State your Intention Front and Center: Physician Coaching provides a powerful communication tool

As physicians, we make hundreds of decisions every day.  Each is influenced by an intention, whether we are aware of it or not.  Sadly, when we don’t communicate this, we leave a powerful tool untapped, resulting in a less focused and less powerful outcome than if we had harnessed its potential.  And if we’re not aware of our actual intention, we often end up with an outcome that doesn’t satisfy us or the person we’re dealing with.

What do I mean by that?

Let’s say we enter an exam room, ready to discover how our patient has responded to a medication we started at their last visit.  If our intention is to strengthen our relationship and treat them in a holistic manner, we’ll respond with compassion and curiosity if they report that they stopped the medication because of a side effect.  But if our unconscious intention is to see them quickly because we’re running late that day, we’ll become annoyed and our frustration will show, making any discussion about a replacement medication or strategy less collaborative and, therefore, less effective.  As Marlene Chism, author of 7 Ways to Stop Drama in Your Healthcare Organization, suggests, “If you feel obsessed that the conversation didn’t go well, check your intention. We are often unaware of our hidden agenda to prove someone wrong, win an argument or find an excuse to let someone go.  When you have a conversation that goes south, reflect and ask yourself if you had any hidden agendas you were unaware of.” Bringing ourselves back to our overriding intention, to care for our patient, helps us stay focused on our real mission and allows us to act in accordance with our intent to help people, the most common reason most of us entered the profession of medicine.


As leaders, stating our intention is an underutilized communication skill – and one that is easy to put into regular use.  In leading a meeting or any group effort, stating your intention helps the group become focused and energized.  Lead a meeting off by saying, “It’s my intention that we will cover these particular issues today and by the end of the meeting, we’ll arrive at decisions on all of them and plans to execute our decisions,” and watch the group  fall into step with your stated intention and with each other.


When we see the path and where we’re headed, we’re naturally more energized to go on the journey

If we start out along a path that isn’t clear, and we don’t know where we’re going, it’s hard to get excited and motivated.  But if we see the path ahead and have a picture of where we’re going, we’re energized to take that trek together.  As Yogi Berra warned, “You’ve got to be very careful if you don’t know where you’re going, because you might not get there.”

If we’re concerned that our words may be taken the wrong way, it’s helpful to lead with an intention.  This lets the other person hear our words in the spirit we wish to offer and reduces the chance we’ll be misunderstood.  If we’ve had difficulties with a person before and want to communicate with them again, we can begin with, “I know we’ve had our conflicts in the past. It’s my intention that today,  we have an opportunity to share our perspectives with each other and come to a resolution together that works for both of us.”  A space is now opened for respect, understanding and collaboration.  And before any difficult conversation, stating our intention is an extremely powerful technique that puts a stake in the ground, inviting the other person to join us in this important venture.

By stating our intention, we become clear about what we wish to accomplish with any interaction and we enlist people to join our cause.  It’s powerful both in its simplicity and its effect.



About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
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