Troubling but true: At my annual checkup, my primary care physician took my blood pressure, recorded my weight, listened to my heart and lungs, and declared me in decent health. Yet he didn't ask about my diet and exercise habits (inconsistent at best), stress level (off the charts) or sex life (nonexistent-hey, I've got two small kids). When I mentioned that I was having trouble sleeping and that my skin-which had been clear my whole life-was suddenly very greasy, he handed me a prescription for Ambien and a referral for a dermatologist.
I left feeling frustrated. My MD was right: I was healthy in the sense that I wasn't suffering from any chronic diseases. But I often felt tired, unmotivated, foggy. I wanted to feel better-I knew I could feel better. I just didn't know how.
Paging the health coach
It turns out my experience is not uncommon. The kinds of lifestyle changes I needed to make take time and effort. And the reality is, primary care docs can only do so much, says internist Yul Ejnes, MD, past chair of the American College of Physicians' Board of Regents: “It's hard for a doctor to help patients change their daily habits when you see them for only 10 minutes every three or six months.”
Enter the wellness coach. Providers in this rapidly growing field help bridge the gap between your office visit and your everyday life, explains Karen Lawson, MD, director of integrative health coaching at the Center for Spirituality and Healing at the University of Minnesota. “Most of us leave a doctor's appointment scratching our heads, wondering how we're going to sleep more or lose weight or eat cleaner given our busy schedules, finances, and support system, or lack thereof,” says Dr. Lawson. “A wellness coach works with you to determine the best way to integrate your physician's recommendations into your plan, so you can lead a healthier life.”
How it works
When Leah Martinson, a health coach in Minneapolis, first meets with a new client, she typically asks her to visualize a clear picture of what she wants-her ideal wellness scenario. Then they work together to create what Martinson calls a client-driven action plan. “I don't tell people what to do,” she says. “I prompt them to figure it out for themselves.” She asks questions like “What is it about the gym that you dread?” “What kind of exercise is exciting to you?” and “What do you enjoy cooking at home?” The idea is to identify your personal barriers and how to overcome them. After that first session, Martinson sees the person regularly (for anywhere from 20 to 90 minutes at a time) to help her stay on track. “It's sort of like therapy, but with a mind-body health twist,” she says.
Wellness coaches aren't supposed to recommend specific exercise routines (as a fitness trainer would) or advise you about your nutritional needs (as registered dietitians do), explains Ruth Quillian Wolever, PhD, director of Vanderbilt Health Coaching at the Osher Center for Integrative Medicine at Vanderbilt University. They also don't diagnose conditions or suggest medications. Instead, a health coach is supposed to, well, coach you.
Consider this familiar example: Most of us know that it's healthier to order a side salad than a side of fries. “But there's a big difference between knowing what you should do and actually doing it,” points out Wolever. Coaches help people make those types of healthier choices by brainstorming with them about what will really motivate them.
But she can help you figure out how to manage your stress better, says Kate Motz, a health coach in Mountainside, N.J. With her clients, Motz discusses various strategies- everything from getting massages to starting a new hobby-so the clients can choose what sounds most appealing (and feasible).
The concept of wellness coaching isn't exactly new. Health-oriented destination spas like Canyon Ranch and Miraval have long offered this kind of service to their guests. What is new? The idea that most people could benefit from it, and the fact that it's more widely available right where you live.
Some doctors around the country are even starting to add coaches to their practice. Mott Blair, MD, a family physician in Wallace, N.C., says his in-office coach has been a vital addition, especially for patients dealing with new diagnoses. “When I tell patients they have diabetes or high cholesterol, there is so much information for them to absorb,” says Dr. Blair, who is also on the board of directors of the American Academy of Family Physicians. “Our health coach spends a lot of time with each person-often regularly scheduled 30-minute appointments-to help them stay motivated and accountable.”
Dr. Ejnes-whose practice in Cranston, R.I., has nurse care managers on staff to play the role of coach, keeping in touch with patients between office visits-sees this trend as a very good thing. It's part of a movement toward a more collaborative, team-based approach, he says, that will eventually lead to better, more comprehensive care.
Could you benefit from one?
Anyone who is struggling to get healthier might want to consider hiring a wellness coach, says Deborah Lee, PhD, an instructor in the Integrative Health Coach Professional Training Program at Duke Health. “When making a major change, it's totally normal to think of all the reasons you can't do it,” explains Lee, who's been there herself. After losing and then regaining 50 pounds and finding herself mentally and physically depleted, Lee hired a coach six years ago. “I'm a nurse and thought I knew how to take care of myself,” she says. “But I had hit a wall. I needed to make a change on the inside before I made a change on the outside.”
Today her wellness coach helps her incorporate movement and mindful meditation into her daily life. Lee also coaches other nurses, in addition to teaching. “I help them focus on putting their own self-care in the forefront of their lives,” she says.
Katy Cabbage, a 35-year- old research scientist in Boston, was also in a rut when she decided to make an appointment with a health coach. Cabbage had already managed to lose nearly 100 pounds on her own but had reached a plateau. “I didn't want a weight-loss coach,” she says. “It was really important to me that I was improving in all areas of my life. I knew weight loss was just one component.”
Cabbage and her coach, Ryan Sherman, set up a schedule that involved weekly emails, a phone call every six weeks and face-to-face meetings every six months. In time, she learned to trust his advice. “He was encouraging but not unrealistic,” she says. “He would challenge me if a goal seemed wimpy or help reframe something that seemed too difficult.”
But what she found most helpful was the accountability: “I used MapMyRun+ and would send Ryan a screenshot of a run I just did, and I loved having him immediately respond with enthusiasm,” she says. Their partnership paid off. Over the course of two years, Cabbage lost another 50 pounds. “I realize now that leaning on someone to help you with your health isn't about being weak-it's about being brave. I finally have achieved a quality of life that I love,” she says.
As for me, a good friend of mine happens to be a wellness coach, and she has been helping me learn various ways to relax (that don't involve wine). I've started working out regularly and journaling about my feelings. She also connected me with a massage therapist for my body aches and a facialist for my skin. Even better, when I told her I was looking for a new doctor, she gave me the name of an internist with a holistic approach. After just a few months, I have more energy, I'm sleeping better, and my sex drive is back. At last, I feel like myself again.
Your first appointment
Got a date with a coach? Bring these essentials.
1. Your health history
Be ready to discuss chronic conditions, any medications or supplements you take, your eating habits, your current ailments and challenges, and your sleep and exercise patterns.
2. Good intentions
You may have a specific target in mind (like dropping 20 pounds), but if not, that's OK. Simply wanting to get healthier is enough. The coach's job is to help you clarify your goals.
3. Your doc's digits
If your coach isn't already working directly with your healh care providers, bring their contact info so she can reach out if necessary.
4. An open mind
A coach might help you explore complementary therapies backed by science, like acupuncture or hypnotherapy. Follow up with your doctor about any treatments you plan to pursue.
5. Your wallet
Most coaches offer an initial conversation for free. After that, expect to pay about $100 or more per session. The cost of coaching isn't typically covered by insurance, but you may be able to get reimbursed through your Flexible Spending Account.