Health Coaches: New Health Team Member?
Public health experts say chronic diseases like heart disease, diabetes and arthritis are the leading causes of death and disability in Canada. According to the Public Health Agency of Canada, more than half (58%) of all health care spending in the country goes towards chronic diseases. And with health care spending spiraling upward, an ounce of prevention might be more cost effective. Health coaches, a new type of health professional, just might be perfect for the job.
You've heard of financial coaches and life coaches. The new breed of health professional is called a health coach. There are roughly six thousand health coaches on the job in the U-S - many of who were trained at Wellcoaches Corporation based in Massachusetts. In the U-S, they are a fledgling group but are being used more and more to help people with chronic and often preventable diseases like obesity, type 2 diabetes, osteoarthritis, and heart disease. In the U-S, Medicare has started paying for up to twenty coaching sessions a year for people with obesity.
Here's how they work. Your doctor might advise you to lose weight, eat better and to exercise more. It's the job of a health coach to show you how to do it - to help guide you to set realistic health goals, and to show you how to break those goals down into manageable steps. When obstacles are identified that get in the way of those goals, a good health coach helps you figure out how to overcome them. Patients (coaches tend to call them clients) are accountable to their health coach for the goals they set. The coach is there to support you and to help pick you up if you stumble. Some of the best health coaches are able to motivate their clients because they've traveled the same path. It's no accident that the first health coaches counseled clients in drug rehabilitation programs - in which counselors are often drawn from the ranks of people in recovery.
There's a growing number of studies that show that health coaches improve outcomes. A group of breast, prostate and colorectal cancer survivors who received an in initial ninety minute coaching session followed by regular thirty to forty minute sessions over three months exercised more, had lower depression scores and improved quality of life. In a study of more than twelve hundred patients with diabetes and heart disease (published earlier this year) concluded that health coaching by phone could lower blood pressure. A study that looked at a worksite wellness program that featured coaching was found to get workers to exercise more and to eat more vegetables and fruits. The benefits were found to last two years. All of these provide evidence that health coaches might be very effective.
If it's such a good idea, why not have doctors do it? Just because it's a good idea doesn't mean doctors should coach patients. First, I don't think doctors have the time to coach patients. We're not talking a ten minute appointment here. Coaching requires at least an hour for an initial visit and at least half an hour for subsequent visits. As a coach, the doctor has to be available for telephone advice, which many doctors are reluctant to provide these days. More than that, I see little evidence that MDs are good at coaching. I don't think MDs receive any special training in school at how to be a good coach. If a doctor wants to become a coach, I think they should take specialized training. The thing is, I don't think physicians particularly want to become health coaches.
Is health coaching something we're starting to see in Canada? Health coaching has been available here for some time. Savvy employers are starting to hire coaches to whip their employees into shape. If doing that trims the bottom line, it has to be good for business.
Trouble is, the majority of health coaching in Canada is provided by private or concierge medical clinics like Copeman Health in BC and Alberta and Cleveland Clinic Canada here in Ontario. At clinics like these, you pay an annual fee to have premium access to a basket of health services not paid for under provincial health, including access to a health coach. Clinics like these are allowed to charge for access to coaching because health prevention coaching is not paid for in most provinces. In other words, prevention in provinces like these is considered a luxury item. I think it should be considered a necessity and therefore covered by universal health care.
There are cancer coaches in Canada. The National Association of Professional Cancer Coaches is a is a non-profit organization whose responsibility is to link professionally coaches with patients. The association says its coaches are licensed health care professionals - RNs, psychologists, registered dieticians, naturopaths and pharmacists who are educated and experienced in both conventional and so-called holistic cancer medicine.
If you're thinking of hiring a coach yourself, ask for references. And, be on guard for product pitches. The only thing you should be buying is help leading a healthier life.