How to Become a Health Coach The Career That Can Bring You Joy ebook by Dr, Sandra Scheinbaum

FUNCTIONAL MEDICINE

POSITIVE PSYCHOLOGY

How to Become a Health Coach:

The Career That Can Bring You Joy

by Dr. Sandra Scheinbaum

Foreword by Cheng Ruan, MD

TABLE OF CONTENTS

Foreword Introduction

SECTION I: THE HEALTH COACHING PROCESS

1. What exactly is health coaching?

2. Why is health coaching such a powerful process?

3. What is the health coach scope of practice?

4. What is Functional Medicine health coaching?

SECTION II: ENTERING THE HEALTH COACHING PROFESSION

5. Who becomes a health coach?

6. Who do health coaches serve and where do they work?

7. What about legal compliance and ethical considerations?

8. What should I look for when choosing a training program?

SECTION III: THE RAPID GROWTH AND RECOGNITION OF HEALTH COACHING

9. Is health coaching a legitimate healthcare profession?

10. What’s on the horizon for health coaching?

Foreword

The landscape of medicine has changed drastically over the last few years. The time is ripe for a new era of engagement and behavior change specialists to assume a position of dominance with the medical community. Health coaching is no longer optional. It is necessary to drive down the economic, emotional, and spiritual burden of chronic disease.

Just 70 years ago, physicians who delivered healthcare to people in need were assumed to possess seemingly magical powers. They were viewed as healers who carried and created potions for uncertain situations. The contents of the doctor’s bag were sacred. The relationships that doctors formed with their patients were considered a sacred bond of trust, respect, and compassion.

The modern healthcare system emphasizes the delivery of care through medical procedures and medications. While technological breakthroughs in acute care interventions led to life-saving advancements in urgent and emergency care, management of chronic conditions falls short, and is being left behind.

In today’s world, patients are increasingly plagued with doubt and question the delivery of healthcare. I find that doctors are having a hard time adjusting to this new ecosystem, and are experiencing burn-out at an alarming rate. What I find most encouraging is that more and more individuals desire to take charge of their health.

In medical school, I vividly remember a section on my exam where we were asked to

label blood pressure medicines that prolong life. Amazingly, that list is shorter than you think. Shouldn’t they all prolong life? We then were asked to label medications that had the best effect on lab values, but were not shown to prolong life. That list contained a majority of chronic care medications that are still prescribed today. What’s the point of improving numbers if they do not necessarily prolong life or improve the quality of life? This is the biggest contradiction in medicine today.

Most doctors recognize, whether they admit to it or not, that the biggest contributor to improved quality of life and increased longevity in those with chronic disease is commitment to lifestyle change. The delivery of care based upon behavior change can prevent the tragedies attributed to chronic illness and improve the overall cost of health care by reducing hospitalizations and emergency room visits.

Physicians are not trained as behavior change experts. Helping people adopt new habits involves the establishment of a trusting relationship. Building trust takes time, requires compassion, and the employment of emotional intelligence by both parties involved.

Modern medicine needs a field dedicated to the behavior change process. This is where health coaching comes in. The field of health coaching can and will bridge the dangerous gap between patient expectations and the modern healthcare delivery system. The role of health coaches is not only viable, but

crucial to the current medical ecosystem. What’s great about health coaching is that the health coaches position themselves as guides and let the patient be their own heroes.

Health coaching sheds light on valuable data, such as the social determinants of health. Medical professionals need to consider possible socioeconomic impediments to creating health and longevity, including the neighborhood where patients live. Another role for health coaches involves recognizing any previous psychosocial traumas that may be what’s driving their poor physical health. When patients engage with health coaches, they have the support and advocacy that they do not typically have access to via the assembly-line styled fee-for-service type of medical care. Coaches meet people where they are, with compassion and accountability. As a result, patients experience connection without fear.

When I first met Dr. Sandra Scheinbaum in 2017 in California at the Annual International Conference of the Institute for Functional Medicine, I had the impression that not only is she passionate and knowledgeable, but she also knows how to execute her vision about what the delivery of healthcare should look like. This was someone I could truly identify with! A few months later, I started a prototype practice in Houston, Texas, now known as Texas Center for Lifestyle Medicine.

When I started Texas Center for Lifestyle Medicine in 2017, I did not fully comprehend how health coaches could accelerate the healing process of my patients. But when I looked at our data for multiple disease states, I found that those who received health coaching had much better scores on measures of depression, anxiety, physical symptoms, and hospitalization rates than those who chose not to work with a health coach.

Encouraged by data showing significant patient improvement, we then initiated a group health coaching program. By harnessing the power of groups, we witnessed even better results when group participants were compared to those who only participated in one-on-one health coaching.

We decided that health coaching is the true core of our practice. The doctors and other allied health professionals support the core health coaching structure, not the other way around. This mindset allowed us to create an even stronger backbone for our medical ecosystem by allowing doctors, nurse practitioners, physician assistants, and dietitians to practice at the top of their licenses. Health coaching alleviates the unnecessary pressures that we experience as practitioners.

My vision entails making Functional and Integrative Medicine more accessible and affordable by bringing these root cause-based approaches into an insurance-based billing model. By choosing this path, I encountered numerous obstacles to making this approach viable within a reimbursement structure set up for acute care medicine. Despite setbacks, I made sure I failed forward. Sandra and I kept in touch and she helped me become a passionate advocate for health coaching.

Health coaching experienced dramatic growth over the last few years. In April of 2021, health coaches were granted their own taxonomy, referred to as a national provider identification number (NPI). This signifies an incredibly important advancement for the field because a taxonomy code designates a provider’s classification when providing health services. Having a taxonomy means that health coaching is recognized as a legitimate profession within the medical system.

Possessing an NPI signifies that they are medical providers.

Despite the significant advancement that having a taxonomy represents, there are still hurdles to overcome. Many health insurance companies still have to “wrap their head around it.” Here at Texas Center for Lifestyle Medicine, when we submitted claims to insurance companies for health coaching services, they had to do their own internal digging before allocating reimbursement. Luckily we were able to show enough proof and documentation of services rendered that our claims were successfully processed in most cases. This set a precedent that is now honored with other clinics and medical systems that utilize health coaches.

I have been working with many major centers around the United States that already utilize health coaches to advance healthcare. Health systems such as Massachusetts General Hospital in Boston, Maimonides Hospital

System in New York, the University of Arizona, the University of San Diego, Spectrum Health, Mayo Clinic, and Duke University are just some of the larger wellestablished systems that employ health coaches in different, yet powerful ways. Due to the creativity I witness when talking to representatives from these groups, I feel optimistic about the future of medicine.

Health coaches have been the missing link no one knew we needed. The era of health coaches has begun and will not stop anytime soon.

I’m grateful for the opportunity to reveal my thoughts to a new generation of people who wish to deliver both quality healthcare and personal empowerment, so that we can all lead healthier, happier lives.

– Cheng Ruan, MD

C.E.O. Texas Center for Lifestyle Medicine texascenterforlifestylemedicine.org

Introduction

• Which career offers one of the greatest opportunities to help people transform their lives?

• Which career has the biggest potential to foster personal growth and bring you joy?

• Which career is considered one of the fastest growing professions?

If you answered HEALTH COACHING, you’re correct!

I hope that reading this book inspires you to become a health and wellness coach.

In 2014, the Functional Medicine Coaching Academy (FMCASM) was established to close the gap between the available training opportunities in health coaching and the need to teach prospective health coaches the Functional Medicine model of wellness. Along with co-founder, Elyse Wagner, and our collaboration partner, The Institute for Functional Medicine® (IFM), we created the solution: an online school that trains health coaches based on the Functional Medicine philosophy.

As we planned the curriculum, I thought about what elements were essential for an aspiring coach to learn. I drew upon my past professional experiences, such as having spent close to 40 years as a licensed clinical psychologist, and many years before that as a college instructor who prepared students to become special education teachers.

The central question we wanted to answer was “what knowledge areas do we need to teach so that our students can shine as a

health coach?” Six Branches of Learning™ emerged as the answer.

In order to become an effective health coach, a firm grounding in Functional Medicine, positive psychology, functional nutrition/psychology of eating, mind-body techniques, and of course, the art and science of coaching is needed. These knowledge areas are critical to be a competent health and wellness coach. Additionally, we want each coach to know how to land a job and attract clients in order to actually use the health coach training received, so we included a sixth Branch: Career Navigation.

I firmly believe that receiving an education in Functional Medicine principles, along with five other important Branches thoroughly prepares coaches to help people create healthier lives. Whether you’re new to the profession or already coaching and wanting advanced training, if you integrate the Six Branches of Learning, you will be an effective and successful health and wellness coach.

The 6 Branches of Learning at FMCA™

6

1. Functional Medicine principles

2. Functional nutrition principles

3. Positive psychology

4. Mind-body medicine

5. The art and science of coaching

6. Health coaching career

Does pursuing a career that consists of supporting people on their wellness journey and helping them reach their goals resonate with you?

If you answered yes to the above question, then consider becoming a health and wellness coach. The fact that you’re reading this book means that you’re already picturing yourself as a trained health coach. And there’s no better time to enter this rewarding profession.

To help you gain insights about the health coaching profession, I asked health and wellness coaches three questions:

1. Why did you choose to become a health coach?

2. What brings you the most joy as a health coach?

3. Would you recommend that others pursue a career as a health coach?

These reflections are sprinkled throughout the book.

Coach Reflections

Why Did You Choose to Become a Health Coach?

“When I discovered health coaching, I saw a way to help people make the kinds of lasting changes that will have a positive impact on the rest of their lives and the lives of their families.”

Jennifer Newton

“I have always been passionate about health and wellness. I wanted to take my knowledge to the next level and learn how to coach people to transform their health.”

Colette Chandler

“To come alongside and support those navigating a health journey. To let them know they’re not alone, and there’s always hope!”

Kerry Chamberlain

“I wanted to help people overcome illness and optimize their health. I believe that there is a root cause to every illness and because of that people can heal themselves.”

Melissa Champine

One of the most rapidly growing careers

LinkedIn identified the fastest-growing job areas in 2020, ranking them based on a combination of growth in demand and number of jobs available. Health care supporting staff titles, including health coaches, ranked third overall. The increase in concerns about health precipitated by the global pandemic will continue to propel growth in this field. A 2021 U.S. Bureau of Labor Statistics report ranked physician assistants as one of the fastest-growing healthcare occupations. It should be noted that health and wellness coaches could be classified as medical assistants on labor surveys.

These numbers are consistent with the exponential growth in the Functional Medicine health coaching model that we pioneered at FMCA. Our first official class in

January, 2016 had 97 students. The March, 2021 certification class consisted of 410 enrollees. These purpose-driven individuals come from around the world and from all walks of life.

I’m excited for our coaches and future coaches to “lead the charge” in this rewarding and much-needed healthcare profession. The demand for health and wellness coaches is soaring and will continue to do so!

