As a physician and a coach to physicians and healthcare executives, I'm aware that there are a sizable number of silently suffering docs who still experience it as a personal failure, if not a stigma, to seek help. Physicians are trained and skilled in putting on a good face even when they're torn up inside.

Whether it's personal matters, past or present, or professional issues such as feeling adrift or disengaged professionally and not knowing how to redirect their talents and interests, I suspect many physicians are not getting the help they need that would improve their personal and professional well-being.

We know that psychological/emotional stress - whether it's due to personal matters or professional factors - causes significant behavioral issues that are harmful either to self (e.g. substance overuse) or to others, or at least perceived negatively by others (as in "disruptive physician" behaviors, sexual harassment complaints, etc.).

Is it possible to create a shift in the medical culture that would make it okay for physicians to admit their vulnerabilities, to need and get help/support that will enable them to continue growing and to flourish? If so, what would have to happen to create this shift?

Interesting thread, when I was building a large physician practice management company a few years ago I was amazed at the number of times I ended up being a type of councillor to physicians who seemed to just need somebody to talk to. I always wondered if it was because they were used to being in charge and didn't want to be seen as needing help and were comfortable opening up to me over the phone. Didn't realize it was as much of an issue as this thread seems to indicate

Glad to see this thread got a bump. One other arena in which coaching for physicians is not getting adequate attention is from the specialty societies and other organized medicine groups, at least from my perspective.

ACPE is something of an exception, but even their publications frame coaching as a matter of getting remedial help when needed, rather than an ongoing processs of self-improvement and career development. I suspect that other orgs might offer assistance to docs who are already floundering if asked.

Again I reiterate that physicians need to recognize what other professionals know already, namely that would-be champions are not afraid to ask for help and stars always have coaches.

I agree that the perception that coaching only exists for people who need remedial help or intervention is unfortunately pretty prevalent in healthcare. I've talked to many (on both the clinical and administrative sides) that seem to think that only "disruptive" docs or those suspended for being behind on their charts warrant a coach. But the power of having an objective sounding board, resource and guide that helps a high-performing physician reach excellence cannot be understated. When more professionals in the healthcare world start to recognize - as others do in the business world - that it IS the stars that have coaches (thanks Dr. Hepler), and that coaching is not something to be kept secret, perhaps more docs will get the support they need for their personal and professional growth and will experience greater overall fulfillment.

Interesting thread. In the pediatric residency program with which I work, we have adopted a more aggressive approach to recognizing residents exhibiting signs of burnout or other potential mental health issues. We've seen first hand the improvement in performance when these residents address their issues with support of their residency program. The only downside is the burden it places on limited administrative resources to manage this process, with frequent meetings, additional evaluations of performance, etc. But for those residents in whom we invest so much, it has been an incredibly successful change. Hopefully, future classes of physicians will accept this type of physician support as normative, resulting in the culture shift desired by the author above.

Seeking help can be framed as positive or not. Building on strengths is a paradigm that acknowledges that in our individual differences- we all bring something different to the table. I have had the privilege to coach for several medical school based leadership programs. What I see on the part of many physicians is a willingness to acknowledge what is not working as well as they would like- when they have a model that makes sense and constructive ideas about how to move forward. Then they are willing to ask for what they need/want not from a place of weakness- but improvement. How all this is framed matters!

Sometimes it just takes a leader who cares and gives the phydician a time and place to open up. I've also formed relationships with mental health professionals over the years who will help me out. Lifetime I'm batting around .500 so that's not too bad. But yes, we are trained to be comic book style heroes, and it doesn't work.