Louisville Medicine Volume 69, Issue 11 | Page 24

Lesley Kellie , DO , FACP & Jessica Hill Powell , NBC-HWC , CYT


Lesley Kellie , DO , FACP & Jessica Hill Powell , NBC-HWC , CYT
A staggering six in 10 Americans are currently suffering from one or more chronic diseases . While genetic factors can play a role , most are preventable through lifestyle choices . 1 You see them in your office every day . Diabetes , hypertension , obesity and heart disease , among others , severely diminish the quality of your patients ’ lives . While you make the most of your 12 to 15 minutes with these folks by giving them solid medical advice , they often aren ’ t able or willing to do the things you ask of them . After all , lowering stress , eating better , exercising more , consulting a specialist and taking medication as prescribed are tall orders .
While in your office , a patient may seem ready or even excited to take on healthy lifestyle changes that could significantly impact their disease progression . Yet when rubber meets the road , they become overwhelmed with the tasks that lie ahead and end up making little to no change before their next visit . For physicians whose values center around improving patients ’ health , frustration abounds .
Health coaching serves to bridge the gap between medical recommendations and your patients ’ ability to implement them effectively . A health coach is a behavior change expert . Trained in motivational interviewing , coaches can incite internal desire and move a patient through the stages of change . Basic principles of neuroscience related to behavior change inform how health coaches guide patients through goal setting . Skilled coaches place great emphasis on taking small steps , including repetition , incorporating positive emotion and sensory experiences as patients set and work toward goals . These techniques effectively increase neuroplasticity , creating more long-term sustainable health behavior change .
The coaching relationship , which requires time to build and extensive follow-up , allows the patients to feel empowered by evoking their narratives of meaning , importance and capacity to change . Coaches facilitate self-directed , lasting health behavior changes aligned with patient values . Ultimately , this translates to higher patient receptivity to treatment and better long-term health outcomes . 2
Last year , an article written in the New York Times about the value of health coaching related to chronic disease progression cited
Dr . Russell Phillips , director of the Harvard Medical School Center for Primary Care . “ Health coaching should be an integral part of primary care . It helps patients better manage chronic conditions like diabetes and hypertension and improves outcomes .” 3 He went on to add , “ As a primary care doctor , I ’ m focused on diagnosis , treatment and a lot of other medical issues . It ’ s great to have health coaches available to help patients make needed changes and sustain them over time .” 3
Coaching is an unregulated industry in all capacities , health or otherwise . As with nutritionists , there is no standardized certification for health coaching . “ The National Board for Health & Wellness Coaching ( NBHWC ) has collaborated with the National Board of Medical Examiners ( NBME ) since 2016 to provide a robust board certification examination which has led to more than 6,500 National Board-Certified Health & Wellness Coaches that hold the NBC-HWC credential .” 4
The NBC-HWC credential is the gold standard , representing training , education and assessment standards to ensure competence and professionalism .
• Coaching structure : preparation and management of each stage of coaching sessions
• Coaching process : ability to use core health coaching competencies
• Health and wellness : knowledge of health behaviors , chronic disease and related topics
• Ethics and legal considerations : scope of practice and professional conduct 5
As a local health and wellness coach , I , Jessica Hill Powell , hold a bachelor ’ s degree in psychology from Bellarmine University and I completed my health coach training and certification at Duke Integrative Medicine . I am one of only 10 coaches in Louisville who hold the NBC-HWC credential . Partnering with local physicians is about improving quality of life for fellow Louisvillians . Expanding further on the role of coaching in fostering long-term , sustainable healthy lifestyle change , I have identified these three concepts as key :