Why are health coaches in demand?

The answer lies in the growing epidemic of chronic diseases, such as obesity and type 2 diabetes, that overwhelm the current healthcare system.

It’s been estimated that almost half of all American adults suffer from at least one chronic illness. These conditions are commonly referred to as lifestyle-related conditions. How we live our lives, including what and how we eat, if we exercise, how we manage stress, and the quality of our sleep, are major contributing factors.

The Center for Disease Control estimates that managing chronic illnesses accounts for some 78 percent of the health expenditures in

the United States. A 2011 study by the World Economic Forum projected that by the year 2030, the cost of chronic illness treatment worldwide will exceed $47 trillion.

Now we face an even larger problem: the lingering after-effects of COVID-19. At the time of this publication, all of the long-term ramifications are still unknown, but the costs to an already overburdened healthcare system will be considerable. Millions are suffering, both physically and psychologically, either as a direct or indirect consequence of the worldwide pandemic.

As you can see, health coaches are needed now more than ever.

Who’s hiring health coaches?

To address the rapid rise and increasing prevalence of lifestyle-driven chronic illnesses, health coaches are sought after by a variety of organizations. Here’s some of the major ones:

• Medical practices, including those that are creating innovative virtual models

• Major corporations and small businesses interested in the well-being of their employees

• Insurance companies interested in lowering healthcare costs by keeping people healthier and preventing the onset and subsequent complications of chronic disease

• Companies developing artificial intelligence-based health tracking devices who realize the importance of human communication to affect behavior change.

• Wellness centers and spas dedicated to offering a comprehensive approach to self-care.

• Individuals who want to become the CEO of their personal health.

What Makes Health Coaching So Extraordinary?

Health coaches help people manage and even reverse chronic conditions, lose weight and keep it off, increase movement and activity, and generally improve their physical and mental health. Employers appreciate how health coaching brings down patient coverage costs and reduces health insurance claims.

We all want good health. It’s getting there that’s challenging.

What do you think derails someone from achieving their best health? Lack of preparation? Lack of willpower? Lack of resources? The number one obstacle people face on their journey toward better health is lack of support.

Everyone wants to get healthy, but we all need someone to hold us accountable and

ask the right questions. We need someone to cheer us on and help us create a plan to achieve our goals. That’s the special role of the health coach.

As the behavior change specialist, the health coach plays an important role on the medical collaborative care team. A growing body of evidence demonstrates that helping people initiate and sustain lifestyle changes improves their overall health and well-being.

The popularity of health coaching continues to grow because the model works. Health coaches build trusting relationships, identify what the client values and desires, and know how to help that client transform their unique goals into actions that create lasting change and true health, wellness, and vitality.

The World Needs Health Coaches Now!

It’s become clearer than ever that the world NEEDS health coaches!

As we enter the third year of the pandemic, we’re seeing an overburdened healthcare system struggling to meet the needs of millions of people suffering from debilitating chronic conditions, including the still unknown long-term impact of COVID-19 and the variants that are continuing to emerge. Our emotional wellness is at stake as the incidence of anxiety and depression is on the rise amongst individuals of all ages and across the globe. On a positive note, many people are showing increased interest in their health and want to partner with a health coach to take proactive steps to maintain or restore wellness.

Coach Reflections

“Health Coaching gives me an opportunity to share my passions and gifts with others. I wanted to be part of the solution to the healthcare crisis for individuals. I realized I could make a significant difference in other people’s lives as a coach.”

Linda Schillinger

“Becoming a health coach fulfilled both my personal and professional passion. I feel that it is my greatest opportunity and gift to the world to help others feel empowered to make meaningful differences in their lives.”

Stephanie Staples

“It married all of my lifelong interests in health, nutrition, psychology, people’s stories, and wanting to help people live more healthy and fulfilling lives.”

Shelby Garay

Join the movement that’s transforming healthcare

At the Functional Medicine Coaching Academy™, we train physicians, nurses, dentists, psychologists, social workers, dietitians, chiropractors, acupuncturists, and massage therapists, to name just a few professions. Yoga instructors, personal trainers, and allied healthcare professionals are becoming health coaches. Many practitioners are enrolling in coaching programs so that they can add coaching to their existing skill sets. I also want to emphasize that many of our graduates had ZERO training in a healthcare field before deciding to earn a certificate in health and wellness coaching. They come from a variety of background and educational levels, and range in age from 16-86.

I hope that you’ll be inspired to join the movement that’s increasingly playing a major role in the transformation of healthcare from acute care management to prevention and reversal of lifestyle-related conditions.

• If you’re someone with a calling to serve others, health coaching is an ideal career choice.

• If you want to be a key member of a medical collaborative care team, health coaching can be a rewarding experience.

• Imagine awakening every morning thrilled to work in a field aligned with your mission and purpose.

• Imagine acting as the catalyst for growth and transformation.

• Imagine that becoming a health coach leads to your own personal growth and transformation, both physically and emotionally.

I’m on a mission to share the power of health coaching with the world. It’s my intention that this guide serves as a gateway to your next step on the path to becoming a health coach. I created it to answer commonly asked questions.

• What exactly is health coaching?

• Why is health coaching such a powerful process?

• What is the health coach scope of practice?

• What is Functional Medicine health coaching?

• Who becomes a health coach?

• Who do health coaches serve and where do they work?

• What about legal compliance and ethical considerations?

• What should I look for when choosing a training program?

• Is health coaching a legitimate healthcare profession?

• What’s on the horizon for health coaching?

SECTION I: THE HEALTH COACHING PROCESS

What Exactly is Health Coaching? Chapter 1

“Health & wellness coaches partner with clients seeking to enhance their well-being through self-directed, lasting changes, aligned with their values. In the course of their work, health & wellness coaches display an unconditional positive regard for their clients and a belief in their capacity for change, honoring the fact that each client is an expert on their own life, while ensuring that all interactions are respectful and non-judgmental.”

National Board for Health & Wellness Coaching (NBHWC)

Health coaching evolved from life coaching

I received my doctorate in clinical psychology at Fielding Graduate University. My mentor, the late Dr. Fredric Hudson, was one of the visionaries behind the creation of the profession referred to as life coaching. In 1984, I had the privilege of spending many hours with Dr. Hudson as we planned The Mid-Career Development Institute, a program rooted in humanistic psychotherapy. Rather than serving those with diagnosed mental health conditions, the Institute met the needs of those wanting to find renewed meaning and purpose in their lives, both personally and professionally.

Participants came together for retreats, which were led by “coaches.” These professionals

may have come from a clinical psychology or counseling background, but when working with clients at these mid-career retreats, they employed the coaching process rather than engaging in psychotherapy.

Dr. Hudson believed that coaches “inspire passion and purpose in others.” They take people from where they are to where they want to be.

Health coaching evolved from life coaching. Michael Arloski, Ph.D., one of the early pioneers in the field, defines health coaching as the application of the principles of life coaching to the goals of lifestyle improvement for higher levels of wellness.

The Coaching Structure

Health coaches meet with clients individually or in groups. Sessions take place in person, over the phone, or online.

During the initial consultation, the client tells their story to the coach, shares their vision for what they would like their life to look like, and together they determine the best number and type of sessions for a successful outcome.

During coaching sessions, the coach and client collaborate to turn aspirations into achievable goals. Specific goals might be formulated around nutrition, hydration, exercise, relaxation, sleep, stress, or interpersonal relationships. A health coach educates and supports clients as they make diet and lifestyle changes. But the process isn’t just teaching them to eat this and not that, or get more sleep and reduce stress. A

The Coaching Process

“Trust the process” has been my mantra ever since I trained in humanistic psychotherapy back in the 1970’s. Many new coaches mistakenly believe that it’s all about the content. They often believe that they need to plan ahead before going into a session. This can’t be further from the truth. It’s not about the content, i.e., the words that are spoken or the themes discussed. It’s about the process: the emotional connection that’s established, the permission to be oneself, the experience of being fully heard and held in unconditional positive regard.

vital component of the coaching process involves helping people discover their own power to change.

Due to the client-centered nature of coaching, the coach doesn’t set the goals, but helps the client establish them through an inquiry process that consists of open-ended questioning. The coach facilitates a decisionmaking process that begins with determining where the client wants to start their unique journey towards better health. While brainstorming ideas, the client arrives at their own conclusions.

Because the client determines the agenda and sets the goals, they experience a strong sense of empowerment. I cannot emphasize enough the importance of allowing the client to “be in the driver’s seat.”

The incredible power of coaching lies in the process. First and foremost, it’s how people become inspired to change. It’s also the reason why coaching wins as one of the most rewarding professions.

Four key features result in client engagement and commitment:

Establishing Rapport

Being in rapport means the ability to enter into another person’s model of the world, and communicating that you truly understand that world in a congruent way. The perception of being understood must be established, as it’s critical for engaging someone’s trust. It also functions as the launching pad for actively leveraging the power of the coaching relationship.

Building rapport consists of creating the safety that allows the other person to be completely themselves, and feel comfortable enough to risk change.

Building rapport enriches not only the client, but the coach as well.

Open-Ended Inquiry

Closed-ended inquiry usually has single word, or “correct” answers. These are questions that don’t require the client to provide insight into their experience in order to answer. They tend to deal in the realm of facts more than thoughts and feelings. Questions that can be answered by a simple “yes” or “no” may close off the conversation.

“Do you understand the doctor’s recommendation?” is an example of a closedended question. In contrast, “tell me your thoughts about the doctor’s recommendation” represents open-ended inquiry.

One of my favorite open-ended questions is “what do you want your health for?” This line of inquiry leads to discovery of meaning and purpose and enhances motivation.

Becoming an Ally and Guide

Client-centered coaching translates to taking the client’s side as a way of facilitating the best possible outcome, no matter what happens, no matter what the client does or doesn’t do. The coach who acts as a genuine ally chooses to see each of their client’s choices as purposeful. In instances where the coach doesn’t understand particular choices that the client made or is choosing to make, they employ open-ended inquiry to look for strengths and elicit a positive outcome. The client knows that the coach is a staunch supporter and will remain by their side, no matter what choices they decide to make or not make. As a result, they typically remain open to opportunities to try new tactics, particularly when their choices haven’t yielded the results they want.

The coach acts as the guide and navigator. When embarking on a journey, in this case, a journey to health, a guide can mean the difference between success and failure to reach the destination. Clinicians who act as the experts by providing advice and recommendations are often at a loss as to why people don’t follow what they were told to do. Having an ally and a guide can make all the difference.

Like humanistic psychotherapy, first and foremost, the health coaching model is client-centered and non-directive. It involves a combination of self-discovery and selfmonitoring, in addition to education, goalsetting and accountability.

Sandra Scheinbaum

Health coaches guide clients on their journey towards better health and well-being. They help people find the intrinsic motivation to create sustainable change.

For clients suffering from chronic illnesses, the health coach often acts as their advocate and navigator through the web of medical care. The health coach makes the difference between “getting doctor’s orders” and actually following through.

