How can I improve health care leadership?

Leaders practice leadership, just as physicians practice medicine.  Here are some details.


Health Care Consulting and Leadership Coaching

We understand the challenges that executive leaders and physicians face. We are experts in individual and organizational behavioral change. Since 1997, we have consulted with hundreds of leaders using the 3A process of (1) assessment, (2) constructive actions, (3) accountability. Our purpose is to help leaders flourish as they achieve business outcomes.


Theoretical models

1. Positive psychology (PP) can be defined as the science and practice of well-being or flourishing.  Prior to 1998, over 70% of psychological research focused on mental illness.  Since 1998, a better balance has resulted from new scientific studies in mental health.

2. Psychological capital (PsyCap) is a developmental state comprised of hope, efficacy, resilience and optimism. Our research confirms that PsyCap can be developed, and explains up to 71% of engagement scores and 65% of job satisfaction scores.


Value to you
• Modeling evidence-based practices in behavior change
• providing a confidential assessment of individuals and teams
• adding a third party, objective, supportive perspective to your leadership team
• increasing accountability of each leader’s personal and professional goals
• improving specific skills related to each leader’s role, such as supervisory or managerial skills, interpersonal communication, executive presence, conflict resolution, productivity
• sharing world-class techniques from superb organizations that have done similar work
• reviewing strategic business decisions related to operations, customer service, marketing, management or financials
• being a sounding board for communication issues
• preventing problems, thereby avoiding more expensive, time consuming or embarrassing actions
• supporting each leader’s growth past any limiting beliefs


Our scope of services
Individual executive leadership coaching typically requires at least 6 months of engagement for over 40 hours. All coaching service levels include an intake session, individual quantitative and qualitative assessments, 360 interviews, written behavioral action plans, milestone meetings with stakeholders, constructive actions, and accountability. We have a network of executive coaches throughout the U.S.  All consulting and coaching services are guaranteed.


Your expected outcomes
Develop leadership capacity in areas that are key to each leader’s success

Drive organizational performance through tactical execution, deliberate practice of desired behaviors, and focused strategic thinking

Leverage each leader’s strengths and mitigate risks, so that each leader can increase the probability of achieving key       organizational outcomes

Increase retention of desired leaders

Our clients have experienced up to 1,200% return on investment, up to 60% increase in productivity, and up to 300% revenue growth. There are 100+ client testimonials at and on social media. Your outcomes need to be defined.


Your next steps
For products and services visit us a  or here


To schedule a meeting or conversation contact:
Doug Gray, PCC  here or call 615.905.1892


The bottom line
Action leads to learning.
All leaders require executive coaching at times.
Your most critical investment is to retain your desired employees.


What are you waiting for?

Download this list of services and investment levels now:

Improving Healthcare Begins with Taking Care of Our Doctors & Nurses

“How are you feeling, doc?

What do you need, nurse?

I think that Healthcare Innovation starts when we ask questions like these. We need to take care of those who are providing our care.

Frustration young female doctor sitting in her consulting room and looking at document.

Too often we get distracted by shiny technology, or efficient processes, when we need to stay focused on the quality of relationships between caring people. Here is a quick example.

Today I shared a panel with 3 brilliant people at an Interactive Case Study led by Mark Kenny (a client) and his team of professional actors at Hippo Solutions in Nashville, TN (see the link here). The theme was “Hospitality in Healthcare,” and this conference/ showcase occurred at Vanderbilt University. Imagine 3 scenes, 6 actors, 50+ in the audience, 2 skillful facilitators, seamless integration of the audience and the actors and the panelists, and you get a picture of how well this case study entertained and educated everyone.

My co-panelists included Paul Sternberg, MD, Chief Medical Officer, Chief Patient Experience Officer, at Vanderbilt University Medical Center, Darren Hodgdon, National VP of Strategy and Innovation at United HealthCare, and Connie Schroyer, PhD, VP at the Hay Group, based in Arlington, VA. And me. The expert on physician burnout, resilience, positive psychology and executive coaching. We focused on the emotions below the surface of behavior, and concluded that the simplest way to improve the quality of hospitality in healthcare is to ask for feedback, listen well, then support constructive changes.

Years ago we had buttons stating “Hug a Nurse” and “Hug your Doctor.” What happened to those buttons?


If you or someone you know is a healthcare professional and would like to know more about burnout and what can be done to help and prevent this Contact Us Here or Call Us: 1-615-905-1892

Telemedicine: What’s the problem and how to increase adoption?

Every U.S. citizen has a vested interest and an opinion about the quality and effectiveness of healthcare delivery, a $3.8 trillion industry with rapidly escalating costs.

