Building a Coaching Culture in Your Department
Most Departments Have a Development Problem
Here is something I see over and over. A department hires talented physicians, gives them a brief orientation, and then expects them to figure out the rest. How to navigate promotion. How to manage a lab. How to lead a team. How to say no without damaging relationships.
The assumption is that smart people will figure it out. And many do, eventually. But the cost of that trial-and-error approach is enormous. Lost productivity. Preventable burnout. Good faculty leaving for institutions that actually invest in their growth.
The missing ingredient, more often than not, is coaching.
What a Coaching Culture Actually Looks Like
I am not talking about sending one or two people to a coaching engagement and calling it done. A coaching culture is something bigger. It is a department-wide commitment to the idea that ongoing development is not remedial. It is standard.
In a coaching culture, asking for help thinking through a career decision is normal. Leaders check in with faculty not just about productivity, but about how the work is going. Conversations about growth happen regularly, not just at annual reviews.
Atul Gawande made this point memorably in his 2011 New Yorker article, "Personal Best". Even elite surgeons, he argued, benefit from having someone watch them work and offer honest feedback. If coaching makes sense for a surgeon at the top of their field, it makes sense for every faculty member navigating the complexity of academic medicine.
The Evidence Is There
This is not just a feel-good idea. Organizations that invest in coaching see measurable returns. A 2023 report from the International Coaching Federation found that organizations with strong coaching cultures report higher employee engagement, better retention, and stronger revenue growth than those without.
In academic medicine, the stakes are even clearer. Replacing a single physician can cost an institution between $500,000 and $1 million when you factor in recruitment, onboarding, and lost clinical revenue. A coaching program that retains even a few faculty members pays for itself many times over.
Why Most Departments Have Not Done This Yet
Three reasons, in my experience.
They think coaching is for people who are struggling. This is the biggest misconception. Coaching is not performance management. It is development. The highest-performing faculty often benefit the most because they are the ones making the most complex decisions about where to invest their time and energy.
They do not know how to start. Building a coaching program feels like one more initiative on an already overloaded leadership plate. The logistics seem daunting. But it does not have to be complicated. A department can start small with external coaching for a handful of faculty and expand from there.
They underestimate the cost of doing nothing. When faculty burn out or leave, departments rarely trace it back to a lack of developmental support. They chalk it up to market forces or personal decisions. But when you talk to the people who left, the story is almost always the same. Nobody helped me figure out how to make this work.
How to Start Building One
You do not need a massive budget or a year-long planning process. Here are practical starting points.
Make coaching available, not mandatory. Forcing people into coaching undermines the whole premise. Instead, make it accessible and normalize it. When department leaders talk openly about their own coaching experiences, it gives everyone else permission.
Start with transitions. New faculty, new division chiefs, faculty preparing for promotion. These are moments where coaching has the highest impact and the easiest buy-in. People in transitions know they need support.
Train your leaders to coach. Not every conversation requires a professional coach. Teaching division chiefs and mentors basic coaching skills, like asking open questions and listening without jumping to solutions, changes the quality of everyday interactions.
Measure what matters. Track retention. Track faculty satisfaction. Track promotion rates. You need data to sustain institutional support, and the numbers will make your case.
This Is a Strategic Investment
I talk to department chairs and division chiefs who genuinely care about their people but feel stuck. They see faculty struggling. They watch talented people leave. They know something is missing but are not sure what to build.
A coaching culture is not the answer to every problem in academic medicine. But it addresses a gap that most departments have never seriously tried to fill. The institutions that figure this out first will have a significant advantage in recruiting and retaining the best faculty.
If you are a department leader thinking about how to bring coaching into your group, or a faculty member who wants to make the case to your leadership, I would welcome that conversation. This is the work I care about most.
