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coaching coaching in healthcare health and wellness

Why You Need A Wellness Coach: The Perspective Of An Internal Medicine Doctor

Jan 04, 2024

 

Have you ever felt utterly rushed during your doctor's visits?

Constantly feeling that there’s more to just getting a prescription along with brief counseling, going home, and struggling to follow through with those well-intended recommendations. As a result, you might not have started the healthy changes recommended to you and, in the end, just feel overwhelmed, exhausted, and, frankly, doomed.

You are not alone, and here is why.

As a physician who practiced primary care full-time in a large hospital system, I can appreciate your struggle. Your provider is typically allotted 15–20-minute visits to make sure you are OK, your labs are reviewed, your questions are answered, and if a new problem like diabetes or high blood pressure comes up, that is addressed, and the medications are appropriately prescribed. They must ensure that your forms are filled out, your prescriptions are sent, and your notes are done. This time also does not usually include the time taken to check in at the front desk, get your vitals (blood pressure, heart rate, etc.), and complete measurements like weight. If your primary care provider (PCP) is working in a more unique manner involving a process that includes a direct payment model, bypassing insurance companies, you might have more time allocated for your visits. However, the general model of adult primary care in the United States allocates 15-20 minutes for you to follow up with your PCP.  

You recognize that that is a lot to cover in 15-20 minutes. I agree with you.

Enter the concept of the “Gap.” The Gap between your provider doing the best they can and you trying to do the best that you can. Still, the needle is not moving forward to results. You are still overwhelmed, overweight, sleep-deprived, and feeling stressed. 

This is the Gap a health and wellness coach can help you fill. 

Now before I move on, I want to share what this type of coaching looks like. It is not counseling, including nutrition, counseling, or therapy. If you are a diabetic, yes, seeing the nutritionist is a critical step to progress. But a physician, for example, will share their expertise on what you should and should not do as a diabetic and what medications to take. If they are willing and able, they will try to customize their advice as well. However, they will not use enhanced techniques to determine specific barriers as to why you are not following through with your medications. Knowledge of what you need to do, as shared by your doctors, your nutritionist, and other experts, is not equal to understanding why you are able or unable to follow through with the necessary action steps.

Coaching operates on the belief that you are unique and hold all the answers to your current issues. This includes all the issues that are holding you back from optimizing your physical and emotional health. Using validated coaching tools, you can move forward to your goals. Not just that, you can learn these techniques and apply them throughout your life. Coaching is backed by evidence-based medicine. 

Research studies demonstrate that health coaching can be a valuable adjunct to chronic disease management, leading to improved self-care behaviors, medication adherence, health outcomes, and overall well-being for individuals with chronic conditions.1,2 Studies employing various models of health coaching have shown a reduction in overall healthcare costs, hospitalizations, and emergency room visits and a parallel increase in the self-reported quality of life by participants.3,4

Healthcare providers are not trained in coaching techniques unless they have opted to undergo further specialized training. I can attest to this deficit as a past primary care physician and current wellness coach. Then, I was the expert at managing diabetes, high blood pressure, and other such issues, and I knew what advice to give my patients. But before getting certified as a coach, I did not know how to help my patients identify in depth how to apply my great advice in a tangible way to their own lives. Frankly speaking, I was also completely boxed in with time constraints, so even if I knew coaching techniques, it would be extremely difficult to undertake that journey in a 15-minute visit. So as you think of your overall wellness, working with your team is the best way to optimize your wellness goals. This team should include your medical providers and your health and wellness coach.

So, what happens when you start working with a coach? Will all your problems magically disappear?

While I cannot give a 100% guarantee, you might come surprisingly close to achieving an incredible amount of forward momentum. Wellness coaching may not align with everyone, but for those that it does - the impact can be powerful. There are so many humans on this earth, but there is something unique about each of us. Then why do we expect the same cookie-cutter advice to fit all of us? It is not just bubble baths, pedicures, massages, and shopping, finding a wellness coach might be the truest form of self-care. A form that aligns with your values, holistically finds unique answers to situations you are facing, and sustainably creates your future self! 

 

About the Author 

Amna Shabbir, MD, CPC is an internal medicine and geriatric physician, Duke-certified integrative wellness coach, professional life coach, and founder of Early Career Physicians Institute and Amna Shabbir Wellness Coaching.

References:

1. R. Q. Wolever, M. Dreusicke, J. Fikkan et al., (2010). Integrative Health Coaching for Patients with Type 2 Diabetes, The Diabetes Educator, 36(4):629–39

2. Thom, D. H., Willard-Grace, R., Hessler, D., DeVore, D., Prado, C., Bodenheimer, T., & Chen, E. (2015). The impact of health coaching on medication adherence in patients with poorly controlled diabetes, hypertension, and/or hyperlipidemia: a randomized controlled trial. Journal of the American Board of Family Medicine, 28(1), 38-45. doi: 10.3122/jabfm.2015.01.140123.

3. Sarah Klien. Case Study: Health Plan-Led Coaching Program Leads to Improved Outcomes and Cost SavingThe Commonwealth Fund. Accessed 12 Dec 2023.

4. Wennberg, D. E., Marr, A., Lang, L., O'Malley, S., & Bennett, G. (2010). A Randomized Trial of a Telephone Care-Management Strategy. New England Journal of Medicine, 363(10), 1245-1255.