Doctor Coaching From the Inside: What Happens When the System Invests in Its Own People | Episode 183
The data couldn't be ignored, and it was so shocking it stopped her in her tracks.
When burnout data came back showing 53% of providers in her institution were burned out, Dr. Susan MacLellan-Tobert did not wait for someone else to fix it. She flew to Denver for a weekend coaching course, came back with a business plan, and helped build an internal coaching program that served over 300 staff members in two years, right in the middle of a pandemic.
In this episode, the retired pediatric cardiologist talks about what coaching actually does for doctors inside systems that are not changing anytime soon, why some doctors chose to leave after completing the program rather than stay, and what any clinician can take from coaching even if their organization never invests a single dollar in it.
Timestamped Highlights
[03:00]: Dr. MacLellan-Tobert describes what it felt like to watch medicine shift from team-based care where everyone contributed to a system of standardization and efficiency targets, and why that shift was the beginning of the end of her clinical career.
[12:00]: A burnout survey came back at 53%. She describes what happened next, including a weekend in Denver that changed the direction of her remaining years in medicine.
[16:00]: She explains what she had to fight to establish before the internal coaching program could even get started, and it was not funding or time. It was the perception of what coaching actually is.
[18:00]: Why some doctors who completed the coaching program chose to leave medicine rather than stay, and why she considers that a success rather than a failure of the program.
[22:00]: The difference between a coaching client who is paying for the program and one who receives it for free through their institution, and what that difference reveals about commitment and change.
[33:00]: A short list of the most common reasons doctors come to coaching, including one that surprises people who assume coaching is only for those in crisis.
Three Key Takeaways
1. Coaching does not fix the system. It changes what you can see inside it.
Dr. MacLellan-Tobert is clear about what coaching can and cannot do. It does not change the appointment template, the staffing ratios, or the corporate directives. What it does is shift the question a doctor is asking from why is this happening to me to what do I actually have agency over here. For some doctors that leads to a way of staying that feels more sustainable. For others it clarifies that the fit is no longer right. Both outcomes, she argues, are exactly what the program is supposed to produce.
2. Internal coaching programs work when they are protected, not bolted on.
When Dr. MacLellan-Tobert built the program at her institution, coaches were given 0.1 FTE each, and the institution accommodated scheduling so that providers could access coaching during the working day without it simply becoming another drain on their time. She has seen what happens when that structure is not in place, and the results are predictable: participation drops, commitment wavers, and the program becomes another initiative nobody has time for. The logistics matter as much as the intention.
3. You do not need to become a certified coach to use coaching skills.
Dr. MacLellan-Tobert now teaches with the Physician Coaching Institute, and one of the things she is most direct about is this: learning to listen fully, ask better questions, and be genuinely present with a colleague for 10 minutes is a coaching skill. It does not require a program, a credential, or a formal role. In a system where time and energy are in short supply, those skills are among the most valuable things a clinician can develop, both for the people they lead and for the patients sitting in front of them.
Guest Bio
Dr. Susan MacLellan-Tobert is a retired pediatric cardiologist, certified coach, and faculty member with the Physician Coaching Institute based in the United States. After nearly 30 years of clinical practice, she co-built an internal coaching program that served over 300 providers at her institution and now works as an independent coaching contractor with organizations and individuals across healthcare. She can be found at healingedgecoaching.com and on LinkedIn.
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