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You need a coach

December 1, 2011

Atul Gawande says that you need a coach, even if you are highly experienced at your profession. 

I’ve been a surgeon for eight years. For the past couple of them, my performance in the operating room has reached a plateau. I’d like to think it’s a good thing—I’ve arrived at my professional peak. But mainly it seems as if I’ve just stopped getting better.

During the first two or three years in practice, your skills seem to improve almost daily…. As I went along, I compared my results against national data, and I began beating the averages. My rates of complications moved steadily lower and lower. And then, a couple of years ago, they didn’t. It started to seem that the only direction things could go from here was the wrong one.

Maybe this is what happens when you turn forty-five. Surgery is, at least, a relatively late-peaking career. It’s not like mathematics or baseball or pop music, where your best work is often behind you by the time you’re thirty. Jobs that involve the complexities of people or nature seem to take the longest to master: the average age at which S. & P. 500 chief executive officers are hired is fifty-two, and the age of maximum productivity for geologists, one study estimated, is around fifty-four. Surgeons apparently fall somewhere between the extremes, requiring both physical stamina and the judgment that comes with experience. Apparently, I’d arrived at that middle point.

It wouldn’t have been the first time I’d hit a plateau. I grew up in Ohio, and when I was in high school I hoped to become a serious tennis player. But I peaked at seventeen….

One July day a couple of years ago, when I was at a medical meeting in Nantucket, I had an afternoon free and went looking for someone to hit with…. I asked the club pro if I could use it to practice ground strokes. He told me that it was for members only. But I could pay for a lesson and hit with him…. With a few minutes of tinkering, he’d added at least ten miles an hour to my serve. I was serving harder than I ever had in my life.

Not long afterward, I watched Rafael Nadal play a tournament match on the Tennis Channel. The camera flashed to his coach, and the obvious struck me as interesting: even Rafael Nadal has a coach. Nearly every elite tennis player in the world does. Professional athletes use coaches to make sure they are as good as they can be.

But doctors don’t. I’d paid to have a kid just out of college look at my serve. So why did I find it inconceivable to pay someone to come into my operating room and coach me on my surgical technique?…

The coaching model is different from the traditional conception of pedagogy, where there’s a presumption that, after a certain point, the student no longer needs instruction. You graduate. You’re done…. Coaching in pro sports proceeds from a starkly different premise: it considers the teaching model naive about our human capacity for self-perfection. It holds that, no matter how well prepared people are in their formative years, few can achieve and maintain their best performance on their own.

Gawande goes on to discuss coaching in medicine, music, and teaching; discussing the significant advantages of coaching.  I am not certain I am convinced by Gawande’s argument, but his premise if fascinating (and, unlike many assertions about learning, it is actually testable.)

I think that this article has relevance for most everyone who reads this blog (but if you doubt that, consider the following question:  do professional translators need coaches?)

2 Comments leave one →
  1. December 2, 2011 12:59 pm

    I love Gawande’s Complications in which he questions what can be learned only from textbooks (and what has to be learned in safe and non-public discussions of physicians among themselves in their M&Ms, their closed-door “Morbidity and Mortality Conferences” in which they discuss freely why their science failed them.)

  2. December 2, 2011 7:13 pm

    I have to admit — I was unaware of Complications before your comment. However, I was so impressed with Gawande’s New Yorker essay that now I think I must buy and read his book.

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