A Day in the Life: Health Coach Helps Employees Make Lasting Change

Marathon Health’s Day in the Life series spotlights the role different care providers play in improving employee health at the worksite, at a nearby Network health center or virtually. In this blog, we spoke to Debbie Richardson, a nationally certified health and wellness coach.

More than 60% of U.S. adults live with a chronic health condition like heart disease or diabetes, and 40% have two or more conditions. While a physician can effectively diagnose a health condition and prescribe medication, they may not always be successful in motivating patients to make necessary behavioral changes to address the root cause of the issue.

To help patients take charge of their health, providers often turn to professionals like Debbie Richardson, a certified health and wellness coach for Marathon Health. Put simply, health coaches create a safe space to assist patients to use their own insight to identify their motivations for wanting to make sustainable healthy lifestyle changes. It revolves around the idea that patients are much more likely to succeed when they make changes for their own reasons versus being told what to do.

While the end goal of engaging with a health coach is often to manage blood sugar, quit smoking or improve sleep, the real objective is to understand the lifestyle choices that contribute to the issue, and develop a personalized plan that leads to lasting change.

“In the very first session, we work on identifying the member’s wellness vision,” Debbie says. “What does it look like to function at your best? What’s that picture you’re going for? Sometimes, people have thought about it, and some people don’t know what it feels like to feel good. But the content we talk about is very personal. I feel like I know more than their hairdresser.”

Debbie has worked as a health coach for Marathon Health over the last 12 years, serving in several onsite health centers. Today, she works in a dedicated health center at OneAmerica’s headquarters in Indianapolis.

“My day is never the same, and that’s why I love it,” Debbie says. “There’s so much variety. I work one-on-one with patients, facilitate small-group sessions, serve on various committees, and develop and provide wellness webinars. It’s really engaging, fulfilling and fun.”

On this particular day, Debbie has 10 appointments — she’ll meet with four members in person at the worksite and six virtually. The reasons for the day’s coaching sessions include: managing A1c, tobacco cessation, managing menopause, recovering from surgery, managing stress, food tracking, managing the loss of a loved one and strength training to help with back pain.

“I typically have a mix of initial appointments and follow-up appointments. They could be virtual, in-person or telephonic, and they could be about wherever the member wants to go,” Debbie says. “I work with members in Maine, Texas, Wisconsin, California, Indiana and more. My NBC-HWC certification is nationally certified, so allows me to work with members all over the country.”

When the pandemic hit, Debbie transitioned to 100% virtual sessions with minimal interference. She says virtual sessions are highly effective at driving positive lifestyle behavior change, but she still prefers meeting members face-to-face when possible. “In the room where I work, I’ve got a whiteboard,” she says. “We do brainstorming. We write things down and work through issues, which is a little more difficult over the phone.”

Debbie also leads multiple support groups, including weight management and diabetes support groups. She says support group topics typically address health issues identified in the employer’s population.

“We keep population health management in mind, and that’s usually what drives the lifestyle behavior change programs we offer,” Debbie says. “Currently, I’m co-facilitating a lifestyle balance program. It’s an 11-month virtual program. We have 28 people, and we meet weekly progressing to bi-weekly then monthly as the program progresses.”

The ultimate goal of health coaching is to drive positive lifestyle behavior change. Debbie says each member holds different expectations, goals and boundaries, and the key is to meet them wherever they are in the journey. What works well for one member may not work at all for the next.

“When we look at an individual coming in, I’ll ask, ‘Are you just starting to think about this? Do you want to learn more about it? Are you ready to change in the next 60 days, the next 30 days? Are you already doing something to address it?’”

After identifying where they are in the stage of change, Debbie talks with the member to understand their motivations and partners with the member to determine small steps they can take to be successful. These quick wins give the member confidence. These wins can be as simple as switching from regular soda to diet soda, taking breaks from the computer or walking a few minutes per day. “With coaching, we don’t focus on perfection — any progress we can make is key,” Debbie says. “It’s progress, not perfection. That’s one of my taglines.”

For a member who feels trapped in their ways or unable to make progress, even a small win can spark major change. “It’s all about those ‘aha’ moments, when a member says, ‘Oh my goodness, that’s what’s holding me back’ or ‘That’s what’s helping me be successful,’” Debbie says. “What’s really impactful is the thought came from them, not from the coach. My job is to listen more than talk. I am an accountability partner not the director, I just have to come up with the right powerful question to help them along in that behavior change journey.”

Health coaches usually work in tandem with a member’s Marathon Health provider team. Debbie says members typically come to her after getting a referral from their physician or receiving a troubling lab result, but some members self-refer for a variety of reasons.

The Marathon Health care model uses a collaborative, team-based approach to treat the whole person. Debbie regularly works alongside Marathon Health physicians, nurses, and medical assistants. The team also includes a dietician, diabetes educator and behavioral health specialist.

For example, a Marathon Health physician may diagnose a member with diabetes and prescribe medication. Debbie then works with the member to understand what the member understands about the chronic condition, the lifestyle choices and behaviors that contribute to the problem; develop a personalized plan of action; and provide ongoing support to manage the condition or eliminate it altogether.

“I touch base with our providers after I receive a referral,” Debbie says. “And all of our health coaches chart in our electronic medical record system. I can look at previous clinic visits, I see all of their lab results and all the vitals. I know what the physician has said, so the right hand knows what the left hand is saying and doing.”

Debbie says she loves her job as a health coach at Marathon Health, not only because she gets to help members overcome major life challenges, but each day brings something new. “It feels amazing when somebody says, ‘Oh my gosh, I get it.’ And then I love the variety — I get to do the education, the support groups and just help people improve their quality of life.”