Coach Natalie Yates-Bolton: “We are helping patients fulfil their potential.”

Applying coaching approaches to dentist-patient relationships can revolutionise oral care.

Dr Natalie Yates-Bolton is a trained performance consultant coach with experience coaching in the health service, academia and international organisations. She believes the coaching approach benefits health professionals and their patients by fostering partnerships, decreasing fear, and improving mutual understanding.

What makes coaching within the health sector unique?

One of the most well-known coaching models is the GROW model developed by Sir John Whitmore. G stands for Goal, R stands for Reality, O stands for Options and W stands for Will – what will the patient do?

These days in healthcare, it’s very much about partnership with patients and asking them what is important to them. The old ways of the professionals telling the patients what to do aren’t the most effective way of using the patients’ time, the professionals’ time, or the money that’s involved in providing healthcare. It doesn’t make for effective healthcare on any level if the professional is just telling the patient what to do. But if the professional takes a coaching approach, it creates a much more effective way for the professional to share their knowledge.

It might seem that this approach will be much more time consuming, but that only holds true if you look at it in the short term. But the patients’ care journeys are never just that ten-minute or a one-hour snapshot of time. If you look at the whole of the patient’s journey, which might span decades, it’s going to be a much more time-effective way of giving care. If there is a partnership between the patient and the professional, the professionals do not need to repeat themselves over and over; they do not try to fit the wrong evidence-based care into a patient’s life, but will instead make sure that the care fits the patient’s life in the long run. In the end, employing the coaching approach is a more effective way of using everybody’s time.

Coaching isn’t a concept that is used in a vacuum or in isolation. It complements evidence-based care, it fits with compassionate care, it fits with compassionate leadership, it even fits with cost-effective care, which is so important for all healthcare systems all over the world.

Where do you see the connection between evidence-based care and coaching?

Every healthcare professional will have been trained in evidence-based clinical practice, and that has at least three intersecting parts to it – the best available research evidence, the professional’s clinical expertise, and the patient’s values, preferences and beliefs. The clinician, through their education and years of experience, will already be an expert on the first two parts, the research and the expertise. But coaching creates an opportunity for the clinician to really explore the third sector of evidence-based practice, which is about the patient’s values, preferences, beliefs.

By having a coaching conversation as part of your general care conversation with the patient, you’re asking them about their life, how they want to live it, and finding out how does the evidence-based treatment fit with it. Yes, the clinician is the expert in the evidence, guidelines and treatment options, but the patient is 100 percent the expert in their own life. Often, when we’re giving care, it’s about helping the patient fulfil their potential and live with their optimal health in whatever speciality we’re in. Coaching is a really great fit for making that happen.

Adopting the coaching mindset therefore helps healthcare professionals better personalise how they approach their patients?

Yes. It also shifts the power balance. A lot of patients still expect the professional to be the one who’s the expert and tells them what to do, even though it probably won’t fit their life very well. We need to raise awareness in patients that it is a partnership. And I think coaching gives us the opportunity as healthcare professionals to equalise the power difference that existed for a long time – that the professional had the power and the knowledge and the patient didn’t.

Can this approach also lessen the fear many people have of medical professionals?

Absolutely. What can cause the fear is the lack of control and handing over of your pain, psychological wellbeing or emotional wellbeing to somebody else.

But if you’ve got a coaching relationship established, that fear is less likely to materialise because you know that you’re also in control.You’re not handing your health and wellbeing over to somebody else. You’re working in partnership to have your health and wellbeing promoted.

What would you say are the three most important aspects of coaching that help healthcare professionals thrive?

I think the first thing is asking questions, rather than telling somebody what the evidence-based approach suggests. Don’t start from that point.

Start by asking the patient what’s important to them, about their situation, what problems they have. So that you can then start thinking about which of the different evidence-based treatment options will work best for the patient. Rather than doing it the other way around and deciding on the treatment before asking the patient questions and finding out about their life.

It’s important to pause and not rush in with our usual “I’m the professional and I know all the research”, but rather focus on the patient first. And attend to the patient where they are in their life, find out what is important to them about their condition or treatment, the situation they are in and that you have the expertise to help resolve.

So, to sum up, the first thing is to pause, the second thing is to ask the patient, and the third thing is to work in collaboration and understanding with the patient to see how to best apply the evidence-based treatment in their case.

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