The patient fidgets nervously as she awaits her appointment with her physician. She has a number of questions she needs to ask and wonders whether she will remember everything once she enters the exam room. "I always seem to blank out," she says to herself. "Once I get in the exam room, I get tongue-tied because I know I am only going to have 5 or so minutes to get everything dealt with."

Directly across the room sits another patient. She is on her cell phone, talking amiably with her daughter. She is not worried about getting enough "face time" during her appointment because she spoke with her health coach yesterday to prepare for her visit.

"Her health what?" you may be asking, if you haven't yet heard about the emerging concept of a health coach as an integral part of a medical practice.

Roles of the medical practice health coach

Increasingly, consumers want more control over their healthcare choices, and a growing segment of health-conscious consumers prefers their caregivers to be genuine partners in their quest for better health.

Thus, the new interest in health coaching.

WHAT EXACTLY IS A HEALTH COACH?

Health coaching has its roots in disease management. Although not a new concept—health coaching has been used by the insurance industry to screen for the inappropriate use of healthcare resources—it is a relatively new concept for medical practices.

Physicians and medical practices have only started using health coaches more recently, primarily because many physicians have not been aware of the concept. In a medical practice, the health coach may act as an intermediary in the patient/provider relationship. In this role, the coach brings relevant information to the patient's medical team while also helping to motivate the patient in following appropriate medical protocols.

A health coach also may instruct clients about diagnostic and therapeutic modalities and guide patients in making informed choices about when, how, and where to use community healthcare resources.

Primary objectives of health coaching are to educate the patient regarding self health management and to encourage patients in taking a more proactive role in staying healthy. It is difficult these days to read a medical journal without encountering the topics of "consumer-driven healthcare," "patient empowerment," or "patient-centered care." The ubiquity of the World Wide Web (more than 80% of Web searches are for health-related topics¹ ), combined with the pressure that employers are increasingly exerting on their employees to improve their health behaviors (such as smoking and obesity) are fostering a greater awareness among consumers of their personal accountability in the patient/provider relationship.