Developing A Healthcare Provider Coaching Model

The ability of our current healthcare system to influence needed lifestyle change is a failure. More than two of every three American adults are overweight, and about 33 percent are obese. You should be able to look to your physician for education and motivation to get and stay healthy.

A healthcare provider coaching model is urgently needed. But what would a reliable coaching system look like and how could it be implemented?

A Coaching Model

We should be able to rely on our doctors to motivate us so we can extract ourselves from chronic illness conditions that are primarily lifestyle induced.

In my former medical practice, I ordered lab tests for patients and gave out prescriptions for synthetic medications day after day. I knew I was not able to influence them to make changes to get well. However, soon after leaving conventional medicine for a better way, I discovered it really takes a coaching model to have success at better health.

Healthcare coaching can and should be implemented by every primary care physician. How can a physician do this without proper training? The answer: Physicians don’t need to be coaches; they can hire coaches.

The coaching is best done if it is in coordination with the healthcare provider for access to the patient’s medical history, health conditions, lab-test results and prescription medications. Ideally, it would be the provider who does the coaching. For example, Eileen O’Grady, a certified nurse practitioner with 20 years of experience, is available for her patients and for clients who find her online.

Can The Healthcare Provider Coaching Model Be Profitable?

The economic viability of a healthcare provider coaching system would most likely be your provider’s first question regarding the model. With most providers being closely tied to insurance reimbursement, we must first look at billing codes used by health insurance companies that can fit the model.

The codes are for “provider direct to patient” interactions. Therefore, a coaching session would not be billable unless the provider is present either on the phone call or in the room with the coach and patient. But this defeats the effectiveness of a coach getting into the personal life of the patient. Also, some can be done in the office this way and billed as a 99213-99215 (when more than 50 percent of the time is counseling), along with the diagnosis code V69.1 “counseling for inappropriate diet and eating habits.” It all must be documented and put into the medical record because it may be audited by insurance payers.

But a better way to get good results is to have patients pay cash and leave insurance billing (time and money) out of the equation. This produces better results because patients value the coaching more than if it is all covered under insurance. Of course, each provider must find the right price point for his practice population. It is something that only the really serious patients will pay for.

In the future, it is possible that insurance billing codes will allow for coaching reimbursement (even then, keeping a patient record will be required).

Medical Knowledge

An important area to understand is what a coach needs to know about medicine in order to coach a physician’s patients. The coach will be addressing personal issues with the patient regarding relationships; predominant self-thoughts and feelings; exercise; nutrition; and nutrient supplements. There are lab tests that indicate health risks and disease states that can be communicated to the coach in lay terms by the provider. Also, the medications need to be mentioned only in regard to the disease or symptom for which they were prescribed. If the coach is going to help the patient wean off medications, this would need to be done in coordination with the provider, too. It can be done with a short client review once at the beginning of coaching and again periodically (every one or two months).

What Does A Provider Need To Know In Order To Coach? 

Most importantly, a provider needs to sincerely care about the patient who is being coached. The provider must understand how to get patients to be authentic (establishing trust) and to be accountable and real with how their own choices have caused their current health results. Also, the provider must be able to ask questions tactfully to reveal the emotional blocks and self-defeating beliefs of the patient.

For training, a provider can go through the Lifestyle Coaching Certification program offered through the American Academy of Anti-aging Medicine (www.A4M.com). In this four-module, $6,000 training program, a provider (or ancillary staff member) learns how to guide patients to successfully changing their lifestyle habits for their sustainable, long-term health. That course focuses on these subjects:

• How to get amazing results by shaping one’s belief systems.
• How to balance body pH.
• The nutritional pyramid for optimal health and how to improve nutrient digestion, absorption and nutrient use.
• Hormonal pathways and stress.
• Rest and rejuvenation techniques.
• The immune system, toxins, detoxification and elimination.
• Dietary lessons and food-preparation techniques.
• The co-active coaching principles, practices and other skills.
• Several different topics of lifestyle coaching are explored, including emotions, intuition, power, love, mindfulness and human connection.

To me, it is obvious that personal life patterns (dietary, exercise, communication in love relationships, thoughts and emotions) are the keys to reversing disease — not the prescription drugs doctors may recommend.

If I can effectively coach patients in needed lifestyle changes and also order pertinent lab tests, they can get off as many synthetic medications as possible and use targeted nutrient supplements and bio-identical hormones to get feeling well again. I am developing an M.D. coaching program to be used in my own practice soon.

I strongly believe that provider (himself or herself) health coaching is needed for effective healthcare. This can be billable if the provider is also the coach. Can you imagine a system that incorporates this as a standard of care?