Sharee is a registered Psychologist, Executive Coach, and iRest Meditation Teacher. She is the creator of the workplace wellbeing program RESPOND and of the immersive doctor care program RECALIBRATE.
She has worked in public, private, and not-for-profit sectors over the last 30 years, building a unique combination of expertise in organizational, health, and counseling psychology. Sharee helps people improve their power skills, principally self-care and human connection. Working with Sharee is about developing capacity, purpose, and wellbeing through skills like mindfulness, compassion, and emotional intelligence.
Sharee is an experienced facilitator and coach working 1-2-1 and with small and large groups in health and education. She is accredited with several organizations doing what has become really vital work in this VUCA+ pandemic world, including Resilience at Work and The Potential Project. Sharee works with leaders in healthcare and education, particularly doctors.
You are Australia’s leading doctor coach. Can you tell us about who you are and how you started working specifically as a doctor coach Sharee?
My lived experience is integral to the work I do. As a registered psychologist, an international federation accredited coach, and a meditation teacher, I am intrigued by people. I have been studying psychology, the behavior of people, for 35 years.
Thirteen years ago, my husband Tim was diagnosed with cancer. After a four-year rollercoaster journey with lots of highs and some big lows, Tim died. It was a devastating time for our three young children and me and our whole family.
Even though I was a health professional, our family had been fortunate and hadn't spent much time as users of the healthcare system. During those four years walking beside Tim, we met many healthcare professionals in many different institutions; doctors, nurses, allied health professionals, complementary therapists. It was a real-time study of how the state of the health carer impacted us as patients and families.
Tim and I talked about this a lot, how the people in our care team were relating to us and how those interactions made us feel. Sometimes it distracted us from the work of healing. Navigating health care with a challenge like cancer is difficult enough without managing relationships. We often felt like we were doing more relationship management than we should have been.
I’d been working as a psychologist for about 12 years, but this was different. Being inside the healthcare system, specifically, the cancer universe, looked through a whole new lens, one where we didn’t have many bearings.
We were both meditating as part of our self-care during those years. We were learning a lot about the power of our minds, how to respond to our emotions and how to ask for help, how important community was to our wellbeing, individually and as a family.
After Tim had died, beyond the grieving, healing, and recovery we were doing as a family, I constantly thought about the doctors we had met and the impact they had on the whole healthcare system. I wondered how their wellbeing was taken care of in the context of their work. I started asking many curious questions about medical training, their expectations of work, level of burnout, really exploring everything I could about being a doctor. What I discovered were significant systemic failures, and Coaching for Doctors was born.
In truth, I started on this journey as a patient advocate feeling frustrated and disappointed, even angry, viewing doctors as having poor communication skills and concluding that they weren’t trying hard enough to understand and connect with their patients.
I held many assumptions and biases about doctors back then. Now I know that modern medical training and culture have a bias toward science and technical skill to the detriment of the art of medicine. I love science. It has led to unraveling many complex medical questions and better lives for people. Our response to the COVID pandemic would have been entirely ineffective without science.
However, this bias, like all biases, has a dark side. Neglecting the art of medicine means that many doctors do not feel skilled in communication, connection with colleagues, or patients. They do not have the skills of leadership they need to be truly effective. They cannot take good care of themselves and each other within the demanding and complex environments they work.
I thought the skills I had in counseling, coaching, and organizational psychology and my contemplative practices might be useful to doctors interested in their own high performance and wellbeing.
After working closely with doctors as their coach for more than seven years, I have learned that many of them simply don't have the training they need in what we have traditionally called soft skills, which are better described as power skills. And they want to learn these skills. They know they don’t have everything they need to do their job really well and to feel fulfilled in their work.
I now find myself advocating for doctors in a system that has not valued their humanness and has ignored the high rates of burnout, depression, and suicide they have experienced as a profession around the world. The consistency of these mental health issues across countries does point to systemic issues as much as personal skills gaps.
Can you tell us a bit about a doctor’s working life from your perspective?
Well, I can share some thoughts, it's important to remember that there are millions of doctors working around the world and they are a very diverse group, doing a hugely diverse range of activities. And I am not a doctor. Having uncovered my own biases, I don't want to propagate any more stereotypes!
