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Meet A New Breed Of Medical Professional: The Health Coach

Jul 23, 2012

This story is part of a reporting partnership that includes APRNNPR and Kaiser Health News.

Every morning, Shannon Orley parks as far away as possible from her office in Anchorage, Alaska. And on the sprawling Providence hospital complex that is really far away.

"Right around a thousand steps each way. Definitely worth it," Orley said.

Shannon Orley lost 50 pounds working with a health coach, a small but growing medical profession. The coaches help employees keep track of their health and wellness, which could help drive down health costs (Photo by Annie Feidt/APRN).

Two years ago, Orley was obese. And she faced a dilemma. She had just taken a job helping coordinate Providence's employee wellness program. But her own wellness was far off track. She drank the equivalent of six sodas a day, loved fast food and didn’t exercise much. So she decided to take advantage of one of the hospital’s new benefits – health coaching.

Health coaches are a new kind of health professional, and it's their job to help people make those easy-to-say, hard-to-do behavioral changes that promote good health—getting enough exercise, eating a balanced diet, managing stress. 

At first, the lifestyle changes Orley made were very small.

"We started out where my goal was to take the stairs instead of the elevator once a day. Not even more than that but just really manageable," she said.

Soon Orley was drinking more water and less soda. She began walking regularly and attending Pilates classes. She kicked her fast food habit. She lost 50 pounds. Last year, 300 of Providence's 2,800 employees in Anchorage tried health coaching. Orley’s coach, Kelly Heithold, says her clients have finally made the decision to change.

"When they actually make that step and make an appointment with me, they're ready," Heithold said. "And they say, 'Help me. I know what I need to do, I just don’t know how to get there.'"

Health coaches are still rare in the medical profession. But they are becoming more popular as chronic and often preventable diseases like Type 2 diabetes consume more and more health care dollars. Tammy Green heads up Providence’s extensive employee wellness program. She thinks coaches are an important piece of the health care puzzle that’s been missing. She says nobody wants to be overweight.

"Really, at the core, everybody wants to be healthy. They really do. We just have not been able to help them achieve those goals with our traditional approach," Green said.

In three years of health coaching, Providence has seen a small but steady decrease in the number of obese employees – from 36 percent in 2009 to 32 percent in 2011. Green says blood pressure and cholesterol levels are lower, and fewer employees are smoking.

"Something's happening and you can pretty much assure yourself that if we hadn't been doing anything, we certainly wouldn’t be seeing those trends," Green said.

Green is convinced that health coaches are a good investment. Margaret Moore agrees. Moore founded Wellcoaches Corporation in 2000, a Massachusetts-based company that has trained most of the country's 6,000 health coaches.

"There's a reasonable army now of health professionals that have become coaches in this last ten years," Moore said.

She expects the profession to grow steadily. Especially now that Medicare has started paying for up to 20 obesity counseling sessions a year. But Moore acknowledges there’s debate in the medical field over whether health coaching should be a separate profession or just a new skill set for existing providers. She thinks there’s room for both.

Back at Providence, Shannon Orley has reached an intersection on her walk to work. And like a former smoker trying to resist a nicotine urge, she has an important choice to make.

"As you can see on the left side we have our bank of elevators, ready to rock. On the right side, we have the stairs," Orley said.

On this day, Orley doesn’t hesitate, but she says some days it’s a tough decision.

"You know every time I go to reach for the elevator button there's a little voice in the back of my head asking me, ‘Really, is this going to make you feel better? Is this part of your goal? Is this where you're headed?" she said.

With her coach's help, healthy choices have started to feel better and better.

This story is part of a reporting partnership that includes APRN, NPR and Kaiser Health News
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