Let’s face it, our world needs health coaches because the wellness of our population is suffering now more than ever. Clients rely heavily on a great Health Coach for advice, but there are times when it’s actually best to refer your client to a medical provider. Can you recognize the times that it’s most important to advise an appointment?
Even if you know the right advice to give, it’s in your best interest (and your clients’) to respect the Health Coaching scope of practice. Our scope of practice only extends to supporting health and education and maintaining accountability and providing encouragement for our clients. Our scope ends when it comes to diagnosing a disease or illness, prescribing medication, advising a treatment plan, or essentially any service that a medical doctor is licensed to provide.
Why is it important to be mindful of our scope of practice? Liability. Health coaches, in most circumstances, do not have the training or background required to diagnose or treat illness, and even if we may know what is going on with the client, we need to ensure that the client receives the best care possible and that we stay in our lane. If by chance, you are a health coach who has a medical degree (ie. nurse practitioners, physician assistants, registered nurses), a clear delineation must be made about whether you are coaching under the scope of your medical license or if you’re coaching simply under the auspices of the health coaching role. Keep in mind that if operating under a medical license, state rules apply and will often not allow you to practice virtually or across state lines.
These three instances below are the ones that I have typically come across in my practice where I make no mistake that the client needs to seek medical attention. If you’re not already advising your clients under these circumstances
to seek medical evaluation, then you need to start doing so because your livelihood and your career may be at stake.
1. New Onset Symptoms.
A client may come to you seeking advice for new symptoms that they’ve developed including but not limited to a new cough, chest tightness, fever, feeling an acute change in fatigue, body aches, or similar decline from their baseline. In this circumstance, it may well be a common cold and a health coach may well have great advice to share. However, it is important that you advise this client to seek medical evaluation because the range of conditions that this could be presenting as includes everything from that common cold to electrolyte abnormalities to cancer. Just because the symptoms “sound” like something familiar it could be much more serious. This is why it is also important to give these instructions to the client in writing. If you have a documentation system where you keep notes on your clients, this is also the time to document in your note that you have advised the client to seek medical attention for the symptoms that they noted on that date.
2. A severe reaction to a supplement.
In the Health Coaching world, we know a lot about alternative herbs and vitamins that are used to support the body in many ways. Sometimes those supplements can cause an adverse effect. I have seen everything from extreme fatigue to dehydration and diarrhea as well as rashes and joint pain. Whenever you are in doubt, have your client stop their supplements immediately and seek the care of a medical provider. Our ultimate goal is to help our clients achieve greater wellness and sometimes that path does not include our intended supplement recommendations. Always make sure we are doing no harm by getting your clients evaluated before having them continue as usual. Each body is individual and may react differently to supplements. Also, always check for medication interactions and advise that the client also works closely with their medical provider whenever starting any new supplement or regimen. And put that in writing.
3. The client has never had symptoms evaluated by a medical provider.
Here’s a typical scenario I have encountered many times in practice: a coaching client will describe symptoms they have been dealing with and when asked what has been done previously or what conventional medicine workup has been provided, the
the client will say something like, “I don’t believe in doctors” or “I stay as far away from those doctors as I can”. And while I can empathize with clients who have had poor interactions with providers with poor bedside manner, it does not alleviate them (or us) from advising a thorough work-up for symptoms before we dive into recommending lifestyle changes or nutritional supplements. Very minimal symptoms can be an indication of something much more severe and it must be ruled out by a licensed practitioner.
As a Health Coach we must also do our part to “coach” our clients about their healthcare; how to find a good practitioner and why that’s important. We are not the client’s medical provider and it’s important to make that clear. The client may need help in creating their wellness “Dream Team” and that’s certainly something a Health Coach can help with. Start to create a list of your go-to practitioners: conventional medicine, acupuncture, massage, personal trainers, etc. Every person should have their own wellness squad with all types of providers, including a conventionally trained medical provider. Then, when a client comes to you in need of a specialized service, you’ll have all the right recommendations.
There will always be scenarios that cause your radar to go up. Whenever you feel uncomfortable helping a certain complex client, it’s ok to make your scope of practice clear, and don’t hesitate to refer to a provider. Trust your gut and always err on the side of caution. Looking out for your client’s best interests is why you’re a great Health Coach to begin with.