The Coaching Habit Review: Seven Questions That Changed How I Coach Physician Leaders
Why This Book Keeps Coming Back to My Desk
I first read Michael Bungay Stanier's The Coaching Habit: Say Less, Ask More & Change the Way You Lead Forever years ago, and I have returned to it more times than any other book on my shelf. That is not an exaggeration. For anyone searching for a practical coaching habit review aimed at the realities of academic medicine, this is where I would start -- and where I keep starting.
The premise is disarmingly simple. Bungay Stanier argues that most leaders default to giving advice when they should be asking questions. He distills effective coaching into seven essential questions, each designed to keep a conversation focused, honest, and useful. For physician leaders who are trained to diagnose and prescribe, this reorientation is harder than it sounds -- and more transformative than you might expect.
The Seven Questions and Why They Matter in Academic Medicine
Let me walk through the seven questions briefly, because the genius is in their specificity.
1. The Kickstart Question: "What's on your mind?" This one opens a conversation without steering it. In a department meeting or a mentoring session, it hands the agenda to the other person. I have watched physician leaders light up when they realize they do not have to guess what a mentee needs -- they can just ask.
2. The AWE Question: "And what else?" Bungay Stanier calls this the best coaching question in the world, and I tend to agree. The first answer someone gives is rarely the deepest one. In academic medicine, where people are conditioned to present the polished version, "And what else?" creates permission to go further.
3. The Focus Question: "What's the real challenge here for you?" This is the one that stops faculty in their tracks. When a division chief is describing a conflict with a colleague, the surface problem is almost never the real problem. This question cuts through the layers.
4. The Foundation Question: "What do you want?" Physicians are trained to figure out what other people need. Asking them what they want can feel almost foreign. But without clarity on this, coaching conversations drift.
5. The Lazy Question: "How can I help?" I love this one because it fights the instinct to jump in and fix things. Instead of assuming you know what someone needs, you ask. It sounds lazy. It is actually disciplined.
6. The Strategic Question: "If you're saying yes to this, what are you saying no to?" In academic medicine, where faculty are chronically overcommitted, this question is a scalpel. Every yes carries a hidden no, and most physician leaders have never been asked to name it out loud.
7. The Learning Question: "What was most useful for you?" This closes the loop. It forces reflection and helps the person you are coaching consolidate what they have learned. It also gives you feedback on what is actually landing.
What Bungay Stanier Gets Right About Behavior Change
One of the things that sets The Coaching Habit apart from other leadership books is its seriousness about habit formation. Bungay Stanier does not just hand you a list of questions and wish you well. He draws on research from Charles Duhigg and others to explain how habits actually form -- trigger, routine, reward -- and asks you to build each question into a specific moment in your day.
This matters enormously for physician coaching questions to stick. I have seen too many leadership workshops where attendees leave inspired and then change nothing. Bungay Stanier's framework is designed to prevent that. He wants you to identify the exact moment when you normally start giving advice and replace that behavior with a question instead.
For physician leaders, this is the equivalent of changing a muscle-memory response. Think of a basketball coach who has to stop herself from drawing up every play and instead ask her point guard, "What do you see out there?" The instinct to direct is powerful. The discipline to ask is a skill that has to be trained.
Where I Think the Book Falls Short for Academic Medicine
No review would be honest without acknowledging limitations. Bungay Stanier writes for a general business audience, and some of the examples feel distant from the specific pressures of academic medicine. The politics of promotion and tenure committees, the emotional weight of patient care, the hierarchies embedded in medical training -- these do not show up in the book.
That does not diminish the questions themselves. It just means you have to do some translation work. When he talks about managing a direct report who is underperforming, you might need to think about a fellow who is struggling with research productivity while also carrying a full clinical load. The questions still apply. The context is yours to supply.
I also think the book could go deeper on what happens when the person you are coaching resists the process. In academic medicine, you will encounter faculty who view coaching as remedial or who simply do not have time for what they perceive as open-ended conversation. Bungay Stanier touches on resistance but does not dwell on it the way someone working in medical education might need.
The Question Behind All the Questions
If I had to name the single most important idea in this book, it is not any one question. It is the underlying commitment to staying curious a little longer before rushing to action. Bungay Stanier calls this "taming your advice monster," and for physician leaders, the advice monster is particularly well-fed.
Academic medicine rewards expertise. It rewards having the answer. Coaching asks you to set that aside -- not permanently, but long enough to let the other person think. That pause is where growth happens, for the person you are coaching and for you.
I have used these seven questions in hundreds of academic medicine coaching conversations, and they have not gotten stale. If anything, they have gotten sharper with practice. The book is short, practical, and readable in an afternoon. What it asks of you afterward takes considerably longer.
Who Should Read This Book
If you are a department chair, division chief, program director, or anyone in academic medicine who has people looking to you for guidance, read this book. If you are a physician who has ever left a mentoring conversation feeling like you talked too much, read this book. If you suspect that the best thing you could do for your team is ask better questions, this is your starting point.
Bungay Stanier has written other books since this one, and they are worth reading too. But The Coaching Habit remains the foundation, and it remains the book I recommend first.
If you'd like to learn more, contact us to schedule a time to chat.
