The rise of chronic disease
When the traditional model of medicine was established, the primary health problems were acute infectious diseases: tuberculosis, typhoid, and pneumonia. At that time, the “one doctor, one cause, one treatment” paradigm was effective at restoring health for these types of health problems. Today, non-communicable diseases such as heart and respiratory disease, cancer, obesity and diabetes are responsible for an estimated two-thirds of premature deaths around the world. Effectively treating these conditions requires a collaborative care model and health care coaching is a key component.
Consider these statistics:
- Seven of ten deaths in the United States are caused by chronic disease.
- In America, one in two have a chronic disease; one in four have multiple chronic diseases
- Since 1994, children with chronic disease more than doubled (from 13% to 27%)
- The United Nations estimates—on top of the social and psychological burdens of chronic disease—the cumulative loss to the global economy could reach $47 trillion by 2030 if things remain status quo.
- Although chronic diseases are often multifactorial, an estimated 85 percent of chronic disease can be explained by factors other than genetics.
The need for change
It’s clear that chronic disease is the single biggest threat to our health today. More than anything else, behavior change is needed if we want to prevent and reverse chronic disease. According to the CDC, the top five behaviors for preventing chronic disease include not smoking, getting regular physical activity, consuming moderate amounts of alcohol or none at all, maintaining a normal body weight, and obtaining sufficient sleep daily.
But as of 2013, only 6.3 percent of Americans engage in all five of these health-promoting behaviors. Why? Because change is hard. It’s not that people don’t want to change and improve their quality of life, they just don’t know how to do it successfully over the long term. The truth is, most people need help creating healthier habits and lifestyle changes.
What is Health or Wellness Coaching?
Health coaching is often defined as helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals. Trained health coaches use evidence-based conversation techniques, clinical interventions and strategies to actively and safely engage patients in health behavior change, especially those with one or more chronic conditions.
The Centers for Disease Control and Prevention define wellness as “the degree to which one feels positive and enthusiastic about life”. Health or wellness coaching is a process that facilitates healthy, sustainable behavior change by challenging a client to develop their inner wisdom, identify their values, and transform their goals into action. They utilize the principles from positive psychology and appreciative inquiry, and the practices of motivational interviewing, goal setting and accountability.
The familiar adage “Give a man a fish, and he eats for a day. Teach a man to fish, and he eats for a lifetime,” illustrates the difference between rescuing a patient and coaching a patient. In acute care, rescuing makes sense: surgery for acute appendicitis or antibiotics for pyelonephritis. For chronic care, patients need the knowledge, skills and confidence to participate in their own care. Otherwise, the effectiveness of treatment is limited.
Why can’t doctors help with behavior change?
Simply put, physicians lack the time and training. The average visit with a primary care physician lasts 10 to 12 minutes—barely enough time to review the patient’s current medications, ask them about new symptoms, and prescribe a new drug. It’s not even close to the amount of time necessary to identify areas for improvement, assess a patients diet, behavior, and lifestyle. Even if they make the time during a visit, how are they going to provide the support necessary for sustaining these changes?
The reality is, most doctors, nurses, and physician assistants aren’t trained in behavior change. Instead, they are trained in the “expert” model of care, where they simply tell patients what to do and expect them to do it. This approach works for acute health issues, but fails for long-term behavioral changes like managing stress, starting an exercise routine, or losing weight.
For most people, information itself does not change behavior.
Also, there aren’t enough physicians to address the problem. It’s estimated that we’ll have a significant shortage of primary care physicians by the year 2025. If that’s true, we’ll need them to practice at the top of their license and focus on activities specific to their training; like interpreting lab results, making diagnoses, and recommending treatment plans.
Finally, health and wellness coaches are an incredible asset to any clinical practice. But unfortunately, most clinics lack the staff, training and technology to support these efforts. They don’t have the infrastructure in place to effectively treat patient health before, after, and in-between care encounters.
Here’s where we can help.
Vigilance Health care managers are trained in healthcare coaching and motivational interviewing techniques to effectively help patients become partners in their own care and empower them to make positive changes to their health.
Our suite of services compliment—rather than replace—a physicians supporting staff, and don’t require upfront costs, staff increases or capital investments. The Vigilance care team performs as an extension of a private practice or health system, brings with them today’s leading population health and care management technologies, and provides care programs that address patient health in-between visits as part of our care management program.
This not only helps free up physician time and improve patient care, it offers health care organizations a low-risk way to gain experience and proficiency with population health management and value-based reimbursement models. Moreover, partnering with Vigilance Health will help create several new revenue streams to make this transition with the least amount of financial and operational discomfort.
For detailed guidance on how to begin the transition to value-based care using the Vigilance Health Chronic Care Management program, please contact us here to schedule a complimentary consultation with a Vigilance Health Care Management Specialist.