Health Coaches Facilitate Patient Centered Health Care

Overview

With healthcare costs skyrocketing, socialized medicine failing to deliver the services promised, disease rates climbing, and the public growing ever more skeptical of allopathic medicine, many believe the time for more patient centered medicine has arrived. The Centers for Disease Control (CDC) state on their website that “chronic diseases are responsible for 7 out of 10 deaths each year, and treating people with chronic diseases accounts for 86% of our nation’s health care costs.” Health coaches are being solicited by programs, groups, and individuals to help manage acute or chronic diseases or improve general wellness as they understand how to assist people implement behavior changes. Health coaching programs through universities and certification programs, which use evidence-based Psychology and Motivational Interviewing, address various health conce
s and work with patients and clients by creating realistic achievable goals.

Definitions

Numerous definitions exist about what is a health and wellness coach as they are often used interchangeably. The National Society of Health Coaches 2015 position statement differs between wellness coaching as a support for people who want to enhance their current “overall general health status” by removing unhealthy behaviors such as smoking and learning how to eat better for their body and increase exercises. Health coaches, on the other hand, work with clients that have “acute or chronic conditions.”

The National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) does not separate between the two and explain that coaches “partner with clients” in identifying goals, which “promote health and wellness.” The NCCHWC is creating a national certification program based on “best-practice standards” to ensure efficacy in work being conducted by coaches in the health and medical field. Regardless of the definition key points to verify authenticity is the professional background, experience, and certification of the health coach. Most independent coaches, including myself, offer a complimentary consultation so the individual can learn how we work and verify if we can work together.

Partners in Health Fields

Health care practitioners and health insurance companies are increasingly hiring or outsourcing their patients to health coaches to assist in managing acute or chronic health conditions in individual and group settings, either in person or over the phone. A study at Dartmouth-Hitchcock Clinic found that teaching nurses coaching skills and having health coaches on staff decreased patients from returning for the same health issues and decreased overall healthcare costs. A study on client-centered goals, Behavior-Change Action Plans in Primary Care, found that when clinicians focused on creating goals with their patients rather than telling them what to do, changes in health behaviors improved while chronic health issues decreased.

Coaching Skills and Tools

Health coaches come from a variety of professions and focus on empowering patients in discovering their reason to change unhealthy behaviors. Authors Bennet et al, 2010, stated the five roles of a health coach are “self-management support, a bridge between clinician and patient, navigations of the health care system, emotional support, and continuity.” Coaching skills are based on Psychology and evidence-based Motivational Interviewing, which help coaches and patients understand what is blocking effective changes in healthy behavior. Motivational Interviewing strategies and techniques are effective in discussing the key issues and behaviors causing problems yet in a way that does not put the patient at the defensive.

To further clarify what Evidence Based Health Coaching is and tools used in sessions, the Home Health Quality organization promoted a webinar about Evidence Based health coaching from Melinda Huffman of the National Society of Health Coaches. Also, on the website are tools available for professionals to self-evaluate ambivalence and active listening and which can be downloaded from the site.

Another effective tool to use initially with patients in assessing their overall life such as looking at their education, careers, relationships, physical health, and community is the wheel of life, created by ActNow. This tool can be given to the patient or used oneself to be completed together and then create practical goals based on the areas of conce
the patient may have.

Conclusion

Health coaching is an expanding professional career, which effectively helps patients in reducing acute and chronic health diseases by discussing issues in their lives and co-creating patient centered goals to change their behaviors. With more chronic diseases on the rise and less time practitioners have with patients, coaches are stepping in as advocates and partners to assist in improving public health outcomes and promoting behavior changes. By using techniques in Motivational Interviewing, such as asking patients to discuss their health issues and relying on open-ended questions to promote discussions, health coaches are leading the way to promote healthy evidence-based behaviors.
Discussionr
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