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Health Coaching vs Practicing Medicine

As you know, I’m building my health coaching brand – again. This is my second attempt at health coaching. The first time I tried this was overwhelming, and I didn’t have a niche to focus on. Let’s talk about the main differences between health coaching vs practicing medicine.

This post aims to offer my physician audience an insight into healthcare. It might even become an opportunity for you in the future should you want to do more than clinical medicine.

More importantly, I know doctors fear doing anything online that might be perceived as clinical medicine. Fortunately, there are ways to make it clear that you are acting as a health coach and not a physician.

Practicing Medicine

I know this seems basic, but let’s review what practicing medicine means. It’s a legal definition, after all.

A physician is a medical practitioner who practices medicine—promoting, maintaining, or restoring health through diagnosis, prognosis, and treatment of disease. It’s based on strong medical ethics, showing consideration, compassion, and benevolence to their patients.

As a doctor, I am licensed by a particular state and given the right to prescribe medications, and treatment, and perform surgeries.

As an allopath, my license holds me to the standard of a science-based medical practice. This is commonly referred to as Western Medicine to distinguish it from other alternative practices, such as Ayurveda or homeopathy.

Health Coaching

There is no clear definition of a health coach. As the Cohen Healthcare Law Group discussed in their article regarding the legalities of being a health coach, it’s something you have to definite with each particular business venture.

So what about NBHWC? The National Board for Health and Wellness Coaching is no different from the ABMS or NBPAS. These are groups that, somewhere, somehow popped up and eventually were recognized by groups, organizations, and the government.

One day you won’t be able to call yourself a health coach unless you have an NBHWC board certification or a BC from some other entity. For now, if you can prove that you aren’t doing any of the following, you are safe, maybe:

  • Reviewing and interpreting lab tests
  • Reviewing and interpreting genetic data
  • Making treatment plans based on clinical information

Avoiding Medical Practice

Using medical terminology, ICD10 codes, evaluating labs, and interpreting or prognosticating is considered the practice of medicine. You can do that in your clinical practice, but you might get into trouble if you do that as a health coach.

It’s not medical practice if you are telling someone to engage in an activity. Why? Because the FDA, CDC, and WHO already share that information with the public.

If it’s common sense and publicly vetted information you’re using for health coaching, then it’s hard to prove that you’re engaging in the practice of medicine.

Any regulator can come knocking on your door and put you under the microscope to decide whether you’re health coaching vs practicing medicine.

differentiating health coaching from the practice of medicine for physicians

Slippery Slope of Clinical Medicine

Having a medical degree or a medical license makes you more vulnerable because the state medical board can come knocking and tell you that what you’re doing is clinical medicine.

It will be on you to prove otherwise.

That’s always the risk you’ll take when trying to pry your life out from under the reign of state medical boards and delve into the world of health coaching.

But it’s not hard to prove to regulators that you are avoiding clinical medicine and instead engaging in patient education.

If I tell a customer online that their A1C is elevated and that their Type 2 DM is not well controlled, that’s the practice of medicine. That should be obvious.

If my patient states that their A1C goal is less than 6.5 but hovering around 10 because of their late-night binging, we can discuss the anxiety issues that cause them to want to binge.

Choosing Your Words

My health coaching client can ask me about their weight. I can point them to a BMI calculator online and even review the current CDC guidelines for weight.

I can’t tell them what kind of diet to follow or the particular exercises they should engage in. At least not as an individual prescription for them. That would violate the established practices of nutrition and dietetics.

However, I can share with that person what I do in my medical practice with my patients. “I tell my patients to use more resistance training” or “I have found that my patients maintain their weight better when they cut back on hard cardio and focus on resistance training.”

If you’re going to build your health coaching practice, you should have an attorney draw up a business document.

It would help if you also shared your bylaws and guidelines with your clients. Most will be savvy enough to understand what you can and can’t do, and they’ll respect it. That’s been my experience.

My experience with attorneys has been that some have enough business that they won’t stick their necks out for you. If you’re trying to do something unique, you’ll need an attorney who understands this space and can offer you a complete perspective.

Telemedicine Laws

Mr. Cohen does a great job in this short video explaining how you can run afoul of telemedicine laws.

Each state will have its own regulations when it comes to telemedicine. Remember that any digital communication you have with a customer could potentially be a telemedicine visit – even if you don’t think it was.

To avoid this, it’s essential to make sure that you aren’t acting, pretending, misleading, or confusing the patient into thinking that you are their physician.

