Health Behaviors Coach A New Job Description for a New Health Care System A Proposal from The Montana Medical Association November 9, 2015
THE HEALTH CARE SYSTEM IS CHANGING Financing for the Health Care System is changing away from fee for service and toward global payments for populations. Health Systems will and are becoming larger in preparation for the assumption of increased risk and responsibility to assure quality health outcomes for ever larger groups of people.
A SUCCESSFUL HEALTH CARE SYSTEM will be one that empowers its covered population to assume a greater role and responsibility for their own health. The Health System’s empowered consumer will consume fewer health services as we currently know them but will need and demand increased knowledge and guidance.
THE CURRENT HEALTH CARE SYSTEM is ill prepared to meet the informational, educational, and guidance needs of the empowered consumer- patients we will be caring for. Primary care will be assigned an ever increasing scope of responsibilities. They will be provided by an ever expanding team of individuals some of whom do not currently exist.
We need to train individuals for the roles of the future not only for what we know in the present.
New Team Members with new job descriptions will be created to supplement the needs of the team. Their focused skill set will provide better opportunities to educate, empower and guide patients to better health than are currently available. They will free up other team members to focus on areas of health for which they are better trained. Just as we learned we needed Physician Assistants and Nurse Practitioners to supplement Physicians in delivering care, we will need Health Behavior Coaches to supplement other existing health professionals.
Dietary Counseling is currently done by dieticians in hospitals but is not readily available in clinic settings. Case managers abound in hospitals but less so in clinics. Health educators are limited in their availability. Counselors of all types are in insufficient supply in outpatient settings. We don’t need to solely train expensive additional health professionals with graduate degrees and license expectations, what we need are an expanded group of midlevel providers to work with these health care professionals. This will allow them to focus on the most difficult and challenging cases but also to lead and educate teams of midlevel health educators.
Primary Care Physicians have come to depend on Mid-Level Practitioners like PAs and NPs to provide necessary care especially in outpatient settings. We need to expand the Health Behavior Counseling work force in the clinic settings with an analogous Mid-Level Professional: The Health Behavior Coach.
WHAT IS A HEALTH BEHAVIORS COACH? A non-licensed health professional, who is trained to identify adverse health behaviors and risks and guide patients to more optimal health behaviors and life-style. These are not mental health counselors. These professionals empower, educate, motivate, and guide patients with healthcare needs. They work as part of a health care team, usually in a clinic setting. Their role would have some crossover to care coordination, patient education but would be distinct from current nursing and medical assistant roles.
WHAT KNOWLEDGE AND TRAINING WOULD THEY REQUIRE? AA or BA degree or the equivalent with an Internship TRAINING IN: Basic Anatomy and Physiology • Nutrition • Exercise Concepts • Medical Terminology • Psychology and basics of counseling • Concepts pertaining to readiness for change • Concepts of successful protocols and interventions proven to change • behavior. Understanding of the health system, including regulations •
MINIMUM CLINICAL SKILLS: • Counseling Skills • Ability to Document using EHRs • Ability to work well in a Healthcare Team • Experience Leading Groups • Teaching Skills • Motivational Interviewing • Ability to assess level of patient readiness for change • Conversant in disease related behavior • Able to screen for mental health issues and barriers to improving care • Case management skills
Upon Graduation from their undergraduate program they will be immediately ready to begin employment. NEXT STEPS • Agree that such a job description is desirable and necessary in health care. • Advocate for their acceptance as an EXPECTED member of the health care team. • Plan for their training and internships. • Advocate for their employment. • Document their impact on Patient Outcomes, satisfaction and Quality of Care which will more than offset the cost of their employment.
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