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Atul Gawande Thinks You’re Not As Good As You Think You Are

In Search of Excellence

By any reasonable measure, Atul Gawande is an expert surgeon. He trained at some of the country’s most elite medical institutions and has performed over two thousand operations.

But he could be better.

As Gawande notes in his latest New Yorker feature, he recently brought a coach into his operating room to find places where he could improve. The coach turned up no shortage of suggestions.

“One twenty-minute discussion [with my coach] gave me more to consider and work on than I’d had in the past five years,” he admits.

The premise of Gawande’s article — the idea that brought him to the extreme step of hiring his own surgical coach — is that most of us are lousy at becoming excellent.

Athletes and musicians know that deliberate practice is the foundation for excellence, and that this style of practice requires a ruthless focus on your shortcomings, which in turn requires coaching. The rest of us, however, tend to flee the discomfort of such directed criticism as soon as we’ve acquired the bare minimum of credentials that allows us to adopt the moniker of “expert.” We wield any foundation of skill — even if skimpy — like a shield against the discomfort required to acquire more.

To Gawande’s reasoning, this is a problem. In many fields, from teaching, to programming, to marketing, we could be a lot better than we are — if only we were willing to let down our guard and embrace guidance on where we still need work.

“This is tricky,” admits Gawande. “Human beings resist exposure and critique; our brains are well defended”

In the context our our ongoing Career Craftsman discussion, this article piqued my interest. The idea of hiring a coach for a knowledge worker position sounds radical.  But what if the positive results were equally momentous?

I’m pondering…

(Photo by the ALA)

30 thoughts on “Atul Gawande Thinks You’re Not As Good As You Think You Are”

  1. Rather than hiring a coach, or spending the time to find a good one, you could instead team up with your friends or co-workers or colleagues and then try to have everyone coaching each other. I remember hearing about this charter school where this is exactly what the teachers do. They all attend each other’s classes and then hold feedback sessions later. One teacher described the system as feeling like “the Olympics of teaching.”

    Ah yes, I found it:

  2. You know I never thought about it like that. I think that this might just be the way to go because nobody is perfect and everybody has room for improvement. I love reading these articles because they almost always give me that hey that is a great idea feeling. I can’t wait for your next post.

  3. Good post.
    I think for some people there’s also the initial difficulty of finding someone better than you are- if you’re an expert, who knows more than you? This could be a logical excuse.
    But its an excuse none the less.
    The idea to bring in someone to evaluate you sounds like a good one.

  4. It’s not necessarily about fear of having someone criticize you. I imagine that for most people having a coach would be a financial issue: either they don’t have the money or it’s not something they prioritize so it’s not something they are willing to pay for.

  5. Wouldn’t somebody who could truly guide you usually have better things to do – ie, actually doing what they’re supposed to be so good at?

  6. On one hand, I think you make a good point, but depending on what the coach’s actual expertise is, it might lead one to overthink or apply misguided advice. I agree fully with your point on not being content when you reach the stage of being an expert, but I don’t think this issue is one-dimensional at all.

    So the overarching theme really is something I agree with, I’m just not sure on the whole coach thing, and whether it’s even possible to apply it in a situation where one has reached true excellence in a particular field.

  7. It is so easy to overlook mistakes and the areas you need to improve upon when you are immersed in your own work. So I agree wholeheartedly that seeking and responding to feedback is invaluable.

    I would frame coaching broadly to address the points of some of the other posters:

    I’m just not sure on the whole coach thing, and whether it’s even possible to apply it in a situation where one has reached true excellence in a particular field

    I would argue that you are never above criticism from any source. There is always someone out there who will be better than you in some area of your discipline. Also, an ‘amateur’ or even someone completely unfamiliar with your field can provide valuable criticism. Sometimes just chatting to someone removed from the situation has given me a fresh perspective.

    Wouldn’t somebody who could truly guide you usually have better things to do – ie, actually doing what they’re supposed to be so good at?

    In my opinion, a good coach is someone willing to steer you in the right direction and who helps you to develop the skills to get there yourself. An expert will not always be a good coach, they might not have the time as Adam said, or the ability to articulate how they got to where they are and what you need to improve on. Having said this, some experts are able to do all of the above and are very generous with their time. They might even seek out coaching roles through mentoring, teaching or blogging about their area : )

    Thanks for another great post.

