What is a Health Coach and why do I need one?

Our current health care crisis shows that despite the top dollar spent on health care and technological advances, chronic diseases are on a steep rise.  The rate of diabetes rose by 50% in the last 30 years and will double again by 2050.  Heart disease kills 1 American every 37 seconds;  and 1 of every 3 Americans is obese.  These are related to unhealthy lifestyle choices.  We know how hard it is to make and keep healthy behaviors, and our health system is not set up to help them address the complex factors impacting these lifestyle choices.  Physicians have under 10 minutes to talk to their patients, only enough time for crucial medical recommendations.  Recommendations or information alone is insufficient incentive or resource for actual behavior change.  Physicians also are not trained to engage patients in health behavior change and patients often do not expect to participate in their own care.  This phenomenon of people not feeling motivated or empowered to direct their own care is called low patient engagement and activation.  Our healthcare system is missing a healthcare professional available with expertise in health behavior change and the skills and the time necessary to provide patients with the opportunity to discover their own direction, motivation, and support in reaching their goals.  To help meet this need, health coaches are trained to help people develop their individualized care plans focused on healthily lifestyle changes. 

Why would I ever need a Health Coach?

Health Coaches can understand your story.  Each of us has a unique story about our personal journey through life; we might also have a mission or purpose, a dream to fulfill.  Somewhere along the way, you or your loved one (or patient) was derailed off the path, disrupting the balance in your life.  This might have been due to an accident, stressor or life-changing event, or just bad luck.  Such events might not manifest initially, but may over time fester into maladaptive coping skills (i.e. smoking, drinking, overeating, or other addictive behaviors), discouragement, a sense of loss of control and possibly even a dependency on others.  Regardless of the specific cause or effect, you are where you are now…And now, you might be suffering from a chronic condition that has you and your loved ones overwhelmed. You might feel at a loss of where to turn for help.  Hospitals and rehab facilities treat your problem when it flares — but this feels just too little, too late. Your primary care doctor sees you for check ups, tests, and referrals for specific problems— but might not be able to take the time to probe deeper into all the challenges you face and why those things became challenging in the first place.  Who is there to see you through the time spent at home between visits, when you are resorting to the usual remedies that aren’t the type of cure you need?

What is a Health Coach?

 An Integrative Health Coach works in a dynamic partnership with clients to help them achieve and sustain optimal health and vitality. Our clients are living with conditions like cancer, heart and lung disease, cancer and diabetes.  Since most of these conditions are affected by lifestyle choices, research has shown that health coaches help such clients with lifestyle behavior change within a holistic framework of health. Significant improvements in dietary, exercise and weight management, and medication compliance behaviors were found in these studies.  The key elements to success were goal setting, motivational interviewing (which is part of health coaching), and collaboration with health care providers (Olsen JM, Nesbitt BJ).  


Integrative health coaches work with the Wheel of Health, developed by Duke Integrative Medicine, to examine the areas that influence their health.  The areas include: relationships, personal/professional development, exercise, environment, spirituality, nutrition, and mind-body connection.  Health coaches empower clients by building on their strengths in any of these areas so they can achieve the change they desire.  Together, they design a care plan that allows the client to work at their own pace.  The process takes time, sometimes up to six months with weekly face-to-face meetings or teleconferencing.  Regardless, your health coach will see you through the day-to-day, when you are home, to gently guide you back on track to the healthiest YOU!

 Olsen JM, Nesbitt BJ. Am J Health Promot. 2010 Sep-Oct; 25(1)e1-e12. doi: 10.4278/ajhp.090313-LIT-101.


Telehealth Is the Future Now

 What is Telehealth? 

Telehealth is the integration of telecommunication systems into practice of protecting and promoting health, while telemedicine is the incorporation of these systems into curative medicine” (World Health Organization, 1997)

 How is it used?

First used successfully in the military to provide care for wounded soldiers in the field, telemedicine is expanding not only within the government but spilling over to the private sector.   You can guess what’s driving this enormous change in how we deliver care — the pressure to cut costs!  The move towards telehealth is also prompted by Obamacare pressures to improve quality, reduce ER visits and readmissions, and allow for better access to care by the elderly, disabled and rural residents. 

Patients who find it hard to visit a doctor or specialist can now teleconference their office for personalized medical advice…from the comfort of home.  When heart failure patients are remotely monitored on a daily basis for any subtle changes in weight or vitals, their doctor will be alerted immediately and will make timely adjustments in their diuretic and blood pressure medications to keep them from returning to the hospital with fluid overload.  Providers can push text messages to clients needing a daily nudge with their diet and exercise regimen and help them stick to an exercise and diet plan they designed with their providers.  This technology is an excellent way to deliver patient-centered care.  How many times has a simple injury or infection been ignored because it was a hassle to see the doctor, only to have it explode into a fulminating painful medical emergency?  With monthly prepaid contracts with the primary doctor, people will be less likely to delay seeking help and more inclined to fire-off a text or video call to their provider that is covered in their plan.  

Real-time communication using online voice and video interactions or “teleconferencing” allows providers to conduct consultations and deliver care, health education and health coaching at a distance.  Providers can also gather real-time data from patients through store-and-forward imaging, streaming media and remote wireless devices that detect subtle day-to-day changes in their physical and mental states.  

Patients and providers can save a lot of time and money engaging in this electronic information exchange.  They use a variety of platforms that suit the needs of both provider and client, such as smartphones, mobile apps, cloud-computing, tablets and laptops.  For $49 per cyber visit, people seeking medical advice on common symptoms like coughing or on how to better manage their chronic illness can quickly access a doctor 24/7.  To enroll, they simply use their smartphones to download a mobile app such as “Amwell” by American Well. 

What does the research show on its effectiveness?

Studies on hypertensive and diabetic patients that were telemonitored at home reported a significant decrease in blood pressure and glucose level, respectively.  Also, cardiac patients on such monitors showed significant improvement in their quality of life.  Data transmitted is reliable and well received by patients.  Research on home-based telemonitoring of chronically ill patients is promising; its data is reliable and accurate, it empowers and influences their behaviors, and this technology might improve their medical status.  

What are the laws on telehealth?

Reimbursement for telehealth services is crucial in its expansion.  Medicaid reimbursement for telehealth services is required on some level in a total of 43 states and the District of Columbia.  Telehealth is covered by private insurance plans that are based in 19 states and the District of Columbia, and soon in Arizona.  Fortunately, Michigan has passed laws to allow for both state and private insurance reimbursement for telehealth services in the state.

Further reading:




Systematic Review of Home Telemonitoring for Chronic Diseases: The Evidence Base. Guy Paré, PhD, Mirou Jaana, PhD, and Claude Sicotte, PhD