In fact, that is why I highly recommend that alongside your health coaching business, you run a separate telemedicine practice. Any customer who doesn’t fit into your health coaching practice but insists on working with you should be moved into your telemedicine platform.

I run Digital Nomad Health for my private practice telemedicine patients and Heart Health Coach where I do health coaching. They have nothing to do with each other.

Using Your MD/DO Degree

It’s not that you can’t use your MD/DO degree on your health coaching site, but be aware that if you are presenting yourself as a physician, a state licensing body could claim that you misled the consumer.

The first question is whether Dr. Tom, in his afterlife as a health coach with specialized knowledge about weight loss, is engaged in clinical activities online (telemedicine) or merely an educational, informational enterprise.

Cohen Healthcare Law Group

Mr. Cohen highlights some critical strategies that a health coach can take to avoid inadvertently entering a patient-doctor relationship:

  • avoid clinical terminology reference
  • explain on your site that you have an MD degree but will be acting in an entirely non-clinical role
  • make it clear on your site that you are trying to educate the client and not treat or diagnose or prognosticate
  • avoid health claims of any sort
  • don’t diagnose the patient, don’t order medication, and don’t tell the client to use an OTC regimen
  • have strong disclaimers to ensure the customer has their own physician for ongoing care
  • focus on group seminars and educational digital content

Health Coaching vs Practicing Medicine

Health education is imperative in our current healthcare system. Patients are disempowered and lack health education more than ever.

As a health coach, I educate people based on readily available information. With my background as a physician, I can offer insight into my own clinical experiences.

Practicing medicine is something that I do with those who knowingly enter a patient-doctor relationship with me. I diagnose them, treat them, and prescribe them medication.

To make it clear that you are a health coach vs a doctor, you need to take some steps. It’s not difficult to do this and your patient narratives should reflect this.

12 replies on “Health Coaching vs Practicing Medicine”

Thank you Dr. Mo. I am an NP trying to become a health coach. I am careful with words and how we represent ourselves. I am curious as to your thoughts on as health coaches referring to themselves as health care providers

I think the beauty of health coaching is that you don’t have to get caught up in terminology like being a “provider.” But if you feel that it would be important for your marketing then I would contact the regulating medical board in your state or any state where you are considering advertising in and find out if that term is reserved for certain individuals.
As a health coach I am just a person with coaching expertise and knowledge in health matters. If I refer myself to anything other than a health coach I find that I would risk overstepping my bounds.
I’m a guide, a teacher, a coach, a facilitator, an organizer, a supporter, an instructor, advisor, and mentor. All of these are vague enough and convey that the person who is doing the seeking is tasked with putting in all of the work and effort.

Dr. Mo, I’m so glad I found your content, this was wonderful. Am I understanding that you took it upon yourself to learn behavior change principles and psychology to be a health coach or you used a program? I am interested in using health coaching principles in my lifestyle med virtual practice and have struggled with this very thing.

Thank you so much

I am really confused by the information here. If someone is an MD then why does it matter if they give medical advice as a health coach. If you are a licensed medical provider can’t you give medical advice all day long? How could you get in trouble for practicing medicine just because you are calling yourself a health coach? You have an active license to medicine so where does the problem of practicing medicine come in? Don’t all doctors basically act as health coaches when they tell you what to eat or do to be healthy and manage your illness? Its seems very weird to get in trouble for practicing medicine when you have a license to practice medicine. Can you please clarify?

Or is this only in reference to telehealth since you aren’t licensed in every state? I apologize if I seem obtuse regarding the article but I just found it in a Google search.

Hi Tracy. This website is geared towards physicians. I appreciate you posting here and asking for more feedback but it would be tough to explain it to a non-physician and it’s self-evident to a physician.

Hi I have a MD but no state licence. How can I get started I. Online health coaching?thanks in advsnce

All of this is nebulous and borders on practicing medicine even in the example you gave. Discussing “anxiety” around binging, it can be argued, is labeling with a medical diagnosis. I think any specific medical advice given- regardless of about a prescription medication or a lifestyle change- is the practice of medicine when you have an MD/DO. have talked to several attorneys who all state that this is the case and most advise that you only health coach in states you have an active medical license in. Please be careful.

This is an important comment. Everyone but you gets to decide whether what you did or didn’t do was the practice of medicine. Just like when you get curbsided by a friend, it can be construed as medical advice.

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