What is a health coach, and why are they paid $121 an hour?

The movement of “health coaching” is gaining some traction in health care circles.

PookieMD explores the phenomenon, and finds that a health coach, among other duties, “help people clarify their health goals, and implement and sustain behaviors, lifestyles, and attitudes that are conducive to optimal health; guide people in their personal care and health-maintenance activities; and, assist people in reducing the negative impact made on their lives by chronic conditions such as cardiovascular disease, cancer, and diabetes.”

As she says, that sounds suspiciously like what primary care is supposed to do, but can’t within the current paradigm of the 15-minute office visit.

So, instead, people with no prior medical training are taking advantage, by signing up for courses over the internet and training to become a health coach. Some sites promise $121 an hour (“at least”), without having to leave home, and there are no worries about malpractice.

Imagine what those with an actual medical degree can do as a health coach. It’s no wonder why so many physicians are leaving medicine, and finding cash-only alternative medical practices so appealing.

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  • Anonymous

    “but can’t within the current paradigm of the 15-minute office visit.”

    Don’t whine. Change the paradigm. Doctors can be soooo passive sometimes.

  • Dr. IKE

    Two things:

    1. At best, a doctor is a consultant providing an opinion which the patient has the right to approve or deny.

    2. I think to “change the paradigm” patients would have to accept more responsibility for their personal choices instead of expecting doctors to save them after they’ve abused their bodies.

  • Anonymous

    This should help lower health care costs, huh?
    “Don’t whine. Change the paradigm.” Just take away your paid time and replace it with unpaid time counseling your patients. I’m curious, does any other profession get this suggestion so often, to cut into billed time with unbilled activites? Do lawyers replace their paid time with unpaid time advising people who will never pay them? Are there CPAs who will sit down and give you investing advice for extensive time free of charge? Mine don’t.

  • Anonymous

    Anon 8:59 and Dr. Ike, I believe the first poster meant quit signing contracts that lock you into a different compensation method. If you want to be paid on an hourly basis, then stop agreeing to be reimbursed the way you are. You have control over how you are paid, not the patient.

    What do you care about “lower health care costs”? That’s a red herring.

  • Strong One

    Be that as it may…
    How are we as the public allowing an individual with little or no medical training ‘coach’ us into a better ‘you’.
    It’s not the Physician or the ‘Health Coach’s fault.
    It’s our fault for allowing it to be.

  • halfmd

    Unless physicians move to a cash model, I don’t see any changes coming.

  • Nurse K

    “help people clarify their health goals, and implement and sustain behaviors, lifestyles, and attitudes that are conducive to optimal health; guide people in their personal care and health-maintenance activities; and, assist people in reducing the negative impact made on their lives by chronic conditions such as cardiovascular disease, cancer, and diabetes.”

    Don’t smoke, eat healthy food, exercise 30 minutes per day or more, get your mammograms and colonoscopies, take your pills as prescribed.

    That’ll be $121.

    I would guess that this “health coach” stuff is mostly a scam to make money off people for training. with lofty promises of instant wealth.

  • Anonymous

    “I think to “change the paradigm” patients would have to accept more responsibility for their personal choices instead of expecting doctors to save them after they’ve abused their bodies.”

    Isn’t that the motivation for getting a health coach?

    The only “health coaching” I ever got from my PCP was to stop running because it triggered my asthma.

    I wouldn’t pay a health coach when much of the information is available on the internet. There’s great advice out there for running with asthma.

  • Dr. IKE

    Anonymous (10:25 AM)

    I would say choosing to hire a health coach shows someone has decided to take more responsibility than most patients do.

  • Deb

    Good question…and maybe medical care reformers could be paying attention to answers from people who engage a coach to guide the direction we’re heading? It seems there is a difference too between illness care and health maintenance/enhancement. Pre-emptive strikes vs reactive.

    As a consumer I want: relational care, accessibility, good listeners, Motivational interviewing and other skills/insights, shared responsibility, competence, compassion… What else would contribute to physicians and consumers being better satisfied?

  • DennisB

    At first blush, the idea of getting certified from some unknown web service to be a “health coach” sounds like a disservice to the public. And it almost makes sense to say “people with no prior medical training” are doing this and make it sound like a terrible thing.

    But I ponder this for a minute and questions come to me like, if we are doing such a great job of coaching people for health why is diabetes II an epidemic? Why are 60%+ of the people in this county overweight, and many obese? Why are degenerative diseases the leading causes of death? Why do legal prescription drugs kill 180,000 US citizens a year and no one seems concerned?

    We have an multi-billion dollar industry that thrives on people being sick, not people getting well or being healthy in the first place. What if we paid these people to keep us healthy and didn’t pay them if we get sick? And why is the answer to every health question always involve a prescription drug?

    I read that the children born after the year 2000 will be the first generation that will not outlive their parents. And this same group has a 1 out 3 chance of getting Type II diabetes. Is this good or bad news for the medical community?

    This paradigm isn’t working. Someone needs to help these children. Someone should have been helping them before this. Where do I sign up to be a health coach?

  • Livelean

    I see the role of a health coach as a friend to talk with that has some experience or knowledge dealing with life’s struggles. All of us could do that if we are willing to listen. The real question is, if you want to make changes, and need someone to do it with or to be accountable to, can you find a sympathetic friend, or should you pay someone? Either way, having a support system is crucial for success, so find a support system, either free or for a fee, and go for it!

  • Livelean

    I see the role of a health coach as a friend to talk with that has some experience or knowledge dealing with life’s struggles. All of us could do that if we are willing to listen. The real question is, if you want to make changes, and need someone to do it with or to be accountable to, can you find a sympathetic friend, or should you pay someone? Either way, having a support system is crucial for success, so find a support system, either free or for a fee, and go for it!