Why evolve the health coach workflow?


You just finished your first appointment with a new patient. It went a little long (2 hours, yikes!) but you’re feeling good. The patient was agreeable and open to any suggestions you made – which was a good thing, because you had a LOT of suggestions.

The next week you’re surprised to see their follow-up is cancelled… and even more surprised when your calls and emails go unanswered.

What went wrong? You really gave the patient your all.

If this has happened to you, you’re not alone.

It’s common for patients to shake their heads in agreement when sitting across from the medical provider. However, as soon as they walk out the door they are thinking “No way, I can’t do all of this.” They feel defeated before they even begin.

This speaks to the number one reason I see amazing medical providers lose patients: way too much information, all at once.

Patients get totally overwhelmed and bolt. I know because not only has this happened to me, it’s happened to my business integration clients. It happens to the best medical providers in the world.

But the answer is NOT dumbing down your message or diluting your recommendations. That might help you get a 2nd appointment scheduled, but it won’t serve your patients.

Instead, I have a solution that is outside-the-box for functional medicine clinics, but has worked time and time again.

Why patients get overwhelmed

In functional medicine, we ask patients to play an active role in their own health. But most patients don’t know this when they walk in the door. Or they don’t know exactly the extent of their participation required for Functional Medicine to be successful.

The patient is either coming from the allopathic model and they are used to expecting the doctor to ‘fix’ them. They want to heal the root causes so they seek out Functional Medicine providers but they have yet to claim their rightful role as the hero and assume Autonomy of their care. Or patients have tried many functional medicine doctors and are playing doctor hopscotch because no doctor yet has cured them.

The patients have yet to learn their role as an equal, therapeutic partner. They have yet to find their voice in co-designing a personalized and reasonable 3-month care plan. They have yet to focus on the long-term investment of the Functional Medicine process and partnership and are still operating in a state of instant-gratification expectation.

Instead, they arrive for their first appointment with you as a blank slate. When they hear you give them not only medical prescriptions but lifestyle recommendations all at once, they panic. It’s too much responsibility, information, and too high of expectations. They want to do this but feel like the tasks are not a match to their current ability. They need more guidance, hand-holding, and explanation.

How coaching solves overwhelm and sets patients up for success

In my model for integrating a health coach, the purpose of the coach driving the first encounter is to listen/retell the patient’s story so patients understand how the antecedents, mediators, and triggers have accumulated over time. This helps patients begin to connect the dots and think of more important events that possibly they had not considered sharing with their provider. Likewise, when the patient sees how their symptoms set has happened over time, the patient can agree to the functional medicine process which takes time to heal the root causes. This transforms a patient’s instant gratification expectations to partnership agreements at the very beginning of your relationship.

This first coaching encounter sets your patients to focus on long-term gains rather than short-term wins. And ideally, you want your patients to stay with you long enough to experience the profound results they are seeking. Plus, this first coaching appointment prepares the patient to be the provider’s equal therapeutic partner in this mutual participatory medical model. This takes the burden of education on the basic functional medicine tenents off the medical provider, reduces overwhelm, and sets your patients up for success. Of course, you will always be educating your patient, however, now you and the patient are speaking the same nomenclature and sharing a similar healing philosophy.

(Yes, this model does flip the usual role of a health coach in clinical practice on its head!)

Here’s a sneak peek into what it looks like when a coach drives the first encounter. To see a more in-depth explanation of how a coach may structure the patient’s first encounter Download this

9 Steps to a Health Coach Driving the First Encounter PDF.

  • Reflect back patient’s intrinsic motivators
  • What modifiable lifestyle factors they have implemented and are working on currently (and how it’s going)
  • Elicit change talk for the lifestyle changes patients are they thinking and preparing to implement next. Then the patient is well organized to share with you and you the provider can hear their lifestyle readiness.
  • What character strengths they are relying upon
  • What sources of inspiration they will the use to circumnavigate adversity
  • How are they bringing all of the lifestyle and medical recommendations to work in combination
  • How will they work with their GP, other specialists, and you!
  • How are they budgeting their finances to sustain their functional medicine lifestyle
  • And even more importantly, how they are communicating and working with their family and circle of influence to go against the cultural norm and live the Functional Medicine care plan

Meeting with the health coach connects the patient with their voice and gives them the responsibility to own their care and truly engage as part of an equal, therapeutic partnership.

The patient is now talking more and the provider can listen. Instead of trying to educate the patient, the provider can hear what the patient is mentally, emotionally, spiritually, and financially ready for. The provider then can personalize the medical recommendations to fit their current ability more easily.

This is how we transform the old ‘prescribe and treat’ model where patients still look to the provider as the hero. Let’s teach our patients that we don’t wave a magic wand and heal them. Instead, let’s introduce a new Functional Medicine mutual participatory medical model that positions the patient as the hero of their story and the rest of us as their Guides.

Ready to get started, integration the Health Coach next evolution Workflow? Schedule a free 20-minute Welcome Call with Kara Ware here.

Or read the blog-Coaching Isn’t An “Add On” – It’s A Must For Your Practice and How Integrating a Health Coach Can Transform Your Practice.


I am a paid advisor at Pure Encapsulations, I do not have any other conflicts of interest. All podcast productions represent the opinions of the co-hosts and do not represent the position or the opinion of the sponsors. Reference by the presenter to any specific product, process, or service by trade name, trademark, or manufacturer does not constitute or imply endorsement or recommendations by the Sponsor. The podcast is not a substitute for standard medical care. The podcast is intended for licensed health care practitioners. Practitioners are solely responsible for the care and treatment provided to their own patients.

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