It’s easy to fall into the trap of thinking there is a single model for practicing neurology—try to see as many patients as you can fit into a day without sacrificing quality of care. And make sure you document everything correctly so you don’t miss out on any reimbursements.
So when a new way of looking at how a practice is organized comes along, it can be easy to dismiss it. When you’re simply trying not to get flung from the hamster wheel, changing the practice model can feel like trying to run that wheel with your ankles tied together. That’s how many physicians feel about the idea of adding a health coach to their practice. But it isn’t necessarily going to make things more difficult for you. In fact, it might just make things more efficient for you and mean improved care for your patients.
What is a Health Coach?
In recent years, there has been increasing interest in adding health coaches to patient care, and this has resulted in tighter definitions and licensing for the coaches. Within these parameters, the role a health coach fills can vary from practice to practice, but in general they attempt to understand the patient’s social context and how it affects his or her health. While the physician focuses on addressing specific complaints and diagnoses, the health coach focuses on lifestyle factors that may contribute to the patient’s health even though they aren’t the primary complaint.
In one practice, a health coach may help patients with new diagnoses understand how they can translate the doctor’s advice into specific actions. They can make sure patients understand how to take medication. Or they might help make a plan to implement the doctor’s dietary recommendations within a specific budget.
In a different practice, the coach may serve as an educator and sounding board when a decision about treatment modality needs to be made. The coach may also work with patients prior to medical appointments to be sure they have gathered all the necessary information so the appointment is productive.
Each collaboration between a physician and health coach will have its own personality depending on the strengths and weaknesses of the team members. But the end goal for the health coach is to be an educational resource who helps patients become more proactive about staying healthy.
How Much Will the Health Coach Cost?
For many, if not most, neurology practices, this is the first question that will pop up. With declining reimbursements, it may seem that adding another employee is out of the question for today’s neurologist.
However, this will depend on a number of factors. In some cases, insurance will cover the cost of a health coach. When it doesn’t, you can offer the services of a health coach as a self-pay option.
An article in the AAFP journal Family Practice Management outlines how one family medicine practice added a health education specialist (HES). It provides information on reimbursement rates for both coaches and HES’s, along with great detail on how they incorporated these caregivers into their practice. While some specifics may vary between family medicine and neurology, it gives a general idea of what to expect.
It is also worth considering how a health coach can improve the efficiency of a practice. For example, if a health coach is tasked with helping patients prepare for medical appointments, those appointments can become more efficient. In turn, this can free time for the neurologist to see more patients or increase the number of office procedures performed. It is possible that a thoughtfully integrated health coach can save money or even increase revenue for a practice.
Will the Health Coach Help Me Provide Better Care?
This of course, is the real question that must be answered. Evidence seems to suggest that the addition of a health coach to a medical practice does improve outcomes. A review of 13 studies in 2014 showed statistically significant improvements in weight management, physical activity, and physical and mental health status. Researchers concluded, “Health coaching improves the management of chronic diseases.”
How this translates into a neurology practice is another question, and we don’t have the evidence to directly answer it at this time.
However, in a specialty where diagnoses often reveal disease that will dramatically alter the course of a patient’s life, it’s not difficult to imagine a role for the health coach. Their primary job is to understand how disease course will affect social context and how social context will affect disease course. It’s seems reasonable to expect this information to shape better outcomes for patients.
A health coach may or may not be a good choice for your neurology practice. Many factors must be considered including the role of the health coach, the cost, and the potential outcomes. If you are interested in exploring the option, visit the International Consortium for Health & Wellness Coaching to learn what to look for in a coach.