  8. I read the article before you blogged about it and was very pleased to hear your thoughts on it. In my opinion a good coach does not necessarily has to be better than you in a given area of expertise. In my experience of having different chess coaches for the past 17 years (I am 25 now and ranked in top 10 among women chess players in the US) not all that were great players turned out to be good coaches. There were few bad coaches that gave destructive criticisms what contributed to loss of confidence and poor play. Overall, it is a very sensitive situation to be coached by someone as you open up and show your weaknesses. And it seems that if you involve someone non-professional (like your coworkers, friends), the process can be quiet destructive. My question is how to apply coaching in grad student’s life?

  9. Good to see that you’ve discovered Gawande. His life definitely affirms much of what you’ve been advocating on Study Hacks–in particular, take a look at his recent Ohio University Commencement Address:

    He describes how he CONSTRUCTED, not DISCOVERED, his passions for both surgery and writing. In addition, he hits directly upon your three tenets for a remarkable life: autonomy, competence, and relatedness (although not using those exact terms).

    Gawande is an absolutely brilliant writer. I have read all three of his published books and the majority of his articles and recommend everyone do the same. They give not only spectacular insight into the field of medicine, but also into managing life in any high-complexity field.

  10. I completely agree with this post! For the last few months, after graduating, I’ve had a lot of time to reflect on my career and my future. Even though I’ve had my fair share of successes, there was always that nagging feeling that things could be better. For me, the hardest part is being cognizant enough to realize what those areas of improvement are. I don’t believe that the issue is that we generally shy from correction, as you alluded, but more that we naturally (as flawed humans) lack the ability to clearly and objectively opportunity for correction. I’ve been journaling daily to reflect on things I want to improve on, professionally, personally, with regards to relationships, etc. This includes softer things like character items, attitudes, perspectives, as well as more structural items like professional tactics, career strategy, failures, successes opportunities for change and expansion. I think it’s important to be directed and intentional about improvement, whether or not you can afford a coach. Expansion and growth should always be intentional, whether or not it’s career-related, and is relevant at every stage and season.

  11. But what if, as a knowledge worker, your coach feels authorship over your research? What if you are in college writing your first ever paper, take some advice from your prof, and then he wants to be listed as the first author?

  12. But what if, as a knowledge worker, your coach feels authorship over your research? What if you are in college writing your first ever paper, take some advice from your prof, and then he wants to be listed as the first author?

    If you look at it this way, as first author your supervisor gets recognition for the input they have made and the guidance they have given you. Also, you now have the benefit of being able to say that you have published a paper with them, which gives you and your research credibility. Plus, the recognition they receive may lead to more funding for the department which will likely filter down to you and your research projects. When you have ‘paid your dues’ and further developed your own research skills I am sure that you will get to be first author. In the mean time, congratulations on your upcoming publication 🙂

  13. I completely agree that asking a coach for feedback can be very intimidating. At some level, we all know that asking for feedback is essential if we want to overcome our weaknesses and maximize our strengths.

    But asking a coach–or anyone, for that matter–for feedback almost seems like you’re inviting criticism. Who wants to be criticized, right?

    When I gave my first paid talk, I knew that the right thing to do was to hand out feedback forms to all of the attendees at the end of the talk– but it felt so unnatural to do that. I imagined receiving horrible responses like “Everything about the talk was bad” and “Total waste of time.” Instead, I received plenty of constructive feedback and many good ideas for subsequent talks.

    There really are both tangible and intangible benefits you can reap from hiring a coach and asking for continual feedback. We all seek comfort; we need to learn to desire growth and improvement more than we fear discomfort.

  14. But what if, as a knowledge worker, your coach feels authorship over your research? What if you are in college writing your first ever paper, take some advice from your prof, and then he wants to be listed as the first author?

    “Advice” isn’t quite “coaching”–coaching is more about perfecting the process of attaining a given outcome, but that outcome has to be definable. Ex. serving a tennis ball, hitting nine high Cs in a row, ensuring every student in a classroom understands a given concept, or completing a given operation without any complications occurring are all definable goals that can be coached to. I don’t know that grad students have such clear-cut objectives–the outcome of research is not known beforehand, hence what makes it research. Since you don’t know what target is going to be hit, you can hardly have a coach help ensure that you hit that target.

  15. Re: Vivek@20: I disagree. Learning to do good research is in part about mastering a set of techniques. Sometimes it’s also about revolutionizing the techniques, it’s true, and coaches who don’t share the vision or the process of discovery that produces the revolutionary new method can then be a hindrance if their advice is followed rigidly. But this hardly seems unique to research: see the high jumper example in Gawande’s article.