What I can say is to be accepted into a medical course at university, a student must be very committed. They need to apply themselves consistently for a long time, five to seven years of study, and up to 15 years to specialize. They are rigorously examined and assessed throughout those years, and the environment is highly competitive. These young adults are willing to sacrifice a lot of their early adulthood for a long-term goal.
These young people in the main are achievement-oriented, perfectionism is a common problem, and they are by necessity competitive. They are excellent at delayed gratification, able to persistently apply themselves to their goals, willing to face challenges, and to witness human suffering. These qualities along with high expectations of self and an unwillingness to ask for help or admit their emotions, especially fear or confusion out loud, are common.
The phrase doctors use to describe themselves to me more than any other is problem solvers. Doctors generally work long hours, giving up a lot of their family time and social life to benefit their patients. Their work can be very complex and can include hundreds of interactions with people in a day where the outcomes are uncertain, and the problems are not resolved in the way people would like. Many doctors, though not all, are regularly exposed to heartbreak, distress, trauma, and grief.
Most doctors feel time-poor and find it very difficult to prioritize their own needs when patient demand is high. The support offered to doctors is highly variable and often non-existent, which is a serious problem in their mental health and burnout. This lack of support is also an issue for doctors who want to build their leadership skills, as there has been no clear avenue for this in most healthcare organizations.
The culture of medicine in many countries still endorses implicit ideas about doctors being superhuman. We have seen a lot of this in terms of expectation and behavior during the pandemic. These are powerful forces that prevent people from asking for help and perhaps limit the development of relationships and collaboration skills in healthcare.
To learn, we need to be able to ask questions. There is a vulnerability in doing that, and doctors have been trained to limit their expression of vulnerability and a whole range of other emotions. This notion of look like you are in charge of instilling confidence in others has some serious downsides. By creating this culture of don’t ask, don’t tell for doctors when it comes to emotions and collaboration, we have limited their opportunities for learning and development in the power skills of emotional intelligence and effective communication.
How are doctors using coaching to support their work?
When we are fatigued, under pressure, and time-poor, we are less effective in our decision-making, emotional regulation, and relationships. We tend to get tunnel vision and become very narrow in our thinking. In this very task-focused state, we can damage or neglect relationships. Healthcare is about taking care of people, which means relationships are central to being effective. To be truly effective, we need to have insight and respond to whatever we learn, perhaps change our behavior at the moment. We need high levels of awareness to alter our habits and transform them into another way of being.
Coaching is contextual, emergent, and contingent. As the trust develops between coach and coachee doctor, more nuanced goals can develop. Coaching focuses on performance, awareness, wellbeing, and meaning. It is a future-focused creative process designed to help the coachee behave in ways aligned with their values and help them meet their goals. Together the doctor-coachee and coach consider the impact of the doctor's mindset, attitude, beliefs, decisions, and behaviors on themselves and their system, their environment.
Many doctors use coaching as a safe space, a sounding board to test ideas, confront difficult feedback, process problems and envisage the future. Coaching intends to facilitate new thinking, unearth barriers and build a scaffold for accountability. A doctor might use coaching to make a career decision, to learn particular skills - for instance, how to improve their exam or interview performance, they might want to learn or hone their skills in mindfulness or communication and practice applying their skills at work.
Another example might be that the doctor wants to have a greater influence as an educator helping junior doctors, or perhaps, they are worried about their emotional regulation and recognize a gap in their capacity that they want to understand and address. Many doctors want to learn how to manage their time or priorities, find more work-life balance, or practice managing other people. The range of goals that can be bought to coaching is really unlimited.
You are a big advocate for doctors having a coach, particularly psychologist coaches, is there any research evidence for this?
Yes, I think that if more doctors had a coach they trusted and worked with regularly, many of the problems in health would be reduced or resolved over time. In the first instance, coaching is a protective factor for the doctor who can build skills to improve performance and prevent or minimize problems like burnout.
Once the doctor has raised their own awareness and has more clarity about their goals, they are empowered and are more likely to seek changes within the wider system. I believe they will relate to their patients more effectively, mentor junior doctors differently, lead teams effectively, challenge organizational culture more, and choose not to enable unhelpful structures in the same way. In other industries, coaching has shown itself to be a useful mechanism for achieving greater good goals.
Coaching facilitates insight and activates personal agency, empowering the coachee to take action, not just wonder about what they could do. This focus on achieving goals sits well with doctors. They want to solve problems and help people. I advocate for coaching because it is preventative action, and prevention is better than cure.
