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April 14, 2014 | Posted By Jane Jankowski, LMSW, MS

A coach is defined as a person who is tasked with teaching or training others, usually in conjunction with athletic endeavors. When this term is applied to health, we often presume the coach is a personal trainer of sorts, focusing on optimizing fitness and nutrition for those who can afford the fee for this level of personal attention. Over the last few years, however, there has been a growing movement to provide a different kind of health coaching within the medical arena for patients who have difficulty adhering to health related regimens for medication, office visits, and management of chronic medical problems. This endeavor has been found to work for many reasons, but remains in the wings of the contemporary healthcare industry.

The first time I read about the concept of community based health coaching was via Atul Gwande’s article “The Hot Spotters” published in 2011 in The New Yorker magazine included here in its entirety for interested readers. What resonated for me was the comment from one recipient who stated that the coach was effective because of the way the advice and encouragement and nudging was delivered, “Because she talks like my mother” implying that there is understanding, concern, and discipline delivered as the underlying message between coach and patient. I think most good athletic coaching is the same. While success is not measured in trophies, medals, or college scholarships when it comes to medical coaching, the potential for life changing outcomes are very real. And the opportunities for cost savings are very real as well.

Another important article on this kind of health coaching provides a more in depth discussion of what kinds of things a health coach can offer. Tina Rosenberg’s piece “The Health Coach You Know” notes that the cost savings occur when people with poorly controlled chronic conditions are repeatedly hospitalized but with some selective criteria applied. Not every patient is going to benefit from this kind of coaching. Patients fail to adhere to medical recommendations for many reasons. What seems to come into focus in both articles is that where there are identifiable and difficult barriers for a patient that make it hard to stay on track with medicine and office/clinic visits, a coach may be just what is needed. The other theme is that the coach has to be able to relate to the patient either from personal experience or with a sound ability to provide non-judgmental motivational interviewing and a lot of caring persistence.  

In sum, the healthcare system would be well advised to consider placing health coaches in communities where utilization is likely to be beneficial both to the patient population and to the healthcare system. Establishing meaningful connections for patients who may otherwise feel overlooked in the giant engine of healthcare by providing a person who is committed to helping navigate the ups and downs of illness alongside the patient seems likely to pay off in very important ways. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

1 comments | Topics: Cost, Health Coach, Health Insurance

Comments

Athene Aberdeen

Athene Aberdeen wrote on 04/15/14 2:14 PM

I rather like the idea of a health coach. I think that someone who volunteers in a hospital/living facility for the aged would be ideal. The observations that such a person be someone with caring patience and able to establish 'meaningful connections with patients' are well made.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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