Co-sponsor of the Summit

An invitational Health and Wellness Coaching Summit was held outside Boston on September 26-27, 2010 with the goal of developing a plan of action for national standards and certification. The meeting had instant credibility: sponsors were

I was able to attend the first day, but not the all important second day when directions were to be clarified and set.

U Minnesota program: Summit co-sponsor

A formal report is not yet out. I will report on it when it is public. Meantime, here is a look at the substance of the meeting from Jennifer Johnson, ND. Johnson is a clinical faculty member at the University of Bridgeport program in naturopathic medicine. She was tabbed for the Summit by Guru Sandesh Khalsa, ND, dean of the Bridgeport program, chair of the Association of Accredited Naturopathic Medical Colleges and board member of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), with which I am involved. Johnson has a counseling, wellness and empowerment focus in her practice and an interest in the formal coaching field. Khalsa recognized a good fit.

Johnson, the sole member of her profession at the Summit, filed this report for ACCAHC. She answered affirmatively when I asked if I could share it in the Integrator.

The Summit

Johnson: Reporting the Summit

The recent Summit  on Standards & Credentialing of Professional Coaches in Healthcare & Wellness brought experts from very far and wide to help define an entire profession in 2 days, a seemingly insurmountable task. Through group work, brainstorming sessions, fun and creative performance pieces and an overwhelmingly positive attitude the group made significant headway in creating a real plan for change. And a plan that paves the way for Health Coaching to become a unique field of expertise through certification processes and the development of a national licensing examination.

Coaching & the American healthcare dysfunction

Health coaching sees itself as primed to solve the American healthcare dysfunction, namely the overwhelming issue of abbreviated office visits and lack of time one on one. Healthcare providers frankly do not have enough time to properly treat and educate/empower their patients and lack to training to offer proper motivation.  Health coaches offer real solutions by acting as both a liaison who works with patients in conjunction with other healthcare providers  and/or as an independently sought after professional working one on one with their client.  Expanding these providers to be part of a treatment team would increase access to their skills and therefore bring about health, wellness and prevention.

What is a health coach?

To be coached is to be supported, listened to and respected. Clients are encouraged to create a goal and the coach facilitates the process of attaining this goal. The summit participants, although focused on healthcare outcomes and potential measurements of these outcomes, did not spend time identifying these goals. Clients create the goal in concert with their own life, their own story.

Participants used terminology of "following the story" to further refine the role of a coach. Patients are often too aware of their doctor's goals (orders), yet these do not necessarily match those of the individual patient. Therefore shifting the focus to the patient's story and allowing the patient to really explore how they will see themselves in better health brings about an important paradigm shift. Patients are not always interested in watching the numbers (ie total cholesterol, weight, BMI, HA1c), they just want to enjoy life and be able to play with their grandchild or take a long walk or be able fit into those skinny jeans. These are the client-centered goals of true importance.

Grappling with competencies for coaches

Another large concept that participants grappled with was the issue of competency.
 

• Should health coaches create competencies that can be shared with other healthcare educators, ie nursing and medical schools or used exclusively for their own field?
  
• Is there one set of competencies for all coaches and a subset for health coaches?
  
• Is there still a need or a place for the independent health coach if all healthcare providers are taught the basics of coaching as a core of their curriculum?
  

Defining competencies truly is an integral aspect of creating the new profession of health coach. The group did come up with agreed upon competencies that will be further refined and developed, paving the way for national standards and certification.

Role of research

Changing the current healthcare paradigm requires solid reproduceable research. The current disease model of care needs to pull itself out of the rut it has become. Doctors are deprived of the time they need to properly educate their patients. Patients often leave without feeling that they were heard or cared for on a holistic level. Very few if any healthcare providers have the time or training to create a therapeutic relationship that allows the patient to effectively make the health changes they need to make.

If coaching can show their services will reduce healthcare costs and improve health (through measurements of biomarkers or other trackable tools) they can prove the necessity of their interventions. Areas that would benefit from study and already overwhelm the healthcare system because of overinflated costs related to management and prescriptions include: coronary arterial disease or cardiometabolic syndrome/pre-diabetes and or low back pain.  Additionally, if these studies can show a time savings what a huge splash coaching can make into healthcare at large.

Time, and lack there-of

The issue of time is what continues to plague the current disease-care model. Providers are not reimbursed properly to allow them to provide optimal care including patient education. Why then not focus on changing that paradigm?  Why create another band-aid to fix the broken system? If all providers were fully reimbursed for time to allow for patient education this alone could make a significant shift in the disease care model towards a prevention model. What if these providers were also trained in the basics of coaching and helped to facilitate patient directed goals? Wouldn't this not only turn healthcare on its ear, but also negate the need for health coaches. The reality is that the system is not set up to consider this option. The reality is that there is room to create a new area of expertise and that patients need personalized attention. Patients need to be empowered and they deserve to have a vehicle to allow for their own health evolution.

  Can coaching be an agent of change for resolving the healthcare crisis?

Who can fix our broken health care system? Yes this is the question of the millennium. Many health professions believe they have the answer, from holistic nursing to naturopathic care to integrative medical care they all have the potential to solve the current healthcare crisis. And yet none of these groups have succeeded in shifting the current model from disease centric to prevention and wellness oriented.

The new field of Health Coaching is positioning itself to become the agent of change, to bridge the ever widening gap between provider orders and patient non-compliance.  The summit provided concrete tools in the creation of health coaching. Patching up a broken system by coaching significant changes in people's choices may be a long lasting answer and one that has much energy and strength behind it.