Put Me In, Coach

Get into the game by adding health and wellness coaching to your practice

By David Henslee, PT

Were we ready—really ready—for the change thrust upon us by COVID-19?

Last fall, did we have any concept of social distancing, stay-at-home orders, mandatory shutdowns, or wearing a mask every day? Nope. We generally live our lives like tomorrow will be pretty much the same as today. But nothing could be further from the truth. Change is the norm. If nothing else, the pandemic has taught us that. Unexpected change can be a “game changer” and a huge problem if we are unprepared.

Fortunately, we are problem solvers. Every day, we help people trade obstacles for progress. However, research confirms that over time, as we focus on problems, negative emotions begin to arise.¹ Uncertainty leads to fear. Fear to frustration. Frustration to anger. These, in turn, may give rise to unhealthy coping strategies such as stress eating or alcohol and drug overuse, and so on. Add to this the financial pressures of keeping a healthy bottom line for your practice and the end result: Your stress quotient goes off the chart. This stress spills over to your clinic staff, patients, friends, and family, all of whom are experiencing their own version of pandemic-related issues. Nobody wins that game.

I have experienced all of this at one time or another in my 43 years as a staff physical therapist, clinic owner, and clinic manager. I realized that I needed to practice in a way that lessened the physical, psychological, and emotional stressors on me personally. As I delved into health and wellness coaching, it became apparent that I needed to be practicing more self-care activities—breath control, meditation, and improved sleep and eating habits—to be at my best as a clinician and co-worker. These simple changes could make a big difference. And thus, my journey into health and wellness coaching, which began in 2015, started with helping myself and led me to making a positive change in the lives of others.

DEFINING HEALTH AND WELLNESS COACHING

What exactly is it that health and wellness coaches do? According to the National Board of Health and Wellness Coaches: “Health and wellness coaches partner with clients seeking to enhance their well-being through self-directed, lasting changes, aligned with their values. In the course of their work, health and wellness coaches display an unconditional positive regard for their clients and a belief in their capacity for change, honoring the fact that each client is an expert on their own life, while ensuring that all interactions are respectful and non-judgmental.”² The most notable credentials of the coaching profession in the United States is the attainment of the NBC-HWC (National Board-Certified Health & Wellness Coach) designation, accomplished after passing the national board examination, which is given twice each year. However, multiple companies are licensed to provide the training and education to achieve certification.

LAUNCHING A NEW SERVICE IN AN ESTABLISHED BUSINESS

Folding a health and wellness coaching program into a physical therapy practice makes complete sense. Health and wellness coaching is not generally covered by most insurers, so it is an attractive cash-based service line. And then, there is the convenience factor—patients love one-stop shopping. If they trust your practice with the rehab of their injuries, then your practice is the likely choice for coaching services that will improve their health and guide them down the road of wellness and prevention. And the reverse is true: adding health and wellness coaching offers another opportunity to be an entry-point into the health care system and your practice. Last, you don’t need to go out and buy a lot of fancy equipment to add this service line. And it is easily deliverable via telehealth, which is certainly a plus these days!

An important consideration when adding health and wellness coaching to your practice is your market. Coaching is especially applicable to those with chronic conditions such as heart disease, diabetes, and chronic obstructive pulmonary disease (COPD). Other coaches focus on recreational and high-performance athletes and stressed-out professionals. Focus on what you know and what you love. Natalie Zollinger of Moab, Utah, has chosen to use her new skill set in “adventure-based health coaching.” Zollinger has been a professional river rafting guide, competitive stand-up paddle boarder, and elite outdoor athlete. “My heart is in the river,” she told me during a recent interview. Zollinger has found a way to help people adopt a healthier, more confident, and more fulfilling lifestyle while remaining true to herself. She had the wisdom to choose a service delivery model that completely meshes with the kind of life she wants to live. Everyone wins.

TaVona Denise Boggs chose another path. A physical therapist since 2000, Boggs began to experience an unhealthy case of professional burnout. She pushed back and asked herself, “What can I do?” She became a certified health and wellness coach in 2013, and was drawn to life coaching, acquiring her certification in 2014. Boggs has built a thriving—100% virtual—practice primarily tailored toward coaching and mentoring entrepreneurial women. “As a life coach, I deal more with mindset—helping people achieve any goal in their lives, overcome obstacles, find the ‘why’ behind the ‘what’ they want to achieve.”

Physical therapists and physical therapy assistants, with their knowledge-base and skills in motivational interviewing, educating and influencing, are poised to be effective coaches. If your physical therapists and physical therapy assistants are offering coaching, it is critical to distinguish skilled physical therapy and coaching sessions, especially for clients with Medicare. There may be other employees in your practice for whom becoming a certified health and wellness coach is an exciting professional development opportunity. In the end, you may decide to create a professional relationship with an independent board-certified health and wellness coach. This approach gives your practice another referral source.

Not wanting to simply hang a shingle that I was now a “wellness” practitioner, I sought avenues for education and certification in the wellness field and eventually achieved national board certification in health and wellness coaching. Initially, I integrated coaching clients into my schedule one day per week. Health and wellness coaching became a small, but growing, cash program for our clinic. In the second year, wellness coaching revenues almost tripled. In 2019, I was able to leave full-time clinical practice for a small, extremely satisfying cash-based mobile practice performing physical therapy consultations and health and wellness coaching.

HEALTH AND WELLNESS IN THE CLINIC

It doesn’t work to just drop Health and Wellness coaching onto your menu of services. Patients and clients will see right through that. It’s an attitude, an approach, that is embedded in your mission and core values. What does it look like to have a health and wellness approach to your clinic? It starts with you. A stressed-out practice owner has a negative impact on all aspects of the practice, whether or not they are physically present. Before you start your workday (which usually starts in your mind before you ever get to the clinic), pause long enough to take some deep breaths through your nose, relax, and focus your attention on bringing the air deep into the lungs, filling them from bottom to top. This nasal diaphragmatic breathing technique stimulates your parasympathetic nervous system, lowering your heart rate and blood pressure, helping you to feel calmer. Your employees, coworkers, managers, and partners will benefit from a better, less stressed you.

Consider adding health and wellness coaching to your staff’s benefit package. This signals that you care about their well-being and that goes a long way with employees. Equally important, your patients benefit from brighter, healthier, more engaged therapists resulting in loyal customers. An emotionally and physically healthier workplace benefits every aspect of your practice, including lowering health insurance costs, decreasing sick days and injuries, increasing productivity and thereby improving profits. Your practice should be the model for the health and wellness services that you can offer to employers – who are another source of cash-based revenue and patient referrals.

EMBRACE CHANGE

Change and uncertainty have become a part of our lives over the last year. In truth, change and uncertainty have been with us all along. Maybe the pandemic has been good for us in a way. It has exposed our vulnerability to the unexpected. Let it be the wake-up call that “coaches” us to make the changes in our lives and our practices that leave everyone in a better place. Continue to provide excellent care; not only to our patients, but to our co-workers, staff members, and ourselves. And, that, is a win all the way around. 

References:

¹US Centers for Disease Control and Prevention. STRESS…At Work. https://www.cdc.gov/niosh/docs/99-101/ . Published 1999. Accessed March 6, 2021.

²National Board of Health & Wellness Coaches. https://nbhwc.org. Accessed February 1, 2021.

David Henslee, PT, a physical therapist for over 40 years, is a private practitioner providing physical therapy and health and wellness coaching at Henslee Health & Wellness in Wichita Falls, Texas. He can be reached at David@hensleewellness.com and on Facebook at Henslee Health & Wellness.