From Emergency Decisions to Systemic Change: How Coaching Can Transform Patient Safety in Medicine
When patient safety is on the line, every decision counts. This fundamental truth became crystal clear to me early in my career as a trainee anaesthetist, during a moment that would shape my understanding of both clinical excellence and the broader challenges facing modern medicine.
A Lesson That Changed Everything
It was during an emergency case when my wise consultant shared something simple yet profound: "If you're considering doing a rapid sequence induction (RSI), you should do it."
At the time, I didn't fully grasp the weight of those words, but I've reflected on them countless times since. RSI represents a more challenging approach to inducing anaesthesia, adding significant time pressure to an already complex process. However, when there's uncertainty about a patient's risk of aspiration—where gastric contents could enter the lungs and cause severe pneumonia or potentially fatal complications—RSI becomes the safest option available.
That pivotal day taught me two fundamental lessons that continue to guide my practice:
First, some decisions, though difficult and demanding, are absolutely essential for patient safety. The complexity or inconvenience of a procedure should never outweigh the potential benefit to the patient.
Second, patient safety must always come first—regardless of external pressures, time constraints, or personal comfort levels.
The Bigger Picture: Burnout's Hidden Impact on Patient Care
Recently, while reflecting during my morning shower (because let's be honest, some of our best insights come under hot running water), I found myself connecting that early lesson to a much larger challenge in healthcare today.
The question that emerged was both simple and profound: Are we doing our best for patients all the time?
We all entered medicine with the fundamental principle of "first, do no harm" deeply embedded in our professional identity. Yet there's a silent threat undermining this mission across healthcare systems worldwide: physician burnout.
The evidence is clear and concerning. Burnout doesn't just affect individual doctors—it directly impacts patient safety and quality of care. When healthcare professionals are emotionally exhausted, depersonalised, and lacking a sense of personal accomplishment, the ripple effects extend far beyond their own wellbeing.
A Promising Solution: The Power of Coaching
What gives me hope is that burnout isn't an inevitable consequence of medical practice. Research is increasingly showing that targeted interventions can make a significant difference, and one approach stands out as particularly promising: coaching.
A standout study by Kiser et al., published in JAMA Network Open in 2024, demonstrated that coaching interventions reduced burnout rates by an impressive 21%. This isn't just a statistic—it represents real doctors feeling more engaged, more resilient, and better equipped to provide excellent patient care.
Imagine the cascading positive effects this could have across our healthcare system. When doctors thrive professionally and personally, patients receive better care, healthcare teams function more effectively, and the entire system becomes more sustainable.
Making Coaching Standard Practice
This brings me to what I believe is one of the most important questions facing medical education today: How can we make coaching a standard part of medical training—from medical school through specialty programs?
Coaching isn't just about addressing problems when they arise; it's about building resilience, enhancing communication skills, developing leadership capabilities, and creating sustainable career practices from the very beginning of medical training.
The benefits extend in multiple directions:
For individual physicians: Enhanced resilience, improved work-life integration, better communication skills, and increased job satisfaction
For patients: Safer care delivered by more engaged, less burned-out providers
For healthcare systems: Reduced turnover, improved team dynamics, and better overall performance metrics
Creating Cultural Change in Medicine
I'm passionate about fostering this cultural shift in medicine, moving from a reactive approach to physician wellbeing toward a proactive, coaching-centered model that supports doctors throughout their careers.
This transformation requires collaboration across multiple levels of healthcare education and leadership. Medical educators, wellbeing officers, healthcare administrators, and clinical leaders all have crucial roles to play in making coaching a cornerstone of medical training and practice.
The Path Forward
The connection between that early lesson about RSI and today's discussion about coaching might not be immediately obvious, but it's actually quite direct. Both represent situations where taking the more challenging path—whether it's a complex induction technique or implementing comprehensive coaching programs—ultimately serves patient safety better than choosing the easier alternative.
Just as we don't hesitate to perform RSI when patient safety demands it, we shouldn't hesitate to invest in coaching and wellbeing programs when the evidence shows they improve both physician satisfaction and patient outcomes.
The question isn't whether we can afford to implement these programs—it's whether we can afford not to. When thriving doctors provide better patient care, everyone wins.
Are you a medical educator, wellbeing officer, or healthcare leader interested in collaborating on this mission? I'd love to connect and explore how we can work together to make coaching a standard part of medical training and practice.