The client-centered nature of coaching transforms the coach as well as the client. Stepping into the role of advocate and guide yields profound satisfaction.

Being an ally involves maintaining unconditional positive regard for the client. A defining principle of humanistic psychotherapy, it’s the act of seeing another person as perfect and whole at the present time, regardless of their behavioral choices.

The coach accepts the individual as they are. By doing so, and refraining from judgment, the client perceives the coach as being “on their side.”

Creating a Meaningful Connection

A sense of belonging and positive connections to others significantly contribute to both mental and physical well-being. Research in positive psychology, (a cornerstone of the coach training at FMCA that we’ll discuss in a later chapter) supports the power of meaningful relationships.

In a client-centered relationship, the coach is both the teacher and the student, the leader and the follower. Both coach and client benefit from the meaningful connection that their relationship provides.

Coach Reflections

Listen to health coaches describe the experience of deep connection and the immense joy they experience from establishing meaningful relationships with clients.

“Becoming a health coach fulfilled both “I am a very curious person and love learning and hearing about someone’s story, where they come from and where they hope to go. I feel a sense of pride in knowing I can help support someone on their journey to a healthier, happier and fuller life. I love seeing people grow into their optimal, most healthy version of themselves.” Andrea White

“I love the first meeting with a person and hearing their story. Then, seeing them figure out what healthy habits they want to add in, and how they’re excited over it and proud of their accomplishments - that’s the best.” Beth O’Leary

“My greatest joy is actually ‘connecting’ one-on-one with clients and asking questions that open their minds to how best to care for themselves and how to set and pursue goals for healing.”

Lura Kay Robison

“What I love most about being a health coach is the honor of taking the journey with the client. It is so gratifying and empowering to see them learn about themselves and get revitalized by their plans and commitments to improve their health. Many clients have had a hard road and felt less than optimistic and seeing the transformation through small but significant victories is a gift for them but also to me; they light up with possibility and hope. It’s the best feeling to see someone succeed and transform.”

Tita Arroyo

Pause to Reflect

• Imagine how strong and powerful a relationship becomes when the other person knows that you’re holding them in unconditional positive regard.

• Imagine having an ally and being the recipient of unconditional positive regard.

• Consider times in your life when you had a trusted guide.

CHAPTER 2:

Why is Health Coaching Such A Powerful Process?

I consider the coach to be the most powerful person on a medical collaborative care team. Why? Because they’re the behavior change specialist. They support people through the process of finding their motivation and the resources needed to create lasting health, and reduce or eliminate the particular conditions they may be suffering from.

Here’s seven of the crucial ways that coaches support clients:

1. Takes the time to truly listen

2. Provides education and clears up confusion

3. Facilitates problem-solving and resolve ambivalence

4. Helps set realistic goals and celebrates tiny wins

5. Provides crucial emotional support

6. Promotes self-management

7. The coaching process is equally powerful for the coach

Takes the time to truly listen

• “I went to my doctor and they only spent seven minutes with me.”

• “I tried to tell my doctor what was wrong, but didn’t feel like they heard me.”

• “They weren’t interested in what I had to say.”

• “My doctor was looking at the computer screen while I was talking.”

• “I felt rushed during the appointment.”

How many times have you heard people voice these types of comments after seeing their doctor? Now consider the significant impact of being heard, the positive effect of being with someone who is truly listening. First and foremost, coaches are listeners. By doing so in a nonjudgmental manner, they become allies. Coaches are frequently described as “personal cheerleaders.” That’s what makes coaching such a powerful process.

2

Provides education and clears up confusion

• “I didn’t get a chance to ask my doctor all my questions.”

• “I have unanswered questions because I was too embarrassed to ask my doctor.”

• “I don’t understand why my doctor wants me to do this.”

• “I’m not sure why I need all these medications that they prescribed.”

• “I walked out of my appointment feeling confused.

Health coaches are trained to listen. I believe that’s their most important role because it validates the client’s experience and leads to a sense of empowerment. A second role is that of educator. The examples above show that people are often confused when they see their doctor or leave with questions still unanswered. There may not have been an opportune time to ask the question, perhaps they felt rushed, or maybe they were reticent to ask due to shame, embarrassment, or simply not thinking the question was important enough to waste the doctor’s time on.

Health coaches convey the message that there’s no such thing as a dumb question. They let clients know that having a coach means they have an ally and an advocate. Clients come to appreciate that their coach has the time to answer questions, or find the answers to any they can’t answer.

Health coaches make sure that clients understand their practitioner’s plan of care. How do they do this? They listen and ask the right questions to make sure that clients are

not confused, and are fully-committed to following the plan that their healthcare provider laid out.

3

Facilitates problem-solving and resolves ambivalence

Another important reason why the coaching process is so powerful has to do with helping people make choices. Let’s face it: lifestyle change is hard. People hear lots of conflicting advice from experts, particularly regarding diet and exercise. Coaches are not experts; they do not take a stance and tell their clients what they should be doing. Instead, they guide people so that they arrive at their own conclusions. Coaches accomplish this by listening and asking questions so that clients realize the pros and cons of each decision. The process may involve asking clients to remember how they felt in the past when they made a particular choice. Alternatively, clients are asked to imagine their future self and determine whether the direction they choose at the present time supports or hurts their ideal future self. In this way, clients resolve ambivalence about committing to making healthier lifestyle changes that may be difficult to initiate and sustain.

4

Helps set realistic goals and celebrate tiny wins

One of the most effective ways that coaches inspire people to commit to change is to break down goals into realistic, achievable steps. Big goals morph into smaller increments that are of the client’s choosing. The client is in control of setting their goals at all times. They decide how and when they want to start and how they want to be held accountable by the coach.

There’s something inherent in coaching

behavior change that makes the process particularly magical. That has to do with celebrating tiny wins. The renowned behavior change expert, B.J. Fogg, author of Tiny Habits, coined an emotion called “shine” that captures the essence of how you feel when you accomplish something that you set out to do. The coach helps their client understand that the most powerful step is the first one and when the client accomplishes that initial step, no matter how small it may be, the accomplishment is acknowledged and celebrated together. Imagine an athlete crossing the finish line and spontaneously throwing up their arms, jumping in the air and saying “yes!” That’s shine! It’s a powerful feeling that’s experienced by both the client, as well as the coach who was at their side.

5

Provides crucial emotional support

Coaches are not therapists; they don’t offer psychotherapy. They do provide essential emotional support that involves helping clients build resilience, typically through acknowledging and expressing their signature strengths. Coaches show up for their clients with compassion and offer hope that problems can be resolved.

The reason coaches provide emotional support connects to their role as a nonjudgmental listener and an ally. Just being heard is therapeutic. Having an alliance with another human being alleviates loneliness. It shows the client that they are not “crazy” for having particular thoughts and feelings and are not alone in their suffering. The coach guides the client to experience hope and imagine that they can create a better, healthier future for themselves.

We’re seeing a rapid growth in behavioral health coaching. What’s encouraging about this initiative has to do with the removal of labels and the stigma of psychiatric disorders. As a clinical psychologist, I saw the emotional toll that so many experienced as a direct result of being diagnosed with a psychiatric disorder. A health coach who engages in behavioral health coaching does not focus on what’s wrong or broken, but helps normalize symptoms and offer individuals a road map for change that includes awareness of how poor diet, lack of exercise, insufficient sleep, and stress contribute to emotional distress, anxiety, and mood shifts.

6

Promotes self-management

The ultimate goal of coaching is to guide people towards self-actualization. Coaches help clients realize that change is up to them. They can take charge and become the CEO’s of their health. During coaching sessions, clients always take the driver’s seat, determining the direction of the conversation, as well as how, when and if they’re ready to change. The special nature of the coaching process has to do with client empowerment.

7

The coaching process is equally powerful for the coach

Witnessing the behavior change journey unfold is incredibly satisfying for the coach and makes their work meaningful. Over and over again, I hear coaches describe the joy they experience when helping people change and celebrating wins together.

Coach Reflections

“I have gratitude for the ability to hold a safe space for my clients to be heard and cared for. I always meet my clients where they’re at and support them at their own pace to work on their health goals. When I see my clients reclaim their health and freedom it’s a very precious and special honor.”

Carla Alpert

“My favorite phrase to hear from a client is: ‘It’s just not worth it!’ That tells me they picked something to work on, they stuck with it long enough to feel the positive effects, they’ve gone back to the old habit and have felt worse. Now, they consciously decide which habit serves them best and they usually opt for that habit over the long term, and it’s ‘sticky.’”

Monica Tarr

Pause to Reflect

“I love the magic that happens when clients are introduced to their unique divine blueprint. Supporting them on their journey to achieve their full potential is so rewarding to me. When clients experience shifts in momentum, renewed confidence and a more integrated life, I am so grateful.”

Deborah Schapiro

“I am overjoyed when I see the transformation that occurs in the lives of individuals who enter one of our health and wellness plans filled with uncertainty and doubt to emerge 3-6 months later filled with confidence in their ability to develop a living personalized health and wellness plan that leads to a sustainable life transformation. In addition, these clients are a joy to serve because they are able to express their goals and take responsibility for doing the necessary work needed to reach their goals.”

Erien W. Fryer

• Imagine entering into a deep relationship with a client that will be as transformative for you as it is for the client.

• Picture yourself being uplifted because you became someone’s ally and witnessed their journey to health?

Sandra Scheinbaum

CHAPTER 3:

What’s the Health Coach Scope of Practice?

All of the services that health coaches can legally and ethically provide are commonly referred to as their scope of practice.

The “secret sauce” lies inside the scope of practice!

The health coach scope of practice encompasses all of the ways that they support, guide and educate clients towards better health. Consider all that’s within the health coach scope of practice as the “secret sauce.”

The

following

What’s outside the scope of practice?

Health coaches aren’t licensed providers and don’t provide the types of services rendered by medical doctors, mental health or nutrition professionals. Rather, as the behavior change specialist, they play an important role on collaborative care teams alongside clinicians and allied healthcare professionals.

areas are considered to be outside the coaching scope of practice:

Diagnosing medical or psychiatric conditions

Developing treatment plans

Providing psychotherapy

Ordering and interpreting lab testing

Recommending medications and supplements

Recommending specialized diets

The coach does not make recommendations; instead, they listen, ask questions, and educate. They support clients by helping them mobilize their internal strengths and external resources. They provide guidance by clarifying the physician’s diagnosis and plan, and referring to resources from national-recognized authorities and evidence-based research.

Read how health coaches describe the power of the coach’s scope of practice.

Coach Reflections

“Nothing is more satisfying than sitting back and listening to a stressed out, overworked, chronically fatigued woman have her own moment of enchantment and brilliance where there is the realization that she, like Dorothy from the Wizard of Oz, has had the power all along to be able to become the glorious goddess she was meant to be! When a client comes to the turning point of radical self-honesty and then turns it into a comprehensive health revolution that changes her whole life, there is nothing better than the privilege of seeing that alchemy unfold!”

