Writing a blog on whether certain fitness professionals should be part of the "Health Care System." Care to share thoughts?
After becoming a health coach thru ACE, I found that they have been working on hard on getting professionals with this certification recognized by the health care industry. Do you think that certain fitness professionals should be part of the health care system? Perhaps being a provider for insurance companies or work directly with doctors? Interested in hearing your thoughts and opinions.
The question really has to do with defining scope of practice. Insurance companies tend to look at billable services in terms of what can they offer for how much, and what benefits does that service have. So with medicine: insurance companies have panels that determine what medicines get covered and which do not. Some of that decision is based on medical research and data from medical providers on use in patient populations. Some comes from which drug companies they can cut the best deal with to offer something that works in similar ways.
I teach yoga, so I will use this as an example. There is quite a lot of research suggesting that yoga and meditation have statistically significant effects combating things like anxiety and poor body image. (Exercise generally has good effects on mental health). It could be very helpful for patients to be given a prescription for yoga, and of course, highly beneficial to yoga teachers. More people would be able to afford it. However, no yoga teacher can take the place of a Psychiatrist. People who need medication to help counter an imbalance in neurotransmitters for example need to have someone to prescribe and monitor them. Can a yoga teacher take the place of a therapist? Again, it seems unlikely. A good cognitive or behavioral therapist has spent many years of study and has a tool box of techniques which a yoga teacher does not have. What a yoga teacher can do is teach yoga, and when done correctly it provides benefits. However, this becomes an addition rather than an instead of, and I think that is why insurance companies are reticent. It isn't like with one drug or another where you can more easily replace one with a less expensive one.
The question is what the scope of professional practice is of the 'Health Coach'? What services do they provide? Before insurance is going to cover anything hard cost/benefit data will be wanted.
Please note, I am playing devil's advocate. It would be great to have things like massage and exercise and yoga to be covered. The thing is that our health care system is predicated on a model of sickness/injury/ and cure/treatment. It is not modeled on the ancient Greek and Roman idea of mens sana in corpore sano. To change our healthcare model to one of stopping illness before it arises, by creating a culture of health and by adopting preventative measures will be like pushing a boulder up a hill with your arm in a sling. Our problems with income inequality and environmental degradation also make it very hard to get a cultural change where you can get enough people pushing on that boulder to get it up the hill.
I think a few first steps in this direction are better standardization of certifications. In yoga the Alliance has helped set such a standard. A new yoga teacher generally is expected to have at least 200 hours of training, and that training has to follow specific guidelines. I think if all health coaches and trainers had to have some sort of degree either in exercise science, or in nutrition, or have some sort of training that encompasses both, and takes more than a weekend to master, and requires a certain hands on component, that would be a good way to help set the idea of rigorousness of training.
Of course when we discuss the question of whether insurance companies SHOULD cover fitness services we might spend a lot of time on the question of the skills and training of the coaches and teachers and trainers, but whatever happens will happen or not based on cost and hard data.
My Health Coaching experience has shown me time and again that people really don't know how to make healthy life/food choices.
Doctors need a place/person to refer overweight/unhealthy patients to. Doctors don't have the time or choose not to spend time discussing SMART principles!
I think it makes total sense to have a network of Health Coaches/Coaching services available to physicians.
Exercise is great for a variety of reasons but I have discovered that people really need to learn basic nutrition and re learn how to eat well.
I have always viewed this as a double-edged sword.
Susan and Ariadne make very good cases for it but I look at the potential overhead that comes from dealing with insurance companies and the way they compensate for services rendered.
It is the reason why some healthcare providers choose not to be a part of the insurance continuum. Many doctor's offices have people dedicated to dealing with insurance claims.
Frankly, I am not sure I want to spend my time sorting out insurance plans.