    Coaching seems useful for the process-driven components of research, which at a minimum include learning to write and speak about one’s research, but I think include much more as well. For example, one might notice that there is an abstract category of intellectual moves that one’s research tends to depend on, and then perfect the art of making those moves.

  16. Vivek (and others) – Cal marked the post as “for the working world” not for grad students, so I’d expect it to have more applicability to the working world than to grad students. That said, there is still scope for Grad students to learn from this – e.g. most librarians and digital asset managers think grad and undergrad students have really poor research skills. Having a librarian shadow you conducting that kind of library-specific research could teach you skills and tips that boost your accuracy and efficiency, making the work you build on top of it useful.

    Gawande even says the guy who coached him didn’t necessariyl have much experience in the specific operations he did, but his advice was more practical – about how they room was laid out and how that limited the ability of his assistants to assist. So, for a grad or for a professional, having someone who can e.g. point out hoe ineffective your email system is, or your library research procedure is, or anything else, could pay dividends in creating the space for you to achieve excellence.

    Just my reading of it.

  17. You might also try working with someone with similar skills, alternating working and coaching. This is rather like the way “pair programming” is supposed to work in computing.

  18. Unrelated to this post, apologies –

    You’ve mentioned in the past that you’re always working on a grand project, and that you have several other projects (with a churn rate of about 1-1.5 projects per week!). Could you explain what sorts of projects you have going on or what you label projects?

  19. I teach some classes at a CrossFit gym. Am I better than all of the people I train? Absolutely not. To be a coach there is no requirement that you be better than the person you are coaching, only that you have a general knowledge of the subject and inquisitive nature about what others are doing. To be a great coach you need those skills and the ability to apply corrections to faults in a constructive way, which varies from person to person. This applies to anything, no matter if it is academic, work, or sports.

  20. Hey Cal, you really should write an article on Steve Jobs! Someone as hard working, minimalist, and with the aura of “genius” like him needs to be extracted Cal Newport style.

    May he Rest in Peace.

  21. Weighing in late to the conversation: I hired a coach back in 2008, when I was feeling stuck in my career. I was in my mid-30s; I had joined a start-up company and grown with it. I headed up a small department and was making a decent income, and I was good at the small piece of things that I did, but I was bored. There wasn’t another position inside the company to transfer to–they were all specialized, and I would have needed to go to law school or something. Yet I liked the company and had stock options in it, and I didn’t want to leave.

    On the side, I wrote freelance articles for magazines, and one day I interviewed a lawyer who, after hiring a coach, had increased the amount of business she brought in to the firm by 30 times. Not 30%, but 30x.

    I hired the same coach, whom I’ve worked with on and off since that time. My coach has never worked in business (or law, for that matter). I’ve never even met her in person–we work through phone calls. But in talking to her, we were able to identify and tackle various obstacles in my day. First, I worked on being more productive with my time. (I had a tendency to spend a lot of the workday surfing the Internet.) Then we looked for opportunities to use the new time I found to raise my profile within the company.

    It worked amazingly well. Within 10 months, I had been promoted to VP and was on my way to being seen as a client-facing resource, which opened up a whole new career path for me. I also (finally!) had some of my short stories and essays accepted to literary magazines, a goal I’d been working toward and giving up on for more than a decade. And I finished the next draft of a novel I’d been procrastinating on.

    All this to say: In my experience, the coach doesn’t need to know the ins and outs of your business–you typically already know what you need to know, or you can find out. What’s hard to do is use your time well, and make sure you’re working on the most important things for you, as opposed to spending the whole day reacting to other people’s agendas. Coaches help keep you focused on what’s important to you, and what will make a difference in success as you define it. It was absolutely the best investment I made in my career.

    As a follow-up: Within three years after I started working with my coach, my company went through a major re-org, in which a bunch of people lost their jobs, and then an acquisition. I was the one of only a handful of people on my level to survive the acquisition, and I was one of only two people who were put in charge of a department made up of the combined companies. Now I’m transitioning into a kind of senior-level consultant role. Had I not worked with my coach, I think I would have either lost my job during some of the tumult, or would have wound up in a junior-level position, with new bosses every couple of months. Like I say, I still work with my coach on and off…and since starting to work with her a couple months ago, I got an agent for a memoir proposal I’ve been sitting on. So, bottom line: Good coaches are completely worth the investment. Plus, succeeding is hard, and there’s nothing like having a partner to bounce things off of.

  22. Kirsten, thanks for sharing your experience with coaching. Can you give me her name/ email address? I would like to talk to her and see if I could get some coaching. I just hired a coach but he is nowhere near as effective.


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