The fastest-growing industry in healthcare is telemedicine, which is now used in over 50% of the hospitals in the U.S. to promote remote access to healthcare. Examples range from tele-surgery to tele-emergency care to tele-psychiatry. The reasons for telemedicine abound. It allows specialized care to be distributed from a central hub to a rural location or an underserved population, efficiently and at lower costs.  For instance, in 2012, the Veterans Administration (VA) documented over 1.5 million telehealth sessions, for over 35% of veterans.

Problem statement and opportunity

The primary problem with telemedicine is low user adoption rates because many people resist organizational change. The result is massive waste that can be reduced.   Telemedicine technology and processes exist. However, organizational readiness for telemedicine results from two variables: 1) ability to change, and 2) motivation to change. The innovation diffusion curve (see Figure 1) demonstrates an immediate opportunity for telemedicine initiatives to move from the early adopter phase to the majorities.

Organizational readiness for telemedicine can be measured.   The key variables for organizational readiness include 1) executive sponsors who champion the ability and need to change, 2) buying agents convinced by case studies or ROI data of the economic value for the change, and 3) consumers driven by a compelling need for effective, inexpensive health care outcomes. The need for organizational leadership innovations in telemedicine programs is immediate.

DOI curve

Figure 1: The innovation diffusion curve (in Rogers (2003) Diffusions of Innovation)

Unique opportunity:  Tennessee

Although resistance to telemedicine is a global problem, we have a unique opportunity to provide a solution from Tennessee. Described as the “Global Center of Healthcare,” Nashville, TN has over 400 healthcare companies, spawned from Healthcare Corporation of America (HCA). On January 1, 2015, Tennessee became the 21st state to enact “telemedicine parity” legislation requiring that insurers reimburse licensed health care providers for services delivered remotely just as they would for in-person visits. On February 15, 2015 Tennessee added law stating that telehealth providers will be held to the same level of care as direct care providers (SB 1223). That law “opened the door” for telemedicine services to be delivered remotely, at lower cost, to rural minorities in Tennessee. We are in the right time at the right place to lead innovation in telemedicine.

Sadly, there is resistance to telemedicine from consumers and administrators who do not trust the government, or the technology, or the financial benefits. A telemedicine visit may cost $50 and take 10 minutes (e.g. MD Live, Teladoc); an ER visit may cost $150 and take 3 hours; a hospital visit may cost $15,000 and take 3 days. Telemedicine has demonstrated a 10X cost savings. Unless, of course, there is organizational resistance to change, in which case telemedicine is a waste of time and resources.

One administrator said, “We have 3 telemedicine kiosks sitting in a storage room, hidden by sheets. The vendor who provided them no longer exists.   The technology may be extraordinary, but I cannot get my physicians and nurses to use it.” His experience represents hundreds of wasteful healthcare initiatives.

What can you do to increase adoption of telemedicine? 

Fee ranges for coaching services

There is chaos in the executive coaching and leadership consulting industry.

The top 6 reasons for that chaos include  1) low barrier to entry by anyone who chooses to call himself an “executive coach,” 2) low accountability for the coaching process, 3) unclear business agreements and ROI, 4) proliferation of “certification programs” (often by self-congratulating organizations and/or universities that respond to perceived market opportunities), 5) digital overwhelm of choices at low cost and variable quality, and 6) clients or buying agents in organizations who fear taking action.     My opinion is that the chaos in the coaching industry can be reduced.

So here is my effort to reduce the chaos, by providing fee ranges and best practices.   Please forward this page to your colleagues.

1.  Individual Coaching or Consulting Services.  Fees range from $3,000- $50,000 for 6 months.   Individual coaching may be defined as a customized leadership development process that enables leaders to practice new skills or behavioral outcomes.  Individual consulting may be a more directive style, where we provide expertise based on world-class examples or evidence-based recommendations to accelerate your leadership development.  The average executive coaching engagement is $25,000 for 6 months, about 40 hours.  The average small business coaching engagement is $6,000 for 6 months, about 18 hours.   Typically, an individual coaching process includes an intake, meeting with key stakeholders, written action plan with behavioral outcomes, clear measures of success/ KPIs, quantitative and qualitative assessments, satisfaction survey, and demonstrated behavioral outcomes at completion.   Be wary of anyone who offers a term of engagement shorter than 6 months, because behavioral change takes time.  Be wary of anyone who provides an hourly rate, because that is a transactional approach and it may be unethical (Do I really need to extend this coaching engagement if we have not met the desired outcomes within 6 months?)   Be wary of additional fees for assessments, a sample intake, books, materials, or excessive travel…  Only select coaches who provide tremendous value and exceed that promise.  Only select coaches who guarantee results for their services.  Only select coaches with many testimonials demonstrating clear behavioral outcomes.  Still confused?  Then call us for details or schedule a complimentary, confidential session here.