Tiffany Zwingli

“I get excited when I see my clients excited about their own progress, when they have made some significant, difficult changes and have seen life-changing results. Even more so, I get excited when I see them taking more and more responsibility for their own self-care.”

Jane

Webster

“Nothing feels better than when a client no longer needs my help! Hearing that they’ve learned how to listen to their body, embraced how the choices they make changes their body chemistry for the better, and mastered lifestyle modifications to the point where they’re now thriving on their own is a twofold gift–it confirms I’ve been effective as a coach, and means another member of our local community understands the power of working mindfully with our bodies instead of just medicating away symptoms.”

Kimberly Kaye

“I wanted to be able to empower others to realize their full health potential; to help people learn more about themselves and how the choices they make around food, sleep, stress, or their environment, have a direct impact on the quality of their life.”

Crystal Sgro

The coach as educator

Coaches provide crucial information so that clients can make their own decisions, and that’s more powerful than giving direct advice. This process is way more effective than telling people what to do. If you’re thinking, “this sounds restrictive” or “I want to be able to tell my clients what to eat or how to exercise,” you’re not alone. Many prospective coaches think that’s the power of coaching and may even be drawn to the profession for this reason.

Receiving advice from experts often fails. People may possess the knowledge needed to lose weight or engage in an exercise program. Although they’ve been told by a healthcare provider, read advice in a book or magazine, heard suggestions on a podcast or news report, unlike the famous Nike quote, “just do it,” they “don’t just do it.” They require support and accountability, not merely education.

Coaches can be great resources for healthrelated information. At FMCA™, we encourage our graduates to stay up-to-date on the latest research and recommendations. They definitely play a strong role as health and wellness educators. However, their unique position as the behavior change specialist sets coaches apart from the advicegiving experts .

The coach as behavior change agent

Health coaches provide education, but the process involves so much more than that. It empowers the client to make lasting changes for better health and well-being.

Implementing and sustaining diet and lifestyle changes can be hard. Working with a coach closes the gap between intention and behavior.

In fact, acting as a behavior change agent creates profound satisfaction for the coach and is one of the primary reasons that so many decide to become health and wellness coaches.

Here’s what health coaches had to say about the joy of guiding clients towards healthy lifestyle changes.

Sandra Scheinbaum

Coach Reflections

“I am happy to see my clients thrive as a result of the new habits they have been able to implement. We all know how hard it is to change habits and being able to support people to change their lives and thrive is an awesome experience.”

Juliana

Nikolova

“I love seeing people discover the resources, strength and motivation within themselves to achieve their goals. Seeing hope renewed and transformation happen before your eyes is truly rewarding and I feel privileged to be able to walk alongside people on their journeys.”

Claudette

Jordan

“I became a health coach because I have a true calling to help others heal. I studied psychology for 6 years in college and not one class focused solely on comprehensive strategies for behavior change (usually just research around goal setting as a motivator), and typically just analysis and assessment of behavior. Health coaching is the answer to true behavior change, healing and wellness.”

Keri Sitrick

“Coaching provides me with the opportunity to align my values and strengths as I support others to do the same. I am energized by working with individuals who are seeking greater integrity, a clearer sense of purpose and transformational change. Coaching is a powerful and effective way to help clients bridge the gap between where they are and where they want to be.”

Deborah Schapiro,

Pause to Reflect

• Were there times when you were given advice by an expert, but found it hard to implement?

• Have you seen family members receive recommendations but struggle with adherence?

• What would it be like to have a coach who provided education and support, but always acknowledged that you were in the driver’s seat?

• Imagine the power of setting your own goals and having an ally to help you achieve them.

CHAPTER 4:

What is Functional Medicine Health Coaching?

In 2015, the Functional Medicine Coaching Academy™ pioneered a new type of health coaching: the merger of Functional Medicine, functional nutrition, positive psychology, and mind-body medicine principles with the art and science of coaching. Let’s first define the Functional Medicine and positive psychology approaches to physical and mental health.

The Functional Medicine Approach

Dr. David Perlmutter, a world-renowned Functional Medicine neurologist, describes Functional Medicine as the opposite of “dysfunctional medicine.” Based on systems biology, the Functional Medicine approach identifies the root causes of disease, such as underlying inflammation, and acknowledges the important contribution of lifestyle factors to the development of clinical imbalances. Rather than “one size fits all,” Functional Medicine is personalized medicine.

A Functional Medicine approach prioritizes listening to the client’s story to gain insight into the physical and social environment that caused their genes to express themselves through patterns of chronic illness. By actively listening to their patient’s story, Functional Medicine practitioners discover the antecedents, triggers, and mediators that underlie discreet symptoms and specific illnesses.

Functional Medicine involves a conscious synthesizing process that answers the

questions: Who is this person? Why are they experiencing these symptoms? How can they thrive again? When piecing together the puzzle that each new client presents, the process of mapping symptomatology to the experiential timeline of a client’s life provides clues for the direction of their healing.

The treatment plan created by doctors trained in a Functional Medicine approach typically considers nutrition, hydration, exercise, stress, toxic load, sleep and social relationships. That’s where the health coach comes in, as these are the areas they address with clients.

Many people are drawn to health coaching because they overcame a health challenge themselves. As a result, they have a strong desire to help others heal. This phenomenon is particularly pronounced when we consider the number of prospective health coaches drawn to Functional Medicine health coaching.

Coach Reflections

“It began with my own health journey. I sought answers to my health issues and discovered a holistic approach to health. As I applied Functional Medicine principles, I saw great results. I was so inspired that I wanted to learn more and help others thrive.”

Yvette Aungamuthu

“After battling undesirable symptoms for 10 years I discovered the Functional Medicine approach, and it was my cure. I knew of too many friends and family members who were also suffering from symptoms and I wanted to be able to help. Health coaching seemed like a great place to start!”

Alexandria Larsen

“After facing a health crisis and being introduced to Functional Medicine, which set me on a healing journey, I wanted to make it my purpose to educate and empower others in achieving their health goals.“

Kathy Borthwick

“I was inspired by my own incredible experience with Functional Medicine and lifestyle change. I wanted to share that inspiration with others. I am passionate about the ability of Functional Medicine and all aspects of healthy lifestyle to prevent and heal. I wanted to have a positive impact on the health and wellness of others by educating, supporting and empowering them with the tools of Functional Medicine and positive lifestyle changes.”

The Positive Psychology Approach

Positive psychology nurtures what’s best within people to help them thrive. The focus is on what’s right, not what’s wrong with them.

The application of character strengths constitutes a key element of positive psychology. Considered the foundation for well-being, character strengths are the traits that allow us to thrive. They’re what’s best about human nature and everyone has the capacity to express these essential traits. Some are of the heart, such as love and kindness, while others are of the mind, such as judgment and perspective.

Coaches trained in positive psychology help clients discover their signature character strengths and use them as “psychological capital” to change behaviors, find both physical and mental well-being, build resiliency, and lead more meaningful lives. Guiding the client to discover new perspectives and possibilities initiates a process of growth and transformation.

The coach listens for opportunities to reframe the client’s story in light of their unique strengths and helps them discover the redemptive aspect to their personal narrative.

Marisa Pizzuto Jurassic

They help the client find new meaning in their life stories and become the best version of themselves. This version is the one closest to their dreams, values, commitments, and the

kinds of relationships they want to cultivate. Clients choose their preferred way of being by using their character strengths.

Functional Medicine Health Coaching

At FMCA™, we created a coaching model that merges the positive psychology approach with Functional Medicine principles because we believe that this combination is uniquely suited to helping individuals preserve or restore their physical and psychological well-being. Both Functional Medicine and positive psychology provide a road map for thriving. Integrating these principles creates profound transformations and many health coaches tell us that their own lives, as well as the lives of their loved ones, are positively impacted as a result of studying these disciplines and applying them personally.

A Functional Medicine health coach educates and supports the client as they make important diet and lifestyle changes. Although the coach may know what areas need to be addressed, the client chooses what to work on and where to begin. The process entails acknowledging and using character strengths to build resilience and enhance motivation to change.

Making changes in modifiable lifestyle factors can be challenging. Education is not enough. Scare tactics fail. Coaches support clients as they make the difficult behavior changes required to prevent or reverse chronic disease. That’s why an increasing number of Functional Medicine practitioners are adding Functional Medicine health coaches to their team.

The most important role of a Functional Medicine health coach consists of creating a partnership with clients to discover the

mental, emotional, and spiritual components that drive their motivation to heal. The process begins by listening to the client’s story. The importance of understanding their unique experiences cannot be overemphasized.

The Functional Medicine approach consists of more than hearing the client’s story and the sequence of events in their life. It’s about understanding the client’s interpretation of these events.

The Functional Medicine physician and coach work together to provide a road map for the client’s healing journey. While practitioners create a timeline of significant life events, including medical history, the Functional Medicine health coach ensures that clients fully understand how modifiable lifestyle factors created and perpetuate the current health challenge. The coach and client work together to identify ways to change the story by changing the environment and changing the client’s vision of what’s possible.

I believe that the most important job of a health coach involves creating a partnership with clients to discover what will drive their motivation to heal. Both from personal and clinical experience, I’ve seen that people change when their minds and hearts change, and when their beliefs about what’s possible changes. They often experience a crucial “ah-ha” moment of discovery.

What brings coaches the most joy?

We asked our graduates to describe what brings them the most joy and satisfaction. Many referred to a discovery process and a journey towards enlightenment that they share with another human being. Over and over again, they spoke about that “aha” moment that occurs as a result of the coaching process

Coach Reflections

“My reward is the transformation that I am able to bring out in my client’s lives, the fact they finally have hope and faith in themselves and feel empowered to take charge of their own health, plus the changes that my clients make in terms of mindset, lifestyle and their diet so that they can not only create but sustain health for the long run.”

Anindita

Guha Maulik Rungta

“It brings me joy and satisfaction to educate and empower clients to make positive lifestyle changes and experience real healing and wellness. It is very satisfying to witness clients experience their own learning, growth and change by using food as medicine and evidence based tools of Functional Medicine. I am grateful for the gift of empowering others to have enhanced wellness and joy as it allows me to feel that my life has great purpose.”

Marisa Pizzuto Jutras

Pause to Reflect

“Facilitating the process for my clients to discover and trust their own Super Powers (aka Character Strengths!), and witness their beautiful transformation once they implement simple, micromoments and 5-minute techniques into their day, one day at a time!”

Benedict Sivarajasingham

“Far and away, I get the most joy and satisfaction from coaching when one of my clients has an ‘aha’ moment — that point when they connect the dots and see things in a whole new way.

