Reframing Resistance: When Physicians Push Back on Coaching
The Pushback Is the Starting Point
A few months ago, a department chair called me about one of her senior faculty members. "He agreed to coaching," she said, "but I should warn you — he is going to fight you on everything."
She was right. He did. And that physician resistance to coaching turned out to be the most productive material we worked with all year.
Resistance is not a problem to overcome. It is information to work with. Once you understand what is driving the pushback, you can reframe it into something far more useful than compliance.
Why Physician Resistance to Coaching Makes Sense
Physicians are not resisting because they are difficult. They are resisting because their professional identity was built on competence, autonomy, and self-reliance. When someone suggests they need a coach, it can feel like an indictment of the very qualities that got them where they are.
Amy Edmondson at Harvard Business School has written about psychological safety in cultures where expertise is the currency. In academic medicine, admitting you need help can feel genuinely risky. It is not stubbornness. It is self-preservation.
When a physician pushes back, I try to hear what they are actually saying:
- "I don't trust this process yet."
- "I am not sure this person understands my world."
- "I have been burned by people who oversimplified my problems."
- "I am afraid of what I might have to change."
Every one of those is reasonable. And workable.
Reframing Resistance in Coaching Conversations
The instinct most people have when they encounter resistance is to push harder. Present more evidence. Make a more compelling case. In academic medicine, where we build arguments and defend positions, this feels natural. It also does not work.
What works is treating resistance as data. Here is what that looks like in practice:
Name it without judgment. "It sounds like this feels like a waste of your time. Tell me more about that." The physician expects to be sold. When you acknowledge the resistance instead, it shifts the conversation.
Ask what good resistance looks like. Not all pushback is avoidance. Sometimes the coaching approach genuinely does not fit. A good coach can tell the difference.
Find the value underneath. A physician who says "I do not need coaching" is often really saying "I need to know this is worth my very limited time." That is not resistance. That is discernment.
The Senior Faculty Member Who Fought Everything
Back to my department chair's warning. The physician — a mid-career surgeon with three mentees he felt he was failing — came into our first session with arms crossed and a list of reasons coaching would not help.
I did not argue with any of them. Instead, I asked him to tell me about the mentees.
Twenty minutes later, he was describing a pattern he had never articulated before: he kept giving his mentees the same advice his own mentor had given him, and it kept falling flat.
That was the opening. Not because I convinced him to drop his resistance. Because the resistance pointed us to the thing that actually mattered. Think of it like a running back who keeps hitting the same gap in the defensive line — eventually you stop fighting the congestion and find the open field.
Over the next several months, we rebuilt his mentoring approach from the ground up. He never stopped being skeptical — and that skepticism kept us honest. It was not a bug. It was a feature.
Resistance Is the Real Work
The biggest mistake I see coaches make — and I have made it myself — is treating resistance as something to get past so the "real work" can begin. But the resistance is the real work. When a physician pushes back, they are showing you their relationship to vulnerability, authority, and trust. That is the richest coaching territory there is.
I should be honest: not every instance of resistance transforms into a breakthrough. Some physicians are simply not ready. In those cases, reframing resistance means respecting the boundary while leaving the door open. I have had physicians come back a year later, ready to engage, because that first interaction did not leave a bad taste.
The Real Shift
Reframing resistance is not a trick or a technique. It is a posture. It says: I believe your pushback has intelligence in it, and I would rather understand it than overcome it.
For physicians in academic medicine, where the culture is built on being right and being certain, that posture can be quietly radical. It models the kind of openness that coaching is ultimately trying to cultivate.
If you'd like to learn more, contact us to schedule a time to chat.
