Q&A: Patient Interaction Key to Evidence-Based Health Coaching

Thursday, April 12th, 2012
This post was written by Cheryl Miller


How a health coach interacts with and engages their clients can affect their compliance and outcomes, explains Melinda Huffman, partner in Miller and Huffman Outcome Architects, co-founder of the National Society of Health Coaches, and a cardiovascular clinical specialist, writer and author. We recently spoke with Melinda about what led her into the field of health coaching, how it’s changed over the years, and some of the trends she will lock onto for 2012.

HIN: What led you into the field of health coaching?

Response (Melinda Huffman): I was born with a cardiac defect and had corrective surgery at the age of seven. I went on to lead a very healthy and very active life, but this experience ultimately had a great influence on the career path that I chose. As a professional in practice, I realized that how I interacted with and engaged my cardiovascular patients had a very positive effect on their outcomes. It wasn’t anything scientific, but yet I knew that there was a difference in how they responded.

In 2005, I began to write about how important it was to partner with patients to improve their compliance with the purpose of working from their agenda instead of only teaching at them or directing them unilaterally from my or the provider’s agenda. During this time I also discovered that behavioral health had an awful lot to offer the medical community in this realm with motivational interviewing having caught my attention.

In 2007, Colleen Miller (Melinda’s business partner) and I began talking about our similar work experiences and our conclusions that if clinicians engaged patients differently that we could have a unique opportunity to positively not only affect their compliance but affect outcomes and costs very differently than we had in the past. And we decided, we really needed to develop an evidence-based program of instruction to educate healthcare professionals to achieve this end. Subsequent to this the National Society of Health Coaches (NSHC) was founded as an educational division of Miller and Huffman.

HIN: How has the demographic of health coaches changed over the last five years?

Response (Melinda Huffman): We’re seeing an increase in the movement towards the use of a licensed person as a health coach. And that’s because a licensed provider can more safely guide a patient or consumer through a wider range of issues, from prevention and wellness all the way to living with a chronic condition.

HIN: How are health coaches received by the medical establishment and how has it changed?

Response: (Melinda Huffman) It’s been extraordinarily well received. We get calls regularly from physicians who not only want to learn some coaching skills but also want to extend this to their staff who interact with their patients. They’re now beginning to realize just what an important impact health coaching can have. Five years ago we received very few calls from physicians about educating their staff.

Also, we’re beginning to see in the medical literature more written about health coaching and informational interviewing in particular. For the most part it was nonexistent five years ago, while very prevalent in behavioral health literature and researched, over 30 years of research in motivational interviewing. That’s basically what began to move payors in the direction of health coaching, because it comprised some motivational interviewing concepts. And with the kind of research and outcomes that they were being able to generate in the way of those with chronic conditions such as alcoholism and so forth, they felt like it was time to really look at what could happen when using that type of intervention with those with chronic conditions and had quite a bit of success.

So the medical establishment now wants health coaching practices to be evidence-based, as should. And there are many organizations who offer health coaching or who engage in health coaching that is not evidence-based. That is something that the user needs to keep an eye out for. But that’s why motivational interviewing has gained such widespread interest and appeal for physicians, because it has that 30 years of supporting research behind that particular intervention.

HIN: What trend or path will you be locking on for 2012?

Response: (Melinda Huffman) Working with medical homes, accountable care organizations and state governments to educate staff in evidence based health coaching. Also, mobile applications for clinicians including virtual skills practice modules to hone newly acquired health coaching skills that really make it more convenient whenever the clinician needs it and wherever they happen to be at that time. Those will be our primary trends going forward in 2012.

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