Sometimes it’s the recognition of how their behaviors and habits are directly impacting their well-being. Sometimes it’s connecting with what matters most to them. Sometimes it’s seeing themselves in a new and more positive way. Just watching it happen is gratifying enough, and when the client thanks me for helping them achieve that insight, it is such a wonderful feeling, it reminds me why I do what I do. It brings me joy when a client says thank you for the littlest improvement. I love to see the growth of scientific information to share with clients.”

Jennifer Newton

• Imagine the satisfaction that you feel when you guide someone towards a life-changing realization.

• Imagine helping people experience an “aha” moment

SECTION II: ENTERING THE HEALTH COACHING PROFESSION

CHAPTER 5:

Who Becomes a Health Coach?

People from all walks of life, of all ages, gender and nationalities enter the rapidly growing field of health coaching. Although their background may differ, they share some defining characteristics. From my experience, I can say with certainty that prospective health coaches possess a deep desire to help others. Many also overcame their own medical challenges, or helped a loved one get well, and now they want to guide others on a path to health. The process of health coaching gives them meaning and purpose, often for the first time in their lives.

Individuals with a deep desire to help others

Health coaching offers the opportunity to find meaning and purpose because guiding clients on their wellness journey provides immense satisfaction. It feels good to “do good” in the world.

Individuals who overcame health challenges

The driving force for becoming a health coach could be deeply personal. Choosing health coaching as a profession may have stemmed from the experience of being diagnosed with a chronic illness. Finding the medical establishment lacking sufficient answers, they set out to discover ways to overcome their health issues.

Perhaps someone experienced a health crisis, saw one practitioner after another because the answers provided to them were lacking or nonexistent, and found themselves alone in their suffering. Rather than give up, they kept searching for solutions and eventually journeyed back to health. As a direct consequence of their illness and personal suffering, people frequently decide to transform their lives, including finding a new career path. I would say that the majority of our FMCA graduates share a version of this story when asked why they chose to become a health coach.

Individuals who saw a loved one suffer

Another common theme that draws people to health coaching is witnessing the suffering, and often the untimely passing, of a family member or close friend. They make the decision to become a health coach so that others won’t experience the same fate.

Coach Reflections

“I chose to become a health coach because all people deserve to feel well and thrive. We are surrounded by outdated beliefs and information about food and health and often disconnect our lifestyle choices to our health status. I feel it’s part of my mission and life’s work to help awaken people’s awareness to the simple and powerful ways that they can heal themselves and prevent chronic illness so that they can have more energy to enjoy their lives, families, work and activities.”

Erica

Zygelman

“I struggled with an eating disorder throughout my teen years, then again in my 20s. After doing a lot of work on myself to reverse the damage done to my body over those years, I decided I was ready to be a part of the solution rather than the problem and help others find their way to optimal wellness.”

Rebecca Arsena

“I went through a lot of stress in my life and this had started impacting my health. Through lifestyle changes, I was able to make remarkable improvements and handle my stress much better. This made me realize that there is a lot within our control and I felt empowered! I really wanted to share this experience with others who might be in similar situations.”

Sudha Gopal

“When doctors and psychiatrists continued their failed and frustrating message that pharmaceutical and cognitive behavior therapy were my daughter’s only lifetime treatments for debilitating fear, irritability, chronic worry, repeating thoughts, fatigue, joint pain and more, crushing her ability to live out her dreams and passions, enough-is-enough pivoted my career. I did the only thing a mom can do—I got busy and searched for a way to take care of my girl. Health coaching gave me the tools to help her, and now others, live easier, healthier and happier.”

Debbie VanderWeyden

Health coaches have diverse educational and career backgrounds

Health coaching is open to all who have a mission to serve others. Some are attracted to the profession after having worked in healthcare or the wellness industry. Others have no previous background in healthcare. Many are coming out of retirement to become a health coach.

There are no age limits or educational prerequisites to train as a health coach* (*note that if you seek national boardcertification through the National Board for Health &Wellness Coaching an associates degree or higher is required).

Previous training in a healthcare field

Many choose coaching after working in healthcare fields, including nursing, medicine, pharmacy, physical or occupational therapy, and nutrition. Others have prior experience in the wellness and food industry, such as fitness trainers, yoga teachers, Pilates instructors, and chefs.

Despite having trained in a wide range of healthcare professions, what stands out is how these healthcare professionals found the practice of health coaching to be a refreshing change. By using the coach approach rather than acting as the medical expert, they not only provide better care, but experience renewed meaning in their work.

Coach Reflections

“After experiencing major shifts in my health with Functional Medicine and health coaching, I wanted to learn as much as I could. I had been a practicing occupational therapist and it has been incredible to take off my expert hat (OT) and use a more ‘client-centered’ approach. It’s been great to see clients SO empowered instead of being directed.”

Jill Booth-Clibborn

“As a psychologist I have always been passionate about helping people focus on holistic wellness rather than only treating ‘illness.’ Walking my own journey in the patient’s shoes having an autoimmune condition and hormonal imbalances but not receiving any assistance from traditional medicine, I bumped into Functional Medicine on my quest to help myself heal, learned all I could and applied it to myself. My life was transformed! Being a spiritual person, I came across a quote that read, ‘You have been given this mountain to show others that it can be moved’ and immediately felt energized and full of purpose to help my patients and others find hope, healing and optimal health.”

Claudette Jordan

“I became a Functional Medicine health coach to be a greater advocate to my dental hygiene patients by connecting whole body health. Health coaches are a valuable asset in the medical and dental fields. It’s a career I can continue to grow in.

Antoinette Alaimo

“I am a Reiki Master Teacher specializing in brain health and I help people of all ages to shift their energy and mindset. Healing starts from within and being aware of making conscious decisions that are going to improve our wellbeing. Being a health coach helps me to be my client’s ally to achieve overall well being in every area of their lives.”

Marilyn Ocasio Forward

“With nearly 18 years of testing new medications in development with clinical trial volunteers, I discovered that health could not be found in a pill. Rather, health resides within each of us and can be cultivated through a trusting, compassionate relationship. Embarking on training to become a health coach allowed me to put my patient engagement skills to use in new ways, generating sustainable outcomes aligned with clients’ deepest needs and desires, on their terms.”

Allison Kelly

Sandra Scheinbaum

No prior training in a healthcare field

In Resonant Leadership, Richard Boyatzis describes three elements as key to positive interactions: mindfulness, hope and compassion. Those who become health coaches describe a passion for helping others and a desire to serve. Put this together with mindfully listening, conveying hope, and showing compassion and you have the prerequisites for becoming a health coach.

Coaches come from all walks of life that are outside of healthcare, including corporate, education, entrepreneurship, legal, marketing, engineering, technology, and stay at home parenting.

Some of the best health coaches have no prior training or experience in health and wellness fields. They’re starting fresh, without any previous training that may have led them to assume the role of the healthcare expert. When you’ve worked for many years as a practitioner, you may be used to acting as the expert. You come up with the diagnosis and the treatment plan. Then you tell your patients what they should and should not do. That’s not the coach approach. Coaching is a participatory process where the client ultimately makes the decisions. When you understand this fundamental coaching principle, then you’re on your way to becoming a health coach, no matter what your previous training may have been.

Coach Reflections

“The vast majority of people need help navigating and understanding the overwhelming world of health & wellness. Chronic disease rates are skyrocketing and I want to help people be more proactive with their health before it’s too late. Specifically with longevity and brain health. I was at a crossroads in my professional career—I was making money and had the title, but I was deeply unhappy, unhealthy and stressed.”

Kim Hochman

“I have been passionate about holistic health and nutrition for 30 years, but my education took me down a different career path. After years of career dissatisfaction, I decided that enough was enough. I didn’t think it would be worth putting the time and money into a nutrition degree, so I hired a career coach and we discovered that health coaching was a great option. After much research, I found FMCA and couldn’t be happier to work in a career that serves my purpose and passions!”

Lis Wiesenthal

Pause to Reflect

“I was retired and looking for something meaningful to do. When I discovered the Functional Medicine Coaching Academy, I realized that I could use the loving, nonjudgmental attitude that I enjoyed in my previous work, while adding a fresh component of helping people specifically to move toward optimal health.”

Kirin Loomis

“I am a Reiki Master Teacher specializing in brain health and I help people of all ages to shift their energy and mindset. Healing starts from within and being aware of making conscious decisions that are going to improve our wellbeing. Being a health coach helps me to be my client’s ally to achieve overall well being in every area of their lives.”

Marilyn Ocasio Forward

• Can you relate to wanting to make a real difference in the world by pursuing a career that’s tied to meaning and purpose through serving others?

• Have you also overcome a health challenge or witnessed loved ones battle debilitating conditions, and now want to help others suffering from the same or similar issues?

COMMONLY ASKED QUESTIONS:

Do coaches need formal training in nutrition?

When doctors contact FMCA to find a health coach for their practices, they frequently confuse health coaching with nutrition counseling. The two disciplines are quite distinct and each of these professionals belongs on the collaborative care team.

Effective health coaching requires a skill set that’s different from the requirements to become a nutrition professional.

The curriculum of robust certification programs for health and wellness coaches differs from the educational content that nutritionists and dietitians receive. Training in the client-centered approach to behavior change requires specialized education that incorporates both a deep dive into the study of coaching principles along with adequate time in their course of study for experiential learning and practice coaching.

As a result of highly-specialized training, health coaches function as experts in behavior change. They help facilitate change across all of the modifiable lifestyle factors, not just nutrition. Therefore, at FMCA,

students learn about how to coach exercise and movement, sleep and relaxation, relationships, and stress transformation, in addition to nutrition and the psychology of eating.

Rather than acting as experts in nutrition, coaches refer to the expertise of nutrition professionals and other medical experts. However, many health coaches do have prior training in nutrition and are licensed nutritionists or registered dietitians. But this training is by no means a prerequisite to becoming a successful health coach. In fact, many who come from previous healthcare fields where they were accustomed to acting as the expert who “told the patient what to eat” struggle with the client-centered approach.

Can doctors and other providers become health coaches?

You don’t need to choose between being a practitioner and a coach. Increasing numbers of healthcare practitioners, including physicians, pursue training in health and wellness coaching.

Become a health coach by using any of these three models:

1

Integrate

the coach approach within your existing practice.

By incorporating coaching strategies, such as open-ended questioning, you’ll enhance the therapeutic alliance. Not only will your patients benefit, there’s a high likelihood that you’ll experience more satisfaction in your work and re-discover why you chose to enter the medical field.

2

Keep your existing practice and add a dedicated coaching business.

In this model, you’re switching hats. Maintain your professional license and continue to see patients. Simultaneously, establish a coaching business as a certified health coach. The key to creating dual roles is being crystal clear on precisely what constitutes each position.

Draw up a client agreement that clearly spells out the nature of a coaching relationship. Specify that you’re a licensed practitioner, but that they’re contracting with you for your services as a health coach. You will not be diagnosing or treating any medical condition. Make sure that both you and the client sign the agreement.

Maintain strict boundaries. This may mean having separate coaching clients and not coaching existing patients. If the need arises, refer those clients to medical colleagues. In other words, you’re not switching hats for any given individual.

