bring someone in to help, or at least to start.

Kevin Pho: Can you tell us a success story where an organization implemented what you’re talking about, perhaps brought a coach in, and made an appreciable difference before and after?

Lisa Herbert: Absolutely. There’s an organization that was acquiring practices, which happens all the time. This organization was acquiring some practices, and there was one particular practice that was doing very well but needed to understand the new culture of the organization in which they were now becoming a part. So I was brought in as a coach to help this new practice adopt the vision and mission of the new organization. Part of that meant I had to coach the new practice on what it meant to collaborate and work with other people within that organization.

But it also meant helping the organization understand what acquiring this practice would look like and what some of the challenges were going to be. It wasn’t going to be just an easy, turnkey situation; there needed to be a lot of communication on both sides. There needed to be some skill development for this new medical director, who was now going to be a part of the larger organization. There needed to be continuing communication between all the team members.

Once we established what that was going to look like and what that coaching journey looked like, at the end, after about six to 12 months of being with that organization, it was a positive thing for both sides. The organization was able to successfully acquire that particular practice. The practice was then able to hire more people; it expanded and moved to another location. It worked out to be the best for both sides. But had they not had that intervention, or at least that bringing together of the minds, I don’t know that it would have gone so smoothly.

Kevin Pho: I want to emphasize one point you made: this is a process. You were with this organization for six to 12 months, and I assume you met with them regularly. This reiterates that coaching isn’t a one-time thing, is it?

Lisa Herbert: It is not a one-time thing, absolutely. People always ask, “How long should a coaching relationship be?” The minimum, especially if it’s one-on-one, is three months. The ideal sweet spot is six months, but sometimes it does take a year; it can take 12 months. And I always say that after 12 months, it doesn’t mean that it ends even then. There are always things that come up after that relationship ends. So I think it’s always important for organizations to have internal coaches but also to have those external coaches they can call on anytime there needs to be a reset.

Kevin Pho: In your article, you talk about a ripple effect of coaching beyond burnout, and that it can have downstream effects, like improving interactions with patients. Tell us more about that.

Lisa Herbert: Absolutely. We all went through training in medical school on how to have conversations with patients, and I think it has evolved now to understanding that it’s a partnership. When you’re dealing with patients, you want to make sure you’re giving good care and good recommendations, but the patient also has to buy into what you’re saying. So teaching physicians and health care providers how to have those conversations, even on a coaching level—meaning that you are actively listening, asking the right questions, not assuming, and leaving space for the patients to speak so you can hear them—definitely has downstream effects. Patients are more engaged, the trust factor goes up, and nine times out of 10, they’ll follow your directions more when you’re approaching it from that conversational standpoint.

Kevin Pho: What’s the current landscape like? Do you feel that many health care executives and leaders in organizations today are seeing the value of coaching that you’re articulating?

Lisa Herbert: I think they are. I do. I think it’s still slow, slower than in other industries that have documented what the ROI is. If you look at other industries like finance and tech, they have done the research and documented that there’s a significant ROI from coaching. I don’t know that you can find those statistics in health care yet, but when you’re talking to executives, I think they do understand and are seeing that return on investment.

Kevin Pho: How about those physicians who are like you were before you went into your coaching journey? If they wanted to implement some coaching tactics and techniques into their practice, where can they learn more about that?

Lisa Herbert: They can obviously reach out to me. I’ve held several workshops over the past couple of months on that topic itself, which is coaching conversations: how to have those conversations with your team members and how to influence them. So they can certainly reach out to me for those. They can also just reach out to any organization that offers coaching and hopefully, they’ll be able to offer those same services to them as well. But I think it’s important for them, if they don’t have a coaching resource within their organization, to speak up and ask for it. It’s important and it’s going to help them develop professionally and also help with their patients.

Kevin Pho: Taking a step back, you mentioned that you were a primary care physician for 20-plus years, and you transitioned to incorporating coaching and are now helping organizations implement some of these practices. Tell us about that professional transition and what it was like for you.

Lisa Herbert: We’re talking about probably 10 to 15 years ago now. But I think first and foremost, what I would like to say is that we sometimes go into medicine thinking that it’s linear, that there’s this straight path where we have to check the boxes, we do the one thing, and that’s it. For me, I had to learn much later in my career that it doesn’t have to be linear, that we can have different passions and different things that we like that we can incorporate into our careers.

After having a coach, that is what opened my eyes to thinking about coaching as a career. Being exposed to a coach, knowing how much it had transformed my life and my career, and then taking that small step to get a little peek of what that was like. I took a weekend-intensive course on coaching, learned what that was like, and learned how much it could help my colleagues. I felt passionate about the work, doing some research and finding out how much it was impacting the lives of so many people.

After doing that weekend course, I decided to go full throttle and get my certification as a coach, which took about six months. I enrolled in a school that afforded me the ICF certification. I went forward with that for about six months and then decided that I wanted to eventually transition my career into offering coaching, initially to just my colleagues.

At first, I did it as a side gig. A lot of us have these side jobs that we do, and for many of us, it’s just to fulfill that purpose and passion. So I started doing it as a side gig, and then eventually, it grew. The need was there, and as the need grew, I needed to devote more time to it. It was an easy transition to do that over time. It wasn’t something I did overnight, but it took at least two or three years to build up the coaching practice into something that I now do, for the most part, full-time.

Kevin Pho: We’re talking to Lisa Herbert. She’s a family physician and a certified executive leadership coach. Today’s KevinMD article is “From burnout to breakthrough: how a coaching culture transforms health care.” Lisa, what are some take-home messages that you would like to leave with the KevinMD audience?

Lisa Herbert: One of the take-home messages, which I already mentioned, is that I would love for all my colleagues to remember that medicine is not linear. Think about anything that you’re passionate about, anything that brings that spark into your life. I think that’s one of the ways we can help combat burnout: if we adopt the things that bring us joy. So medicine is not linear; understand that there may be some bumps and bruises along the way. There may be some curves and bends in your career, but anything worth having in the end comes with those turns and twists. That’s one thing I would like to leave with you all.

The second is I always like to tell my clients that there are always two sides to a story. I think that’s helpful when we are in situations where we’re dealing with conflict, which we are typically in a lot. There are always two sides to a story, so don’t go into a conflict with your boxing gloves on. Be open, make sure that you are practicing active listening and listening to the other side of the story, and then you can come to a conclusion and make your decision after that.

Kevin Pho: Lisa, thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Lisa Herbert: Thank you for having me.