Liselotte and colleagues published their work in the Journal of American Medical Association in 2020, looking at the potential benefits of coaching for doctors and found that professional coaching significantly reduced emotional exhaustion and overall symptoms of burnout in physicians and improved their overall quality of life and resilience.
Professor Jan Ritchie found in 2001 that there are benefits if the coach has an academic background in psychology. This is not surprising to me; much of the work we do in coaching is about understanding people, their motivations, and biases. Clearly, I'm biased! I think psychologist coaches have a great deal to offer the medical profession.
Coaching seeks to generate new thinking, insight. The coach doesn't need to have the same skills as the coachee. When they do, this can be a limitation, and the conversation can revert to mentoring or training. This is the risk a doctor coach working with another doctor needs to remain attuned to so that the unconscious biases of medical culture do not limit the exploration possible in coaching.
Coaching offers an evidence-based process that helps us think in terms of strategy and details. It is a safe space for new ideas to be explored, for biases to be recognized without fear of career damage. The coach has a different mandate to a supervisor, and the conversations have a different flavor. In the coaching space, transformation can occur for individual doctors who can be empowered to affect the systems they work in.
When coaching is an accepted process like it is in the corporate world, doctors will engage a coach without fear of judgment. If coaching can be seen as a normal developmental process for the benefit of all, I think it will change the landscape of medicine. Our high achieving, perfectionist doctors, can recognize their humanness, hone their communication and emotional intelligence skills, connect with others more effectively and stay well for the long term even though they do incredibly complex work and meet human suffering constantly.
Obviously, when our doctors are well, the health outcomes of patients improve, and so does their healthcare experience. Patients are better and happier, and doctors are more fulfilled. It’s a win-win situation for everyone involved, including the organization, who can have happier staff and happier patients who are all ultimately contributing to the process of improvement.
It sounds great having a trusted confidant and a process like coaching. What stops doctors from having a coach as you describe?
There are two key barriers to doctors seeking coaching. The first one is time, specifically how they and their employers choose to prioritize time. Sometimes we need to take short-term pain for a longer-term gain, which is hard to do when there are so many demands on the system. Nearly every doctor I have spoken to loves the idea of coaching, but many say they cannot fit it into their schedule.
The second barrier comes from the doctor’s mindset or belief system. I will give you some examples, an unwillingness to lean into what feels uncomfortable, like unfulfilled dreams, difficult emotions, conflict or confusion, an internal story that this is tantamount to asking for help which means failure a very real belief for many doctors.
Coaching is effortful. It holds the coachee to account and requires the coachee to articulate their inner experience and to reflect on it – warts and all. Then it expects action, living true to our values and goals. It takes energy. And it can be just the energizer a person needs to grow and make a change in their life or work.
Like many things in life, starting coaching can be the hardest part because it is all a bit unknown. We are intentionally taking responsibility for ourselves, being accountable for taking action. The coaching process is a careful balance of risk, challenge, accountability, and high trust. The coach must hold a very safe container for the work to happen within. Some doctors arrive ready with a clear problem to resolve. Others immerse themselves in the process, curious to see where it takes them.
You sound really motivated by your work with doctors, Sharee.
I certainly am. I am naturally intrigued by people helping them to understand their lives, themselves, and their behavior so that they can progress in ways that are meaningful to them is an awesome privilege. Very often, it involves big change. I am honored to witness these transformations and am inspired by what people can do when reflecting and leaning into their experience and personal agency.
Doctors are the lynchpin of our healthcare system. They give so much of their lives in service to the community. We can do medicine better as a career and for patients. Coaching offers us a mechanism for individual and collective systemic change.
When doctors raise their self-awareness, emotional intelligence, leadership, and communication skills, they are more effective. I have had the privilege of witnessing this happen many times. As the doctor feels more engaged and fulfilled because they are more effective in their work with patients and more connected with their colleagues, the health outcomes for patients improve.
The ripple effects of well doctors are huge, and they are measurable. Coaching is one of the ways we can transform healthcare. I have so much faith in our doctors if we help them grow their interpersonal and intrapersonal skills. We have to prioritize this work and give them the time and space they need to develop to come to coaching. Doctors are humans long before they are medical practitioners. It’s time we recognize that, and it’s time they recognized it too.
To learn more about how coaching can help doctors be high performers and stay well for the long term, read her white paper here.
