Highly accomplished surgeon discovers—and proves—the universal value of coaching

By Bob Davis

Recently I read an article in the New Yorker that really resonated with me as a trainer and coach. In the article, entitled “Top athletes and singers have coaches. Should you?,” surgeon Atul Gawande, M.D. wrote about what inspired him to ask a colleague to coach him in the operating room (despite the fact that Gawande is a highly accomplished, respected surgeon with excellent patient outcomes), and what he learned about the value of coaching in the process. He admitted that patients might not feel very assured knowing their surgeon has a coach. After all, shouldn’t a surgeon’s medical training, experience and proven outcomes be enough? But after reading the article, I think I will seek a physician who has a coach the next time I need to have surgery!

Dr. Gawande’s interest in coaching began with tennis. He thought he’d peaked at the game at age 17, but three years ago he worked at a club with a coach for just a few minutes on his stance and added ten miles per hour to his serve. “I was serving,” he wrote, “harder than I ever had in my life.”

The experience prompted him to ask himself why it seemed unthinkable for a physician to pay for coaching in the operating room on surgical technique. Would doing so improve outcomes or reduce post-op complications?

First, he thought, he’d look into the concept of coaching in general. He ended up confirming my views on the effectiveness of coaching—whether you’re an athlete or a call center representative, a performing musician or a teacher, a writer or a surgeon. It really makes a huge difference.

The good doctor did some research on coaching, coaches and people who have them.

What you want to do yourself

He saw what most consider obvious—the value of coaches to athletes. But he also discovered that coaches are much like good editors, after reading about Maxwell Perkins, editor for authors including F. Scott Fitzgerald, Ernest Hemingway and Thomas Wolfe. He found that one author said Perkins gave writers confidence in themselves and what they were writing. Gawande quoted another writer as saying about Perkins, “He never tells you what to do. Instead, he suggests to you, in an extraordinarily articulate fashion, what you want to do yourself.”

Gawande learned that violinist Itzhak Perlman has a coach—his wife—and that she is his “extra ear,” hears elements of his playing that he can’t, and helps him accurately assess what he’s doing. The doctor spoke to world-renowned soprano Renée Fleming, who said she works with her vocal coach in 90 minutes sessions several times per week, and that professional singers refer to coaches as “outside ears” that are truly invaluable.

Then he looked at the results of a five-year study of teacher skill development in 80 California schools. The research showed that after workshops alone, teachers took their new skills to the classroom just 10 percent of the time. Those who had practice sessions, demonstrations and feedback in addition to workshops took what they learned to the workplace less than 20 percent of the time. But when coaches came into classrooms following workshops, the adoption rate rose to more than 90 percent. More importantly, the students of the coached teachers performed better on tests.

What makes a good coach

Next Gawande consulted Jim Knight, director of the Kansas Coaching Project at the University of Kansas, about what makes a good coach. He learned that good coaches set clear goals, break tasks into steps, and make the person receiving coaching “visualize, verbalize, and write the idea.” They also engage the team member to help set the coaching direction, because the team member knows better than anyone what he or she is having problems doing. Additionally, according Knight in the article, good coaches:

  • “Speak with credibility.”
  • “Make a personal connection.”
  • “Focus little on themselves.”
  • “Listened more than they talked.”

Gawande concluded that “good coaches know how to break down performance into its critical individual components,” noting that legendary UCLA basketball coach John Wooden “even had his players practice putting their socks on,” he wrote, because, “wrinkles cause blisters. Blisters cost games.”

Practice is essential in any endeavor, and I agree with the research Gawande cited in his article, that elite performers “must engage in ‘deliberate practice’—sustained, mindful efforts to develop the full range of abilities that success requires.” This is why I always follow up the training programs I deliver with coaching that includes intensive practice that helps team members “keep the change” and sustain improved results.

Two of the points in the article that resonated most with me were that:

  • Coaches achieved successful outcomes with a variety of approaches, but the most common one “is just conversation.”
  • Coaches need to “get out from in front of the white board and walk among the students.”

In call centers, I call the second activity “hot laps,” making the rounds on the floor several times per day to interact with and coach agents as they work.

Based on what he’d learned in his research, Gawande eventually decided to try coaching for himself. He enlisted a retired general surgeon, Robert Osteen, as his coach in the operating room.

Exhibiting many of the good coaching traits cited in the New Yorker article, Osteen was highly effective for Gawande in the very first session. “That one twenty-minute discussion gave me more to consider and work on than I’d had in the past five years,” he wrote. “Yet the stranger thing, it occurred to me, was that no senior colleague had come to observe me in the eight years since I’d established my surgical practice. Like most work, medical practice is largely unseen by anyone who might raise one’s sights. I’d had no outside ears and eyes.”

Osteen continued to coach Gawande for months after the initial session, and Gawande reported that his complication rate, already low, has gone down. He also made an observation about relying on modern technological tools. “In the past year, I’ve thought nothing of asking my hospital to spend some hundred thousand dollars to upgrade the surgical equipment I use, in the vague hope of giving me finer precision and reducing complications. Avoiding just one major complication saves, on average, fourteen thousand dollars in medical costs—not to mention harm to a human being. So it seems worth it. But the three or four hours I’ve spent with Osteen each month have almost certainly added more to my capabilities than any of this.”

He also observed that, “with a diploma, a few will achieve sustained mastery; with a good coach, many could,” he wrote. “Coaching may prove essential to the success of modern society.”

No surprise, more proof

None of what Dr. Gawande learned about the value of coaching surprised me. I’m just delighted about what it confirms. It’s simply more proof on top of the results I’ve seen in coaching in my daily work as a trainer and coach, such as:

  • An authorized reseller for major cable companies increased its closing ratio by 13 percentage points and its multi-product sales by 14 percentage points.
  • By making just a few changes in agent behavior and coaching to them, average agent sales per day moved from $800 to over $2,000 in one 400-seat contact center, adding millions to the bottom line.
  • Outbound sales associates are generating between $25,000 and $35,000 in advertising revenue each month in a multimedia sales center.
  • A company increased its vendor transfer rate from three percent to 25 percent. At $5 per transfer, it meant millions to the organization’s bottom line.
  • A major high-speed Internet provider increased its saves rate on inbound cancellation calls from 49 percent to 62 percent.
  • A newspaper publisher boosted its average EZ Pay conversion on inbound calls to six percent. This also was a multimillion-dollar ROI.
  • An outbound retention group now gets 3.4 saves per hour per rep on requested permanent stops, up from one save per hour per rep before training and coaching were implemented. That’s a 240-percent increase.

What would sustainable results like these—results that prove the value of and high return on investment from coaching—mean to your organization?

Bob Davis is the president of Robert C. Davis and Associates (www.robertcdavis.net), a consulting firm in Alpharetta, Georgia, specializing in improving sales, customer service and retention results in customer contact centers across North America using his company’s exclusive Quality Conversation approach. He is also a principal in RCDA’s subsidiary, QCS, LLC (www.qcsims.com), which builds customized video game simulations for training contact center and other sales agents on The Quality Conversation.