Establishes and Maintains Agreements - Co-Creating the Relationship

The International Coaching Federation (ICF) Core Competencies outline skills and approaches used by professional coaches. These principles are explicitly stated in the context of coaching and fundamentally about the application of positive leadership characteristics in the hospital and beyond. In this blog series, we look at how the ICF Core Competencies apply to physicians in the areas of personal growth, peer support, and patient care.  

The third Core Competency domain we will address in this blog series is critically important on the path to success: Establishes and Maintains Agreements

This Core Competency is defined by eleven skills or approaches.

Why Coaching Agreements Matter to Physicians

 Creating clear agreements is the bedrock of a successful coaching relationship which extends beyond the physical agreement, and includes the intangibles like establishing trust, setting clear expectations, and fostering a collaborative environment. Whether you're coaching a medical team, mentoring a junior doctor, or guiding a patient through a difficult diagnosis, the ability to establish and maintain agreements ensures that all parties are aligned and working towards a common goal. You don’t need to coach professionally to experience the power of establishing and maintaining agreements.

 

1. Explains what coaching is and is not and describes the process to the client and relevant stakeholders

 For physicians, clarifying the scope and limitations of coaching is essential to ensure expectations are effectively managed. Coaching is not about giving medical advice; it is about facilitating self-discovery and growth. In practice, when coaching a colleague, it is important to make clear that your role is to guide them in finding their own solutions, rather than providing direct answers.

2. Reaches agreement about what is and is not appropriate in the relationship, what is and is not being offered, and the responsibilities of the client and relevant stakeholders
   

For physicians, defining what is appropriate in the coaching relationship prevents misunderstandings. This includes setting boundaries on confidentiality, responsibilities, and the extent of support offered. In practice, when mentoring a resident, establish that you can offer guidance during work hours, but they should seek immediate help from on-call staff for urgent issues outside those hours.

3. Reaches agreement about the guidelines and specific parameters of the coaching relationship such as logistics, fees, scheduling, duration, termination, confidentiality and inclusion of others
 

For physicians, clear guidelines on logistics, fees, scheduling, duration, and termination help create a structured and predictable coaching experience. In practice, when coaching a medical team, it is important to agree on regular meeting times, the duration of each session, and the process for rescheduling or canceling sessions.

4. Partners with the client and relevant stakeholders to establish an overall coaching plan and goals
 

For physicians, partnering with clients to establish coaching plans and goals ensures that the coaching process is tailored to their unique needs and aspirations. In practice, when coaching a patient on lifestyle changes, work together to set realistic, achievable goals that align with their health objectives.

5. Partners with the client to determine client-coach compatibility

 For physicians, assessing client-coach compatibility is crucial for a productive relationship. This involves mutual respect, trust, and a shared commitment to the coaching process. In practice, before starting a coaching engagement, have an initial meeting to determine if you and the client are a good fit for each other.

6. Partners with the client to identify or reconfirm what they want to accomplish in the session

7. Partners with the client to define what the client believes they need to address or resolve to achieve what they want to accomplish in the session

For physicians, it's essential that each coaching session has clearly defined objectives that align with the overarching coaching goals. This approach ensures that every session is both purposeful and productive. In practice, begin each meeting with a medical student by asking them to articulate what they hope to achieve during the session. This not only sets a focused agenda but also empowers the student to take an active role in their own learning and development.

8. Partners with the client to define or reconfirm measures of success for what the client wants to accomplish in the coaching engagement or individual session

For physicians, establishing metrics for success is crucial as it helps track progress and provides a tangible sense of accomplishment. These metrics should be revisited and adjusted as needed to ensure they remain relevant and effective. In practice, when coaching a healthcare administrator, it is important to set specific milestones for improving team communication and review these regularly. This approach not only fosters a culture of continuous improvement but also ensures that everyone is aligned towards common goals, ultimately enhancing the overall efficiency and effectiveness of the healthcare team.

9. Partners with the client to manage the time and focus of the session

Effective time management is crucial for physicians to ensure that coaching sessions stay on track and comprehensively cover the necessary ground. By using a timer during sessions, physicians can allocate specific time blocks for discussing different topics, ensuring that all key areas are addressed. This structured approach not only maximizes the efficiency of each session but also enhances the overall impact of the coaching experience.

10. Continues coaching in the direction of the client’s desired outcome unless the client indicates otherwise

11. Partners with the client to end the coaching relationship in a way that honors the experience

For physicians, ending the coaching relationship with respect and gratitude acknowledges the significant journey and growth experienced b y both parties. In practice, concluding a coaching engagement should involve a final session dedicated to reflecting on achievements, discussing future steps, and expressing mutual appreciation. This approach not only honors the progress made but also sets a positive tone for future endeavors.

The Benefits of Mutual Agreements 

Mastering the competency of establishing and maintaining agreements can revolutionize your approach to physician coaching. It fosters a culture of clarity, trust, and mutual respect, which are essential for any successful coaching relationship. By integrating these skills into your practice, you can enhance your effectiveness as a coach and create a more supportive and empowering environment for your clients.

Watch for the next blog in the Physician Coach Training series, where we will explore the fourth ICF Core Competency: Cultivates Trust and Safety.