I spent last week in a room of professionals with a variety of healthcare backgrounds including physicians, physician assistants and nurse practitioners. I point out these professions in particular because we are most likely the ones to go in, assess a patient, make a diagnosis, and direct care. But what if we actually included the patient in the process? What if we asked the patient how they would like to see their health care progress?

There will always be the patient who would rather have someone else direct their care. There are those who will just want numbers and facts. However, as I am sure you have experienced, patients today are asking more questions. They want to know all their options, and they want to have a say in making decisions about their health.

Suppose there was a health care professional present at the conclusion of each appointment to work with patients and help figure out the best course of treatment. Or maybe this would consist of you enlisting the patients’ ideas during the exam to determine what the most important aspect of care is to them.


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Just as the PA profession was started at Duke University, there is a new healthcare profession at Duke Integrative Medicine. I just finished my first week of classes through Duke’s Integrative Health Coach Professional Training Program. What an eye opener!

As healthcare professionals, we know most causes of illness are related to lifestyle and poor health behaviors. These types of illness include chronic diseases such as hypertension, diabetes and heart disease. But our current role is reactive. We treat the problem after it has occurred.

What if we could actually make a difference before the disease occurs? Integrative Health Coaches take a proactive approach to identify risks and create a partnership-based health plan. Patients are coached on all aspects of their lives including the mind, body and spirit. Coaches also ask questions about how a patient’s physical environment, their relationships, and their personal development are affecting their lives, and how these areas might be impacting their health.

In this model, the patient accepts more responsibility for their healthcare because they are the ones deciding what is most important for them at that moment. Coaches provide challenges and support, while still keeping the patient accountable for meeting the goals they have set.                                                                             

I was interested in this process because I feel that there is something missing in our current healthcare paradigm. We have minutes to go in a room, take a history, make a decision, and direct care. We are often prescribing medications that patients don’t want to take or can’t afford. I believe I am an excellent provider, but I want to be able to offer a patient more. I want a relationship with the patient that is participatory.

Integrative Health Coaching is a patient-centered approach to healthcare. A coach does not diagnose or treat disease. They work with providers to ensure that the patient receives pertinent information about their health issues.

Often, we as healthcare providers think we have explained well what a particular illness may be doing to someone’s body to find out later that the patient didn’t hear anything past the diagnosis. A coach can help the patient better understand a diagnosis, identify health resources and develop a plan that complies with a specific lifestyle and set of beliefs.

I hope you will take a minute and visit the website for Duke’s Integrative Health Coach Professional Training Program. You may not be interested in the program for yourself, but think of what a coach could do for your practice.

I feel that the first week of class has already made me a better provider. I listen in a different way than I have in the past. I ask questions I may not have asked before. Coaching is a very different way to practice compared with our training as conventional providers.

My goal is to take this education and incorporate what I learn into my practice. I hope you might consider doing the same. It’s a win-win situation. Patients are more inclined to take care of their health if they are participating in creating their future. Providers see patients whose health is improving and who are happier. Healthcare becomes wellness based instead of disease based. What do we have to lose?

Sharon M. O’Brien, MPAS, PA-C, works at Presbyterian Sleep Health in Charlotte, N.C. Her main interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.