To avoid confusion, refrain from acting like a medical practitioner when you’re coaching.

Pause to Reflect:

It’s easy to slip into the expert role. To further establish boundaries, always refer to those you coach as “clients” and those you treat in your medical practice as “patients.” Rather than referring to you as “Dr...” suggest to coaching clients that they address you by your first name.

When considering whether or not to “switch hats,” it’s important to bear in mind that in the event of a lawsuit or professional regulation complaint, you will be held to your highest license, which would be your medical license if you’re a physician. Take the time to put protective measures in place before starting to coach. The best risk management strategies are the creation of a clear coaching agreement with new clients, strict boundaries between your medical practice and your coaching practice, and adherence to the coach scope of practice when you wear the coach hat.

3

Close your existing practice and become a full-time health coach.

An increasing number of healthcare professionals describe feeling burned-out and exhausted. Many see themselves as data entry clerks and slaves to the electronic medical record system. Some may be frustrated by their particular licensing restrictions. Others are nearing retirement and want to continue to serve the needs of others.

Health coaching offers a path to pursuing a career that’s aligned with your meaning and purpose.

• Which of the pathways to becoming a health coach described above matches your current career status?

• Can you imagine incorporating the coach approach into your existing job?

CHAPTER 6:

WHO DO HEALTH COACHES SERVE AND WHERE DO THEY WORK?

Who do health coaches serve?

You have a calling to serve others, which constitutes a huge first step to becoming a health coach. An additional step involves envisioning who you want to serve when you finish your training,

Before considering the many ways that coaches work, let’s discuss the importance of specializing. This is often referred to as finding a niche. Many of our graduates with an entrepreneurial spirit launch their own businesses, often desiring to focus on a particular niche. It’s common to serve those who you resonate with or who suffer from conditions that you’ve experienced personally. Many coaches choose to serve individuals who have a similar cultural heritage or profession, specialize in female or male health, or narrow in on a particular age group, Some work with children and their families; others with people in midlife transition or the elderly.

Here’s just a few examples of the diverse populations that health coaches serve: Individuals experiencing the following symptoms or conditions:

• Chronic stress

• Burnout and exhaustion

• Hormonal imbalances

• Celiac disease

• Infertility

• Polycystic Ovarian Syndrome (PCOS)

• Female hair loss

• Mold and tick-borne illnesses

• Neurodevelopmental disorders

• Eczema

• Mild cognitive decline

• Alzheimer’s disease

• Type 2 diabetes

• Weight loss

• Chronic pain

• “Long-haul” Covid

Coach Reflections

“I want to help other people, especially the most vulnerable, such as immigrant Latina women who need to feel loved, whole and empowered.”

Laura

Gonzalez

“I’ve seen first-hand the individual suffering caused by dementia and Alzheimer’s disease to the ones who have the disease. I’ve also experienced the potential devastation the disease brings to a family. After learning that this disease can be largely prevented or reversed (if caught early), I wanted to become a health coach to help make that possible for many thousands of people.”

Monica Tarr

“I struggled with my self-image even though I didn’t have a weight problem. When I realized the role that our mind and our nutrition played in our well-being, I knew I had to share. My goal was and is to help women gain control of their lives by restoring that mind/body connection so they can look, feel, and be the best version of themselves.”

Nicole Batiste

“I became a Health Coach to help women who are struggling with health and wellness, to show them they are strong and it’s ok to take time for themselves.”

Lynda Kaye Prior

What are the Various Ways to Work as a

Health Coach?

Let’s discuss three primary ways to work as a health coach.

1. Establish your own business

• Do you have an entrepreneurial spirit?

• Are you a visionary who dreams of creating your own business?

• Do you long to be your own boss and set your own work schedule?

• Do you love to connect with others and form collaborations?

• Are you willing to persevere despite setbacks?

• Are you ok with a certain degree of financial uncertainty?

Looking back at my various careers before founding FMCA, I now realize that I’ve always had an entrepreneurial nature. During the time that I spent as a special education teacher in the 1970’s, I loved helping my students thrive, but didn’t enjoy working within a bureaucratic school system. So after 5 years, I left to establish a private practice as a learning disabilities tutor. Starting with one client, I soon had a roster of about ten students, all based upon word of mouth. I loved the experience of designing my practice and deciding who my ideal client would be, as well as the freedom of arranging my own schedule.

2.

Work for

a

When I earned my doctorate in clinical psychology, I chose to transition my private tutoring practice to one that specialized in health psychology. Once again, I accepted the reality of starting small. Through consistent networking and creating trusted relationships with physicians, I gradually built a successful practice. Early on, I recognized the importance of establishing a niche. I helped people with anxiety and stress-related physical conditions by teaching them biofeedback-assisted relaxation techniques combined with cognitive-behavior therapy.

medical practice as an independent contractor or employee

Here’s some questions to consider when looking for a job with a medical practice:

• First and foremost, what are the provider’s values, mission, and vision? While values and mission pertain to the present-day, the vision is future-oriented. Do you align with these important parameters?

• Is the provider trained in Functional Medicine or an integrative approach?

• What population does the practice serve?

• Is the practice part of a hospital or government-run healthcare system?

• Is the practice insurance or cash-based?

• Will you be expected to see patients in-person or remotely?

• Will you be given the opportunity to facilitate groups?

Work as an Independent Contractor

Although during my previous careers I primarily focused on building a private practice, I also entered into many contractual relationships. For example, as a learning disabilities diagnostician, I worked as an independent contractor for local school districts to provide psycho-educational testing. In these instances, I was paid a flat rate for each battery of tests that I administered. Similarly, as a clinical psychologist with expertise in personality testing, I contracted with psychiatrists to administer test batteries to their patients. My compensation was usually 50% of the fees collected.

Let’s suppose that after initial conversations with a medical practice, they express interest in bringing you on as an independent contractor. Now what?

The first step involves getting an agreement in writing. The practice may already have a template for hiring contract workers and wish to follow their standard operating procedures. If not, work with your own attorney to create an independent contractor agreement. In this contract, state that you’re engaging with the medical practice to deliver services to their patients. This may consist of the following:

• Information about the coaching services you’re offering, such as a package of sessions, typically eight to ten, that would be paid for in advance by the clients.

• Details about how the services would be delivered, such as in-person or remotely, either 1:1 or in a group format.

• Specifics regarding how you will invoice the practice and how they will pay you.

For example, you might contract with a practice to run a group program, such as a meditation group or a group for patients with type 2 diabetes. As an independent contractor, you could offer your services to a number of practices.

If the practices you work for are in the United States, they need to make sure that the terms of service meet the Internal Revenue Service requirements for classification as an independent contractor rather than a salaried employee.

Get hired as a full or part-time employee

I’m often asked about the average salary for a health coach. Pay scales vary widely and take into account experience, the types of responsibilities that you’ll be given, the geographic area where the clinic is located, and the specific population that they serve.

How can coaches be a source of income for practices?

Many practitioners mistakenly believe that adding a health coach to their team amounts to a financial drain on the practice. In fact, coaches can be an added source of revenue.

As discussed above, one popular option consists of paying you a percentage of the revenue collected by the practice for your specific service. You get paid when the business gets paid.

I advise health coaches to demonstrate in a variety of ways that they’re fully-committed to growing the practices of the doctors who hire them. Exceed expectations, such as bringing in new clients, and documenting positive changes in the clients that you work with.

Add value through “secondary skills”

In addition to helping clients thrive, you can benefit the practice by bringing in “secondary” skills. These may include building a social media presence, developing online courses, creating blogs or offering community presentations.

By demonstrating a great track record, you’ll become a highly-valued member of the collaborative care team. I’ve seen many health coaches create successful programs within the office that help both the doctor and allied staff decrease stress and prevent burn-out.

Show your value to the practice’s patients, the team, and to the financial bottom line. By doing so, everyone thrives.

3. Get hired by a company to coach their employees or customers

Employee wellness initiatives

The opportunities for employment by corporations, both large and small, and representing a variety of industries, are rapidly increasing. It seems like not a day goes by when I don’t see a press release announcing that a major company hired health coaches to promote employee wellness.

Insurance companies are increasingly adding health coaching as a benefit to their enrollees. This makes sense because when someone with a chronic medical condition partners with a health coach to address the lifestyle factors that may be the triggers or

perpetuators of these conditions, the need for acute care interventions and medications often decreases. As a result, healthcare costs go down, which is a desirable outcome for payers.

What company would turn down the opportunity to have a healthy workforce? Would they say no if you told their executives that signs of fatigue or burnout amongst employees would lessen, incidence of callingin sick would decrease, and healthcare costs would go down? Would they turn down an opportunity to have a more engaged, energetic workforce and better job

satisfaction? Would they want to deny their employees the possibility of thriving and increasing their physical and mental wellbeing? As a health coach, you could make these arguments.

Tell prospective employers that you have a model that has been demonstrated to improve physical and emotional health while

lowering healthcare costs. Show companies just how valuable your services are. Hiring a health coach for employee wellness is not only a way to increase the well-being of a company’s workforce, it’s good for the bottom line. Employee wellness run by a health coach yields a favorable return on investment.

Artificial intelligence-based (AI) platforms come with a health coach!

We’ve entered the era of the “quantified self” and the movement is growing. More and more people own wearables, such as smart watches, fitness tracking devices, or sleep monitors. They work out on AI-driven exercise equipment and receive personalized results from lab testing that they can order and perform at home. Having access to information from wearable devices or receiving personalized recommendations based on AI can be very beneficial and help people take charge of their health. It’s

Wherever they work, health coaches love what they do

No matter where health coaches find themselves working, it’s the connection with clients and the coaching process itself that brings joy to the coach.

increasingly possible to have access to bio-markers, but the reason that people are unhealthy is not typically due to lack of information. It’s because initiating and sustaining lifestyle changes are hard. The growing number of companies who offer AI-based platforms realize this fact. As a result, they’re starting to include access to a health coach with their consumer product or membership program. Expect this model of AI plus health coaching to explode in the future.

Coach Reflections

“Being in flow with my clients in their process of self discovery, hearing the small wins my clients are making gradually, and when clients come back to me and tell me I saved their life (even though it was all them), it makes all the hard work worth it.”

Zara Faisal

“My best days are the days I am coaching. Hearing a client say, ‘I never thought of that!’ and watching them succeed in fulfilling their health goals is most rewarding!”

Kathy Borthwick

Pause to Reflect

“I find joy and a true sense of purpose by serving others and partnering with them on their health journey. I admire the courage of my clients to share their stories with me and to embrace their inner wisdom to make positive changes in their life.”

Stephanie Staples

“The thing that brings me the most joy in health coaching is listening to my clients discover what works best for them. We are all unique individuals and have so much to bring to the table of good health. Their transformations and lasting changes are what makes it truly rewarding.”

Sandy Zielinski

• As you contemplate becoming a health coach, what would your ideal career look like?

