The Coaching Habit — Review for Academic Medicine
The Best Leadership Book You Can Read in an Afternoon
Michael Bungay Stanier's The Coaching Habit is short. You can finish it in a couple of hours. Do not let that fool you. It is one of the most practical leadership books I have ever read, and I recommend it to physician leaders more often than books three times its length.
The premise is simple. Leaders default to giving advice. They should be asking questions instead. Bungay Stanier gives you seven questions, explains why each one works, and shows you how to build the habit of using them. That is the whole book. And it is enough to change how you lead.
Why Physician Leaders Need This Book
Physicians are trained to solve problems. A patient presents symptoms, you diagnose, you treat. Most physician leaders carry that pattern directly into their leadership roles. A faculty member comes to you with a problem, and before they finish the second sentence, you are already formulating the answer.
Bungay Stanier would say that instinct is hurting you. You solve the wrong problem because you did not listen long enough. You create dependency because your people learn to come to you instead of developing their own judgment. And you exhaust yourself because every problem on your team becomes yours to solve.
I see this constantly. Division chiefs drowning because they have trained their faculty to bring every decision to their door. The fix is not working harder. The fix is asking better questions.
The Seven Questions
The genius of The Coaching Habit is that it does not ask you to become a certified coach or learn a complicated framework. It gives you seven questions. You do not need all seven in every conversation. Sometimes one is enough.
The Kickstart Question: "What's on your mind?"
Not "How are you?" which invites a polite non-answer. Not "Did you finish the IRB revision?" which puts you in manager mode from the first word. "What's on your mind?" is open enough to let the other person go where they need to go, and focused enough to signal that this is a real conversation.
I love this question for faculty one-on-ones. It shifts the dynamic from reporting to thinking.
The AWE Question: "And what else?"
Bungay Stanier calls this the best coaching question in the world, and I am inclined to agree. "And what else?" slows the conversation down and surfaces the real issue, which is almost never the first thing someone says.
The faculty member who says "I am frustrated with my clinic schedule" may actually be worried about making promotion. The one who asks about a grant mechanism may actually be questioning whether they want to stay in research at all. "And what else?" gives them room to get there.
The Focus Question: "What's the real challenge here for you?"
This is the question that prevents you from solving the wrong problem. Conversations in academic medicine tend to spiral. The department problem and the funding problem and the personnel problem all feel urgent. This question cuts through the noise.
The "for you" at the end matters. It anchors the conversation in what the person across from you actually needs, not what the system needs, not what you think they should need.
The Foundation Question: "What do you want?"
This one sounds simple. It is not. Most faculty I work with cannot answer it clearly. They can tell you what they do not want. They can tell you what they think they are supposed to want. But "what do you want?" asked directly and without judgment is a question many physician leaders have never been asked.
I use this question constantly in coaching. It is behind every career decision, every negotiation, every moment of frustration. If you do not know what you want, you cannot advocate for it.
The Lazy Question: "How can I help?"
Bungay Stanier calls this the lazy question because it forces you to stop assuming you know what help looks like. Instead of jumping in with your solution, you ask the other person what they actually need. You will not know unless you ask.
For physician leaders, this is a guardrail against the rescue instinct.
The Strategic Question: "If you're saying yes to this, what are you saying no to?"
I appreciate this question more every year. Academic medicine runs on yes. Yes to the committee. Yes to the collaboration. Yes to the extra clinic session. Every yes is a no to something else, but we rarely name what we are giving up.
This question makes the trade-off visible. When a faculty member is considering a new leadership role, I ask it. When someone is debating a fourth project, I ask it. Making the cost explicit changes the quality of the decision.
The Learning Question: "What was most useful for you?"
This is how you end a conversation. It forces the other person to extract value, which makes the learning stick. And it gives you feedback on what actually helped, which makes you better over time.
Most meetings in academic medicine just end. They drift to a stop or get cut off by the next appointment. Ten seconds to ask "What was most useful?" transforms a routine check-in into something people remember.
Building the Habit
Bungay Stanier uses a simple habit formation framework: identify the trigger, define the old habit, and practice the new one until it sticks.
For physician leaders, the trigger is the moment someone brings you a problem. Your old habit is to give the answer. The new habit is to ask a question first. Pause for three seconds and ask instead of tell.
It will feel slow. Stay with it. Within a few weeks, your people will start coming to you with better-formed problems and solving more of them on their own.
Who Should Read This
Everyone in a leadership role. Everyone who mentors anyone. This book is short enough that you have no excuse not to read it and practical enough that you can start applying it tomorrow.
I especially recommend it to physician leaders who feel like they are doing too much of their team's thinking. If nothing moves unless it crosses your desk, this book will show you why and give you a way out.
Final Thoughts
The Coaching Habit is not a book about becoming a coach. It is a book about becoming a better leader by talking less and listening more. In academic medicine, where expertise is currency and giving advice is reflexive, that is a radical act.
You can find The Coaching Habit and my other recommendations on the book recommendations page. And if you are a physician leader working on how you show up in conversations with your team, I would be glad to help.
