Chris Kresser: Okay, let’s see here. Justin says, “You’ve previously mentioned on our earlier Q&A about working with a health coach. Do you have any tips or suggestions on how to implement this now? I feel like I need to have a higher touch, but I don’t have time to do so personally.”
That is great. That’s exactly what a health coach is for, to help you leverage you and your expertise, but provide a different type of care that you’re not trained for and you don’t have time for even if you were. I think a great possibility would be to reach out, look at the Kresser Institute directory. Our first cohort of coaches is graduating in June, so all of them are still finishing up their practical skills assessment, which is our equivalent of [an] oral final exam. Some have already done that, and they become certified and are listed in the directory and you can reach out to them. When you’re just starting out, I just recommend a 1099 contractor type of arrangement, which means you would bill the patient for the health coaching service and then the health coach would bill from their business for the time that they spend, and as is typical in a certain situation, you’re billing then at a higher rate than they’re billing you so that you cover your overhead cost and have a little bit of profit baked into that. That’s one way to do it.
Another way to do it is, if you don’t want to set it up that way, just to refer your clients to the health coach and not have a financial arrangement, but I think it makes sense to have them in-house as an independent contractor so that you can build up the relationship over time and, eventually, if it’s a successful collaboration, then you can bring them on as a part-time or even full-time employee. That’s what I would suggest.
Note: You can find ADAPT Certified Functional Health Coaches that work in your area or virtually at directory.chriskresser.com.
Justin says, “Do you have an example of a schedule of how you use a health coach?”
Not sure exactly what you’re asking, Justin. Let me know if this gets to it. We’re actually kind of in the process of revising that a little bit right now. We would tend to offer health coaching after the case review. If somebody comes in and they do the initial consult, they do the labs, then we do the case review, and then they’re like, “Whoa, this is overwhelming,” we say, “Consider working with our health coach. They’re really good at supporting people implementing these protocols, and it’s kind of holding your hand through the process.” And even when we don’t necessarily hear anything in the case review that indicates overwhelm, we still put it in the follow-up encounter notes that we send after the case review is finished because somebody might not feel overwhelmed initially, but then once they really get into it, it can still be overwhelming. We’ve considered just including a health coaching session in the initial case review process so that it’s not even optional. It’s baked into the service and I’m strongly considering that because a lot of people don’t really understand what health coaching is and why they would need it, and the only way to really understand that is to have a session. I feel like part of our roles as clinicians and my role as a patient educator is to provide—the reason I created the case review process, the way it is, is I think that that’s the way it works best and gets the best results. If I just let patients come in and say “sit down” and I just say “Okay, how can I help? What do you want to do?” That could be a fact to some degree, but probably not nearly as effective. I know from experience it’s not nearly as effective as the case review model, so I set that up because part of why a patient comes to me is because they’re wanting my expertise on how to get the best results, so I think including a health coaching session within that case review package is another expression of that. We’re looking into that and I know actually Mark Hyman has done that for the past couple of years at his UltraWellness Center with good results. And then, once they’ve had that initial session with the health coach, they just periodically schedule follow-ups.
Other people out there [are] doing packages and subscription models, or a certain number of health coaching sessions are included per month or per package period, and that’s a totally valid way to do it, too, and we’ve continually evaluated doing that. We haven’t yet, but we may be doing a pilot kind of trial of a subscription-based or package-based model in the near future. Yes, I think it’s a question of experimenting and seeing what works best for your practice and your patient population.