The Resourceful Patient

3.7 Resources for patients - coaching

'Boris Becker changes coaches in search of success.'

Newspaper headline

'Coach: Convey in or provide with a coach.' (1612)
'Coach: Prepare for an examination; to prime with information.' (1849)

Shorter Oxford English Dictionary

Knowledge and skills are sufficient for some people to cope with a consultation; others need coaching to make the best use of their resources in the consultation and in clinical decision-making.

3.7.1 Training and coaching

The job of the trainer is to improve the fitness of the individual to ensure that an individual performs as well as possible when under pressure. A high level of fitness is a necessary prerequisite to success, and the provision of coaching does not reduce the need for the individual to acquire knowledge and skills. However, the coach focuses much more on the psychological preparation of an individual for a specific event. Many people can be trained how to find knowledge and given the skills to ask questions of clinicians, but coaching increases the probability that the individual will use the knowledge and skills in the crucial consultation.

3.7.2 The crucial consultation

Every consultation is crucial but the experienced clinician becomes accustomed to crucial decisions, for example about which treatment to choose for colorectal cancer, in which he may participate hundreds of times in his career. For the patient, however, familiarity with the crucial consultation is important for they may only have one consultation in which to make a crucial decision and, for many medical problems, that crucial consultation will occur only once in a lifetime. There is increasing interest in coaching patients to prepare them for the consultation.

3.7.3 The benefits of coaching

Coaching primes and prepares the patient. Sportsmen and women choose a coach to help them realise their potential, and coaches do this by:

  • rehearsal with feedback - the individual can practise a particular move or sequence of moves time after time to become familiar with the moves, with errors being corrected through feedback
  • preparing for the unfamiliar - the coach helps the person imagine what is going to happen
  • building an inner picture - the coach helps the person he is coaching to develop a clear picture of how they are appearing and behaving. The coach can help individuals get a clear picture of how they should behave in any situation they have never previously encountered
  • psyching up or calming down - some people need to have their confidence built up before a sporting event or consultation to help them believe that they are resourceful, competent and able to ask the questions that they want to ask. Other people need to be calmed down, or they may become too tense, and freeze

3.7.4 Coaching provides focused preparation

There are different ways in which groups like Health Dialog provide coaching.

  • On paper: the simplest form of coaching to help the individual ask the right questions is a leaflet written specifically for the patient to read and practise from before the consultation
  • Web-based resource: interactive Web pages can provide an experience almost like a personal coach, helping the individual prepare for the consultation and formulate the right questions
  • Telephone coaching: new services are developing to allow individuals to prepare for a consultation by discussing options with a coach who not only gives information about different options, to allow them to make an informed choice, but who also helps them prepare intellectually and psychologically for the consultation
  • Face-to-face coaching: general practitioners often perform the function of a coach, helping the individual prepare for their visit to the clinic

Coaches also help people by reflecting on their performance, both to assist them to come to terms with disappointment and to help them prepare for the next time they may face the same challenge.

3.7.5 Healthcare organisations can encourage coaching

Healthcare organisations of the 21st century should encourage coaching so that patients can make the best use of their limited contact with the service. They can do this by:

  • providing learning resources that individuals can use before they come to the clinic, and
  • developing their own Web site so that the patient can obtain specific information about the service they are going to encounter