An Open Letter to our Healthcare System

Dear Those Who Care So Well for Patients,

You know it as well as anyone does: you can’t cheat time. You can’t cheat it with processes. You can’t cheat it with technology. You can’t even cheat it with a prescription or a surgical procedure. You deal with this challenge in and day out and recognize that there is just not enough time in the day to do the things that need to be done. You just, simply, cannot cheat time.

Patients in our healthcare system need time and they need more of it than ever before. And doctors do not have the time. Many primary care physicians see upwards of 25 patients per day in their practices. They usually don’t have more than about 10-15 minutes per patient. And it is, unfortunately, nothing that they can control. Their services are in high demand. Nurses don’t have the time either because they’re supporting those same doctors with the needs of those 25+ patients. Nor do mid-level providers. They’re doing the same work as doctors in primary care. As caring and well-equipped as all of these providers are, there is absolutely no more time to give to patients within the walls of our current healthcare system.

The technology that was supposed to save the healthcare provider team time has exponentially increased the amount of time spent away from the patient and re-directed it into administrative functions. Electronic Medical Record (EMR) technology has added time that healthcare providers didn’t have to begin with, so now they’re working extra hours to fulfill their administrative responsibilities. Healthcare providers didn’t sign up for administrative work, they signed up to care for patients. And they’re becoming increasingly burned out. Estimates show that burnout rates among some specialities are higher than 60% and many healthcare providers are considering leaving the field altogether.

Patients need time. But with the structure of our healthcare system, they don’t get the time they need to talk about the things that matter most to them. This is the heart of healthCARE for any patient.

Guess who has the time to dedicate to patients? Health and Wellness Coaches. But they are vastly underutilized in our healthcare system because Health and Wellness Coaching is not yet reimbursed by insurance and is not delivered by a licensed healthcare provider. Guess what? Training your nurses on the coach approach and hiring “Nurse Coaches” is amazing, but if there’s no more time to dedicate to patients than the 10-15 minutes that they’re given, the coach approach cannot deliver the full value of what health and wellness coaching is capable of delivering, no matter who delivers it. Patients will continue to feel unheard and will continue to be sick until the necessary time is dedicated to each of them.

Sixty percent of Americans have at least one chronic condition, usually requiring any number of prescription medications. It is well-established that many chronic conditions, particularly diabetes, hypertension and high cholesterol are not only preventable, but completely reversible with intensive lifestyle changes. Yes, reversible. As in “go off of prescription medications” reversible (under a healthcare provider’s direction and supervision, of course). Health and Wellness Coaches have not only been trained to provide the support necessary to help patients integrate these lifestyle changes, but they dedicate the time necessary in supporting someone to make them. And they keep the patient’s healthcare provider into the loop on their progress and work together with both the patient’s goals and the provider’s goals.

There is an army of Health and Wellness Coaches at the ready, waiting to dedicate their time to support patients on the lifestyle and behavior change that has been prescribed by their healthcare provider. There is even an army of Nationally-Board Certified Health and Wellness Coaches certified by the National Board of Medical Examiners (NBME) and the International Consortium of Health and Wellness Coaching (ICHWC) that is nearly 2000 strong and growing by the year. These highly qualified Health and Wellness Coaches have struggled to find their way into the healthcare system because they are not “licensed healthcare providers”. But, we are uniquely qualified to serve your patients in this absolutely necessary capacity of behavior change toward a healthier lifestyle alongside the rest of the care team. We dedicate our time to guide them through the readiness to change process and help them achieve their personal vision of wellness, in their own personal way and on their own timeline.

When they make the lifestyle changes you’ve prescribed, your job becomes infinitely more fulfilling and rewarding because you start to see the outcomes that are aligned with your recommendations. They’re eating better, moving more, less stressed, more relaxed, sleeping better, more socially-connected and hopeful of the future. And their blood pressures are improving, their blood sugars are decreasing, their cholesterol is dropping and soon, they start decreasing medication dosages and might even eliminate some of them. And you benefit because you can deliver care without ever increasing your time or your team’s time. You leverage those professionals in your own community who are fueled by the work of behavior change and it matters to all of us.

Yes, there is a cost to patients for this service and it is not yet recognized by most insurers (although this is likely coming in the future). Some medical savings accounts reimburse health and wellness coaching. Among the many well-qualified coaches in your area, you will find that many are very reasonably priced, some using a sliding scale to accommodate lower-income patients. Most health and wellness coach’s services range anywhere from $30-150 per hour. Meeting with a coach once or twice per month for half an hour for a period of months is usually sufficient to see significant results. There is immense long-term value to a patient investing in a Health and Wellness Coach in the pursuit of greater health and well-being, as well as potential savings in future personal healthcare costs.

I beg you, on behalf of the many thousands of Health and Wellness Coaches around our country who are ready and willing to serve you and your patients, please find one near you and start sharing this amazing, meaningful resource with your patients. Your patients will love the support, the care and concern, and most of all, the time, that a Health and Wellness Coach will give them.

You can find a National Board-Certified Health and Wellness Coach near you at!directory/map.