• Who would you like to serve?

• Where would you like to work?

• Does the idea of launching your own coaching business excite you?

• Can you picture yourself working for a doctor?

• Are you excited by the thought of being an employee of an organization that’s developing new models of care?

• Would you like to work for a company that’s helping people track their health data?

CHAPTER 7:

What about Legal Compliance and Ethical Considerations?

At the present time, health and wellness coaches are not licensed as providers by any state government. Although anyone can hang up a shingle and call themselves a health coach, the industry has evolved considerably and standards have been put in place to protect the public This is largely due to the tireless work of the National Board of Health and Wellness Coaching (NBHWC), which you will learn about in Chapter 9.

An important requirement for becoming a competent and will-respected health coach involves understanding and adhering to guidelines set forth by NBHWC regarding scope of practice and code of conduct.

I also highly recommend that you take the necessary steps for risk management when entering the health coaching profession.

The following are some of the questions that we frequently get asked about.

Must coaches maintain HIPAA compliance?

Because health coaches are not licensed practitioners and therefore not “covered entities” under the Health Insurance Portability and Accountability Act (HIPAA), they are not LEGALLY bound by HIPAA regulations. However, HIPAA compliance needs to be maintained for ethical reasons.

You owe it to your clients to keep anything they share with you, whether orally or in writing, completely private. If clients want you to share their confidential information with someone else, they must grant formal written permission, commonly referred to as a “release of information.”

Do coaches need liability insurance?

Although there’s no legal mandate to carry professional liability insurance, it’s prudent to do so. Many places of employment require health coaches to have their own liability insurance and provide evidence that it’s up-to-date.

If you’re working for a medical practice, whether as an employee or an independent contractor, that organization would most likely list you on their malpractice policy, just as they would any other allied staff member.

Can coaches work remotely and across state lines?

Health coaches increasingly work remotely and virtual sessions, whether one-on-one or in a group format, are becoming the norm. The worldwide pandemic accelerated the trend away from live encounters. Thanks to online platforms like Zoom (which offers a HIPAA compliant version) it’s possible to create powerful engagement.

Health coaches are currently not licensed as medical practitioners by any state governing body. Therefore, they can work across state lines. This holds true whether they’re working in a medical practice, running corporate wellness programs, or operating their own health coaching business.

Pause to Reflect

• Imagine entering the health coaching profession full-equipped to set up your business.

• If legal and ethical issues seem daunting right now, can you rest assured that experts provide education and guidance?

CHAPTER 8:

What Should I Look For When Choosing A Training Program?

As health and wellness coaching catches on, more people want to train to become coaches. As an increasing number of people call themselves health coaches, will the job market be overrun by trained coaches? Will there be too much competition for jobs?

The belief that the health coaching profession is already saturated, or will be in the immediate future, cannot be farther from the truth. The more health coaches we have, the more credible the profession becomes. As of 2021, there are approximately 109,000 people

Questions to consider:

1. First and foremost, does the program match your values?

2. What’s the program’s mission?

3. How long have they been in business?

4. Do they provide experiential learning where you practice what you’ve been taught, rather than just passively taking in the information.

5. Are there facilitators who provide feedback to you?

6. How long is the training program?*

7. Who comprises their faculty roster? Are they subject-matter experts?

8. Are the program developers accessible to students and graduates?

identifying themselves as health coaches in the United States. Compare that to just over one million professionally active physicians in the US. Consider joining the ranks and encouraging others to enter this rewarding profession. The world needs more coaches.

In order to become a health coach, you need proper training. One of the first questions prospective coaches typically ask is “where should I get my training?” Here’s some important considerations to address prior to enrolling.

9. Are the graduates of the school pursuing the type of coaching career that resonates with you?

10. Is the program fully-approved by NBHWC so that you will be eligible to sit for the board exam and become a Nationally BoardCertified Health and Wellness Coach?

11. Do they provide training in how to set up a coaching business and work on medical collaborative care teams?

12. Do they offer opportunities to connect with those who are hiring?

13. Do they offer support after graduation?

14. Do they teach you how to work outside the scope of practice of a health coach?**

15. Does the school’s sales team aggressively market to you or are their admissions counselors genuinely interested in helping you make a thoughtful decision based on your unique needs?

Sandra Scheinbaum

* Be wary of schools promising to train coaches in a few months. Learning and practicing the coach approach takes time. Don’t sacrifice a quality education for the promise of a fast-track approach. Cutting corners can leave you ill-prepared to be an effective coach and less likely to get the job of your dreams.

** This could be a red flag. Doctors may not wish to hire a health coach who is operating outside of their scope of practice by engaging in practices considered reserved for those who hold a medical license. I hear from many practitioners that they will not hire or refer to coaches who are ordering and interpreting labs. Nutritionists and registered dietitians have filed complaints against health coaches who perform nutritional assessments and recommend specific dietary approaches. The rationale provided by the coach in question has often been that they were trained to do so at the coaching school they attended. As I’ve stated earlier, the power of coaching lies in the coach approach, i.e., the scope of practice, not acting as the medical or nutrition expert.

Benefits of a Functional Medicine coaching education

Just as more and more medical professionals are seeking education in Functional Medicine and functional nutrition, an increasing number of prospective health coaches desire training with a Functional Medicine orientation. The benefits are not restricted to growing your career.

Learning Functional Medicine and functional nutrition principles will lead to powerful personal transformation. Additionally, when you study these powerful approaches to healing, you can be of service to your loved ones as well.

Pause to Reflect

• What would an ideal training program look like for you?

• How important is engagement with other students?

• How important is interacting with faculty and receiving mentoring and support?

• Would you benefit from continuing education, mentoring and community engagement after graduation?

• Would you like to attend a school where employers seek to hire their graduates?

SECTION III:

THE RAPID GROWTH AND RECOGNITION OF HEALTH COACHING

CHAPTER 9:

Is Health Coaching a Legitimate Profession?

The answer is a resounding YES! There are several reasons why we can make this claim.

• Health coaches who graduate from approved schools can be granted national board certification.

• Health coaching is on track for insurance reimbursement.

• More and more esteemed medical institutions or organizations recognize the value of health coaching.

Board-certification is the gold standard that elevates the profession

When asked about which health coach training program to choose, I always recommend enrolling in a school that is fully-approved by the National Board for Health and Wellness Coaching (NBHWC). Graduates of these schools, which includes FMCA™, are eligible to apply for boardcertification through NBHWC.

I advise graduates of FMCA™ and other schools to become nationally board-certified. The process involves logging coaching hours and sitting for an exam. It’s worth it and here’s why:

NBHWC partners with the National Board of Medical Examiners to provide minimum competency standards and assess mastery of

the knowledge and skills essential to the practice of health coaching. Increasingly, it’s becoming the gold standard. A growing number of organizations, including medical practices and corporations, list boardcertification as a qualification in their job descriptions and come to NBHWC seeking out candidates.

Let’s discuss health coaching and insurance reimbursement.

Health coaching is on track for insurance reimbursement

Would you like to submit claims so that your services can be reimbursable through insurance? That’s another compelling reason to go the extra mile and become a nationally board-certified health and wellness coach.

Thanks to the efforts of NBHWC, two significant milestones were recently achieved: the introduction of Category III CPT codes and a taxonomy code for health and wellness coaching. Additionally, coding changes in 2020 created a landscape that offers pathways for medical practices to receive reimbursement through the payer system for services that incorporate health coaches.

CPT codes for health and wellness coaching

As of January 1, 2020, the American Medical Association (AMA) approved Category III Current Procedural Terminology (CPT®) codes for health and wellness coaching.

NBHWC worked diligently for the creation of these tracking codes. Utilization figures and data collection will support eventual AMA approval of Category I codes. Achieving this higher status will open the door for health and wellness coaching to be reimbursed through the payer system.

The Category III codes can be used by coaches who are nationally board-certified by NBHWC. The establishment of these codes is considered a “home run” for the profession, as their adoption increases recognition of health and wellness coaching as a valuable service.

Utilization of the new codes by boardcertified health and wellness coaches will support reimbursement in the near future.

The Category III Health and Well-Being Coaching Codes:

• 0591T Health and Well-Being Coaching face-to-face; individual, initial assessment

• 0592T individual, follow-up session, at least 30 minutes

• 0593T group (two or more individuals), at least 30 minutes

Taxonomy Code

Effective April 1, 2021, health and wellness coaching was granted the taxonomy code 71400000X. This unique 10-character code designates the specific classification and specialization. Coaches can use this code when applying for a National Provider Identifier (NPI), a unique identification number for covered health care providers, that improves the efficiency and effectiveness of electronic transmission of health information.

NBHWC considers this another significant step forward for the profession as it further demonstrates the importance of the role of the health and wellness coach.

Any healthcare provider, healthcare clearinghouse or healthcare organization that conducts transactions or uses health records that fall under HIPAA regulations is required

to obtain an NPI. This includes organizations and providers that use a medical billing company to process their claims. HIPAA requires that any individual, business or health care agency who transmits any patient health information in electronic form in connection with a transaction is required to

have an NPI number.

National Board-Certified Health & Wellness Coaches need an NPI number if they work for a healthcare organization or in partnership with a physician.

Health coaching is on track to “go mainstream”

“I think that within the next 10 years there’s going to be a health coach in every primary care practice.”

Cheng Ruan, MD Founder, Texas Center for Lifestyle Medicine

“Health coaching is such an important and blossoming new profession.”

Tom Blue, Strategic Advisor, Institute for Functional Medicine Co-Founder, Virtual Practices

An increasing number of physician practices, major medical institutions, and corporations recognize the value of health coaching, including prestigious institutions such as the Cleveland Clinic and Harvard University.

Thanks to the CPT coding changes described above, medical practices will be able to receive reimbursement for services performed by a health coach. Increasingly, health coaching will no longer be “cash only.” As a result, doors will open for thousands of people to work with a health coach. Get ready for health coaching to “go mainstream.”

Pause to Reflect

Dr. Cheng Ruan is one of the key physicians leading the charge for health coaching advocacy. He believes that every primary care doctor should have four health coaches working on their collaborative care team. Dr. Ruan refers to his own clinic as a “clinical coaching practice,” meaning that the coaches are the first point of contact with patients, as well as providing the crucial coaching sessions that follow the clinical consultations. The doctors in Dr. Ruan’s clinic provide the diagnosis, lab test recommendations, and treatment plan. The health coaches ensure that the patients are engaged with the plan and making progress.

• Imagine yourself as a nationally board-certified health and wellness coach.

• Imagine yourself as a well-respected member of a clinical care team, working either within a medical practice, or receiving referrals from one.

CHAPTER 10:

What’s

on

the Horizon for Health Coaching?

The health coaching profession is expected to grow rapidly due to a number of factors:

• The after-effects of COVID-19 and all of the variants continue to emerge. We’re facing a significant rise in both physical and emotional health problems brought on by the pandemic.

