Do I Need a Coach or a Therapist? A Personal Encounter with a Physician in Distress

I first met Charles over Zoom. He had scheduled a free coaching consultation after hearing about my work from a friend and former client. As soon as we started talking, I could sense his hesitation—not just about the call, but about the situation he was in.

Charles had been practicing primary care for six years at a federally qualified health center (FQHC). His days were filled with complex patients—not just medically, but socially. He described trying to care for people who were facing job insecurity, the threat of deportation, or not enough food to feed their families. He felt helpless in the face of problems he couldn’t fix with a prescription.

On top of that, his clinic was under pressure—funding cuts, increased productivity demands, and more patients added to his already full schedule. Charles was staying late just to catch up on charting and in-basket messages. He wasn’t sleeping, he dreaded going to work in the morning, and he had lost interest in the things he used to enjoy doing with his family.

He used the word “burnout” to describe how he felt, but as he spoke—his voice flat, his facial expression unreadable—I started to wonder: Is this burnout, or is it depression? And more importantly, am I the right person to help him right now?

Coaching vs. Therapy: Where’s the Line?

This situation—where a physician reaches out unsure of what they need—isn’t unique. Many doctors find themselves stuck in a fog of exhaustion, cynicism, and self-doubt, wondering whether they need help moving forward… or healing from what’s behind them.

Therapy is a clinical relationship. It’s ideal when emotional or psychological healing is needed—especially when there are signs of depression, anxiety, trauma, or other mental health conditions. Therapists are licensed professionals trained to diagnose and treat these issues.

Coaching, by contrast, is a collaborative, goal-oriented relationship focused on growth and transformation. Coaches help clients uncover what they want, identify what’s in the way, and take strategic steps toward change. It’s typically future-focused, but not always.

In fact, some coaches—myself included—are trained to help clients explore their past when it’s relevant. I often work with physicians to uncover the origins of limiting beliefs or internalized narratives that prevent them from thriving. In that way, there can be some overlap in the work of coaching and therapy—especially when done ethically and with clear boundaries.

It Doesn’t Have to Be Either/Or

Many of my clients work with a therapist and a coach. One supports their healing, while the other supports their growth. And depending on where someone is in their journey, they may move back and forth between the two. Personally, I benefit from seeing a therapist and a coach.

That said, I’ve learned not to assume it’s easy—or safe—for physicians to pursue therapy.

Even today, some state medical licensing boards and credentialing applications ask probing questions about mental health or substance use history. Physicians have faced discrimination, delayed promotions, or judgment after disclosing that they’ve taken leave for therapy or mental health treatment.

Because of this, many delay getting the support they need. Coaching can feel like a safer, more acceptable entry point. As coaches, we’re trained to recognize when someone may need clinical care—and when we do, we say so with compassion and care.

Back to Charles

Charles was struggling—not just with exhaustion, but with a deep sense of failure. He felt he was letting his patients down, letting his clinic down, and falling short of the doctor he wanted to be. He had internalized the stress around him as a personal flaw.

I could tell he was in pain. But I also knew that he had taken the first courageous step—he reached out. He wanted support. And even if coaching wasn’t the full answer right then, it could still be part of his healing.

We talked about the benefits of therapy and coaching and came up with next steps. Charles agreed to connect with a therapist to get the help he needed for his mood. A few months later, he reached back out. This time, his voice had more energy. His face was more engaged. He was ready—not just to survive, but to rebuild.

Questions to Ask Yourself

If you’re trying to figure out whether you need a coach or a therapist, ask yourself:

• Am I able to function day-to-day, or am I struggling just to cope?
  If life feels unmanageable, therapy is likely the right starting point.

• Do I want to explore and resolve the past, or gain clarity for the future?
  Therapy focuses on healing. Coaching focuses on growth and momentum.

• Have I done some healing, but still feel stuck professionally or personally?
  Coaching may help you move from surviving to thriving.

• Would working with both help me from different angles?
  You don’t have to choose one or the other—they often complement each other beautifully.

Final Thoughts

It takes strength to ask for help—and wisdom to seek the kind that fits your situation. Whether you’re burned out, questioning your path, or just feeling stuck, support is available.

If you want to learn more about physician coaching and meet some of the best coaches I know, take a look at the upcoming events below. If you’re unsure whether coaching is right for you—or just need help figuring out what kind of support would serve you best—I’d love to speak with you. I offer a free 30-minute consultation to explore your next best step.

You don’t have to figure this out alone.

(The name used in this letter is an alias to protect confidentiality.)