2.  Team Coaching or  Group Coaching.  Fees range from $1,000 per person to $4,000 per person for 6 months.  There is a trend toward providing coaching services that bundle clients together by team (e.g. the IT department in Houston) or by group (e.g. all district managers or all newly promoted supervisors.)  Many coaches bundle these services for one reason– because the coaches then make more money.  We all need to make money.  However, that is not a compelling reason to bundle valuable services into a commoditized market such as “online team-coaching modules…”  We do not recommend these online modules because there is no evidence that the results are significant.  There is conflicting data on the significance of team coaching engagements.  These programs must be customized for specific organizational needs,  they must have executive sponsorship, and they must have milestones for phases of success.  Yes, we can provide team coaching programs for any organization.   Contact us for details or referrals.

3.  Organizational Coaching or Consulting Services.  Fees range from $15,000- $100,000 per person for 6 months.  Fees vary by role of the leader (c-suite or a HiPo), geography (Asia or North America), and client expectations.  There is massive value to any organization if you can be guaranteed access to pre-qualified coaches in New York as well as Mexico City or Paris.  We are affiliated with CoachSource, the largest global provider of executive coaches, in over 1,000 in 45+ countries.  These service providers can provide breadth for any initiative in any geography, thereby increasing the likelihood of your organizational alignment or new program implementation.  If you are interested in a scaled solution for a specific industry or business need, then you need to select an organizational coaching service provider.  We have selected and managed  hundreds of executive coaches at multiple F500 global organizations since 2005.  Contact us for details.

4.  Organizational Assessment Services.  Fees range from $500- $28,000 per person.  Assessments range from an individual validated tool such as the Hogan Suite or DISC (there are over 15,000 validated assessments) to multi-rater, multi modal assessments with high predictive validity.  We can provide virtually any individual or organizational assessment.   Assessments are essential to leadership development.  Just as you would never go to a physician until the nurse provides your vitals, we recommend using validated assessment tools to measure behavioral changes over time.  We often provide assessments by themselves for your new hires or a newly promoted leaders.  We always include assessments in coaching solutions, as part of the process.  Contact me for details or referrals.

Since 1997,  we have seen tremendous changes in the business and leadership coaching services industry.  As a timely example, minutes ago I received a cold call from a “leader” in the sales coaching software industry.  I quickly learned that he knew less about the industry than he should, and I excused myself from the call.  You can avoid the chaos.

If you are interested in seeing trend survey reports from the coaching industry, or from our research on the relationship of positive psychology on business leaders and executive coaching, please contact us.

Now you have some pricing numbers and best practices.  So what is your next step?

  1.  You have to vet coaches.  Call 3-4 of the best.  Read their testimonials.  Make sure that they are working on their own professional development.  I have hired sales coaches at times.  And business coaches at other times.  The terms were clean.  Their value was tremendous.  I currently work with 2 of the best coaches in North America.  (Perhaps I need more help than most people.)  Make sure the consultants that you select focus on value, and guarantee their work.
  2. Take a small step:  Contact us.  Or call 704.995.6647.  Or schedule your initial consultation here.

There is no reason to be fearful amid the chaos.  

Physician Burnout: you are not alone

The goal of this slide series is to focus on you.

Or to help any physician who may be struggling with burnout.  Please forward this blog.

Download this link for the slide deck:


Thank you for taking a few minutes to learn about physician burnout, diagnosis, treatment and care.

We can help you. Our experience is that you are not alone.

For many generations a stigma existed stating that physicians who 1) endure medical school and residency, 2) can endure anything.

Some critics state that such a “social contract” no longer exists in healthcare.

In confidence, physicians often state, “I am not a super hero.  Although my family and patients tug at me as if I have some supernatural power.  It is exhausting trying to keep up with the demands of insurers and employers.”

Amid our current culture of healthcare reform and continued changes in care, all physicians are forced to adapt.  The highest rate of burnout, over 50%, is for mid-career physicians, 11-20 years after residency.

Who is taking care of the physicians?

Like the photo in the opening slide, physicians often state that they wish for a helping hand “On their shoulder.”

All physicians need a helping hand

A coaching question for you is “What do you need?”

A diagnois?  A treatment plan?  A care program?  Something else?  We can help you.

Contact us at 704.995.6647 or schedule your initial consultation here.

What is the core of every physician-patient relationship?

The core of physician-patient relationships is trust.

But what do you know about your physician’s values regarding end of life decisions, or women’s reproductive choice?  What do you know about the treatment and care suggested by your physician, who may be eligible for a $5,000 referral fee or $2,500 volume price incentive?

Leana Wen, MD, is a Rhodes Scholar and author of “When Doctors Don’t Listen.”  Her TED talk, called “What your doctor won’t disclose,” has been viewed by over 1.3 million people.

Her story includes role models from her childhood in China, to a campaign called “Who’s my doctor?” designed to encourage doctors to share their values and be more transparent with their patients.

She states, “we need to change the paradigm of medicine from sickness and fear to openness and healing.