• The incidence of chronic diseases continues to climb and the current healthcare system cannot adequately address the underlying factors, such as poor diet and lack of exercise.

• As healthcare costs spiral out of control, an increasing number of companies will positively appraise the value of health coaching.

• We’re moving rapidly into the era of patient-empowered healthcare. More and more tests, including lab work, are becoming direct-to-consumer, thus bypassing the need to see a doctor to get a medical order. At the same time, there’s an explosion of remote tracking devices hitting the marketplace. These include continuous glucose monitors, sleep trackers, and stress reduction tools. Many of the companies creating these devices and apps are offering health coaching as an additional option for the consumer.

• As a result of the COVID-19 public health emergency, rules and regulations were relaxed around telehealth. This model is ideal for health coaching and we’re seeing a large increase in the number of medical practices hiring coaches to work remotely.

• Changes to the payer system in 2020 paved the way for increased use of health coaches by insurance-based medical practices. Due to favorable reimbursement rates, there’s a compelling financial reason to hire coaches

Payer System Changes

For physicians operating in the United States within the payer system (i.e., they accept insurance), two new changes in 2020 offer the potential for earning additional revenue as well as covering the cost of paying for a health coach: group medical visits and remote patient monitoring.

Group Medical Visits

Facilitating group medical visits is one of the best ways that coaches can bring value to a medical practice.

For example, create a sixty minute group for patients with type 2 diabetes, While the coach leads the discussion, the physician or nurse practitioner takes participants out one at a time for an individual evaluation and management session, typically up to ten minutes. If the group is on Zoom, the breakout room will be the ideal place for the private consultation. Group medical visits set up with this structure can be billed as individual appointments for all attendees. The coach could be paid at a flat rate, such as $150-$200, or a percentage of the total amount collected by the practice for the session.

For cash-based or hybrid practices, where some services are billable through insurance and others are non-covered services, the coach could facilitate specialty groups. Perhaps clients have an interest in participating in a group devoted to learning meditation or breathing techniques. If these sessions are purely educational and don’t include the individual evaluation and management breakout sessions, they would not qualify as billable services. Participants would pay for the training in advance, possibly six or eight online weekly sessions. The practice compensates the coach with a flat rate or a percentage of the total revenue collected for the group.

Remote Patient Monitoring (RPM)

Tom Blue, Co-founder of Virtual Practices, describes the coach as the member of the collaborative care team who helps the practice transition into health surveillance through monitoring of the data from remote wearable devices.

Suppose the physician prescribes a continuous glucose monitor. The health coach educates clients about how to use the device, supports them to intelligently use it, and most importantly, uses the data as a springboard for discussions about setting goals for diet and lifestyle changes.

Although the above scenario did not involve a direct patient encounter, it’s now a billable service through Medicare and the private payers.

Thanks to the favorable reimbursement rates for both group medical visits and remote patient monitoring, the cost of hiring a health coach will be covered and the practice will still yield a profit from these services. Therefore, the dispute, “I can’t afford to pay for a health coach” no longer applies.

Pause to Reflect

• Imagine being a valued member of a medical care team or running employee wellness programs.

• Imagine working for a company that’s creating innovative AI-driven wearables for monitoring health information.

• Visualize how you want to make a difference by becoming a health coach.

CONCLUSION

“Imagine those who are stuck in a maze, walking in circles and are having trouble finding the way out. If you knew you could guide them out, wouldn’t you want to grab their hand and help them? As a coach you can support your clients to reduce confusion, educate them, share resources and partner with your clients to find their own answers and guide them to reach their finish line.”

Carla Alpert

Picture the ideal medical office of the future:

• The patient plays a central role in directing their care

• The practice calls themselves a “medical coaching practice”

• In addition to at least one health coach, the collaborative care team consists of doctors, nurses, nutritionists, and also includes mental health professionals, occupational, and physical therapists, based on the needs of the patient.

• Visits take place either remotely or in-person.

• Group visits facilitated by the health coach, and including individual sessions with the doctor in breakout rooms, are routine.

• Health coaching services are reimbursable through insurance.

• Remote patient monitoring with the health coach as manager is the standard of care.

• Many at-home diagnostic tests are available on a direct to consumer basis and readily available.

• All medicine is Functional Medicine!

Sandra Scheinbaum

The above scenario is not far-fetched. Many of these possibilities are already taking place or in development.

It’s my personal mission to work towards a healthcare ecosystem where it’s customary to find health coaches serving as important members of collaborative care teams, playing a crucial role as the behavior change specialist in every medical office. Each day, this vision becomes more of a reality, as the demand for health coaches is exploding around the globe.

Imagine waking up every morning happy to go to work and knowing that you’re making a huge difference in people’s lives. The clients that engage with you attain better physical and emotional health as a result of their partnership with you. The changes they make have a ripple effect, positively impacting their loved ones and even their community-atlarge. The process of creating and nurturing a strong alliance with clients results in an additional, important benefit: you as the coach will be personally transformed as well. I can’t overstate the value that coaches derive from engaging in client-centered work.

Let’s not forget another group that will benefit from the work you do if you choose to pursue a career as a health coach. The doctors and allied staff that you interact with will be touched by your presence as the behavior change specialist on the team. Their jobs will become easier and burnout will decrease.

I invite you to join the movement that’s transforming healthcare. You don’t need prior formal training in healthcare. You don’t need to enroll in a degree program to become a health coach. All you need is a deep desire to serve others. You already possess that, as it’s what brought you to pick up this book in the first place.

I hear from many burned-out physicians that they would not advise their children to enter the medical profession. I’ve heard similar stories from exhausted nurses, mental health professionals and teachers, as well as from those working in corporate positions. In stunning contrast, Functional Medicine certified health coaches responded differently when asked if they would recommend the health coaching profession to others.

Would you recommend this profession to others?

Coach Reflections

“I am filled with joy every time I work with a client and they are able to feel success with their goals. If helping others find their goals and teach them is something that you are passionate about, this is the job for you! Helping others reach their potential is amazing!”

Melissa Champine

“I recommend this profession as it’s so valuable in this period of our lives. With the aging of America, increased obesity in young people, and sedentary lifestyles, health coaches hold the key to empowering clients to understand and implement changes that result in a higher quality of living.”

Antoinette Alaimo

“It’s a relatively new field and there is a lot of scope for growth.

If you are passionate about health and wellness, and if you want to help others genuinely, this is the way to go. It gives you the opportunity to be yourself, to grow as a person and a professional, and have the freedom to do the work you most love.”

Zara Faisal

“If you have a passion for growth and self development, to empower others and a mission to make a difference, I would highly recommend considering a career in health coaching. The health status of the world is in dire need of professionals with tools and strategies to facilitate change and there are many people out there eager for guidance on how to live a well life.”

Claudette Jordan

“I believe life is about helping and serving others. And as a health coach we are providing both health and service, which is an excellent combination for humanity.”

Deepa Rajani

“Health coaching is not for everyone. It requires empathy, creativity, patience, dissolution of ego, and exceptional communication skills. I would recommend it to anyone with that unique cluster of traits.”

Kimberly Kaye

“This is the very best profession for the person who is willing to allow their client to be the expert of their own life and destiny. As a health coach, getting to observe the client perform their own magic and alchemy and transform into the Divine Being they are meant to be is breathtaking!’

Tiffany Zwieg

“Health coaching offers one of the most exciting opportunities to fuel systemic healthcare change at the most fundamental level. To heal, people need time, while time is the one, critical factor missing in our healthcare system. As a health coach, you get to dedicate your time to meet people where they are and help them go where only they can.”

Allison Kelly

Sandra Scheinbaum

“I think health coaching has the potential to literally transform lives. And while many diseases may not be “curable” in the traditional sense, health coaches can empower, inspire and motivate their clients to heal themselves from the inside out and make the changes required to sustain good health.”

Anindita Guha Maulik

“The coach approach promotes change and wellness not only for the person being coached but also flows to those around them unleashing a powerful and beautiful ripple effect of positivity and meaningful familial, community and even global impact. In a world that is increasingly demanding positive change in their state of wellbeing, the art and science of the coach profession is most effective in moving people from here to there. I wholeheartedly recommend this profession to the person who feels passion and purpose in helping to create a better world for everyone.”

Debbie VanderWeyden

“Functional Medicine health coaching simply transforms lives. You empower people to look actively after themselves, transform their lives and lives of others as a ripple effect! You change the world one person at a time!”

Benedicta Sivarajasingham

I hope you’re inspired by the above reflections, and after reading this book, choose to enter the personally enriching field of health and wellness coaching. If you decide to become a Functional Medicine health coach, you’ll belong to a growing community with a mission to help people address the root causes of disease through lifestyle change. Not only will you be of utmost service to potentially thousands of other people, you will experience abundance and joy from your work.

Join me in becoming part of the movement that’s transforming healthcare. Humanity needs you, now more than ever!

Sandra Scheinbaum

Acknowledgments

With gratitude for the following members of the FMCA alumni community who so eloquently expressed their thoughts about the joy of being a Functional Medicine health coach. I could not have written this book without your contributions.

Margot Akeroyd

Antoinette Alaimo

Carly Alpert

Anne Altizer

Tita Arroyo

Rebecca Arsena

Yvette Aungamuthu

Nicole Batiste

Dawn Bernard

Elisabetta Bernardini

Jill Booth-Clibborn

Kathy Borthwick

Sophie Boyle

Honey Bronson

Leslie Case

Kerry Chamberlain

Melissa Champine

Colette Chandler

Ishita Chelliah

Mary Clevidence

Courtney Contos Cofino

Daniela Cook

Paula DeFreitas

Zara Faisal

Marilyn Ocasio Forward

Erien W. Fryer

Jackie Ganz

Shelby Garay

Polly Geng

Nicole Gleason

Laura Gonzalez, Ph.D.

Sudha Gopal

Kim Hochman

Claudette Jordan

Marisa Pizzuto Jutras

Kimberly Kaye

Allison Kelly

Tracy Klein

Sandy Kleiman

Alexandria Larsen

Jen Lendaris

Kirin Loomis

Rupali Lubchansky

Linda Lynch

Herb Massin

Jennifer Mccann

Kate McMorrow

Jennifer Newton

Juliana Nikolova

Beth O’Leary

Lindsey Pastorova

Erendira Preciado

Lyndakaye Prior

Deepa Rajani

Lura Kay Robison

Anindita Guha Maulik Rungta

Leeann Rybakov

Deborah Schapiro

Linda Schillinger

Crystal Sgro

Jennifer Shorts

Benedicte Sivarajasingham

Stephanie Staples

Robyn Steele

Beatrice A Strayer

Ann Swietnicki (Mesinger)

Keri Sitrick

Angela H Small

Juliet Tabbara

Monica Tarr

Debbie VanderWeyden

Jane Webster

Andrea White

Lis Wiesen

Laura Wild

Sandy Zielinski

Tiffany Zweig

Erica Zygelman