Relationships are important in healthcare — perhaps none more so than the physician-patient bond. Until now, these encounters have largely been focused on treating illness, not preventing it. But as healthcare acknowledges the clinical and cost benefits from health coaching in disease and health management, some experts say that primary care is ripe for the same change. In addition to dispensing clinical advice, it may also be time for primary care physicians (PCPs) to prescribe physical activity, smoking cessation and other healthy habits to guide patients toward self-efficacy.

In this special report, "Health Coaching in Primary Care: Persuading Physicians to Prescribe Behavior Change and Self-Efficacy," three health coaching thought leaders detail their models for incorporating health coaching into the primary care paradigm. While acknowledging existing demands on busy physicians, they recommend that PCPs school themselves in health promotion and make coaching a team effort to foster behavior change in members and patients.

But for this effort to be successful, physicians need a dose of their own medicine, embracing healthy habits themselves — "walking the walk" so they can effectively "talk the talk" with patients.

In this 41-page special report, contributing authors Dr. Rick Botelho, professor of family medicine at the URMC Family Medicine Center, Margaret Moore, CEO, Wellcoaches Corporation and Dr. Edward Phillips, director of outpatient medical services at Spaulding Rehabilitation Hospital Network and assistant professor of the Department of Physical Medicine and Rehabilitation at Harvard Medical School, describe how to leverage the trusted clinician relationship to reinforce behavior change. They provide details on:

• Moving practitioners from "fixers" to "motivators";
• Why healthy physicians don't automatically make the best coaches;
• Teaching physicians to "walk the walk" and "talk the talk" without alienating patients;
• Implementing blended learning methods to support a team approach to health coaching;
• The 10 common mistakes health plans and disease management organizations make and 10 strategies to correct them;
• Developing a culture of health promotion in a physician practice and the training effort to support it;
• Two physician-training initiatives aimed at improving health promotion and disease prevention by physicians;
• Rudiments of a Lifestyle Clinic;

This report is based on a 2008 audio conference on driving improvements in health coaching outcomes through physician collaboration.

Table of Contents

• Driving Improvements in Outcomes for Patients and Clients
  • Getting Doctors and Coaches to "Walk the Walk"
  • Choosing Health Coaches to Work with Physicians
  • A Vision of Coaching and Healthcare
• Integrating Health Coaching into the Primary Care Paradigm
  • A Continuum of Health Coaching across the Healthcare Team
  • Top 10 DM and Health Plan Mistakes
  • Winning Strategies for Healthcare Plans or DM Vendors
  • Looking at the Micro Level
• Engaging Physicians in Health Promotion & Disease Prevention
  • The Exercise is Medicine Initiative
  • Creating a Lifestyle Medicine Clinic Within a Practice
  • Aligning the Lingo
  • The Structure of the Lifestyle Management Clinic
• Q&A: Ask the Experts
  • Coaches Who Produce the Best Results
  • Behavioral Health Support at Lifestyle Medicine Clinics
  • Approaching PCPs with Health Coaching Efforts
  • Measuring a Patient’s Personal Evidence
  • Describing the Ideal Patient
  • Coach Funding Through Health Plans
  • Resistant Caregivers and Coaching Programs
  • Integrating Coaching into Primary Care
  • Overcoming Limitations of Evidence-Based Guidelines
  • The Starting Point for Patient Coaching
  • Benefits of Experience-based Learning
  • What Doctors Didn't Learn in Medical School
  • Feedback from "Coached" Physicians
  • How Health Plans Can Help
  • Incorporating Lifestyle Medicine into Medical School Curricula
  • Coaching a Physician to Walk the Walk
  • Medical Fitness Coaches and Exercise is Medicine
  • Engaging Physicians with Positive Psychology
• Glossary
• For More Information
• About the Authors