Coach Training’s Value – Professional and Personal
Interview with Teresa Larsen
|Julie:||Hi Teresa. Could you tell us a little bit about yourself, where you are coaching patients and what your role is?|
|Teresa:||I’m a chronic care coordinator for a center for primary care in Augusta, Georgia. We are a large primary care facility. We have nine offices, and I’ve been here since 2015. We have a Medicare program that started back in 2015, so that’s where my patients come from.|
|Julie:||Okay, and how did you decide to become a coach?|
|Teresa:||Our office was offering the training, and it was kind of easy to decide. I love training, and when it is offered through our practice, I’m always interested in more education and more training. When they offered it, I kinda jumped on it.|
|Julie:||Do you coach patients telephonically, or in person?|
|Teresa:||Mostly, it’s telephonically, but sometimes I do meet patients in person. It depends on what they need.|
|Julie:||How often would you say you talk with your patients? With each patient?|
|Teresa:||Each patient? Again, it’s kind of individualized. Usually it’s at least once a month. Some patients, once a week, just depends on what their individual needs are.|
|Julie:||How has the health coaching training changed or altered your approach when working with your patients?|
|Teresa:||It’s really helped me to empower those patients. I came from the old school way of teaching. I’ve been in healthcare 23 years and the old school thinking is — tell patients what to do. Coaching was a whole new way of thinking. A new way of empowering the patients. I really enjoyed that aspect of it.|
|Julie:||What impact do you think you’ve created on your patients with your coaching?|
|Teresa:||Giving them the power. Empowering them to take control of their healthcare. Letting them make those decisions, and letting them realize that they have control. They get to make the decisions, and it’s not always what they’re being told. They really can decide what’s best for them.|
|Julie:||What skills would you say that you use in order to accomplish that?|
|Teresa:||Those open-ended questions letting them decide what their goals are. Make them really set their goals, deciding what’s truly most important to them.|
|Teresa:||When we’re talking about the care plan, I always ask, “what’s most important to you? What is your biggest health goal this year?” When we give them that question, for them, it’s, “Oh! Okay.” Sometimes it takes them a minute to think about it because they’re always used to being told what to do.|
|Teresa:||Yeah. Sometimes my patients who are smokers, that’s not the biggest issue for them. Sometimes they’re like, “Oh, you’re not going to fuss at me for smoking.” It’s like, “well, if you don’t think that’s your biggest issue, that’s not what we’re going to talk about. I want you to tell me what’s your biggest issue.” It may be something completely different.
It’s all about what do they feel like is their biggest issue. We may come back to smoking later.
|Julie:||Okay, great. What is your most valuable professional takeaway from the clinical health coach training?|
|Teresa:||I really think … Asking open-ended questions, going back and reassessing, and making sure they knew that we were listening. A lot of the time they don’t get that face-to-face time with their physician. We fill in those gaps. Sometimes, I think they don’t think people are listening. When we do that recap and we’ve listened to them talk and then recap everything, they actually realize that, yes, we are listening to them.
We’ve heard everything they said. That makes a huge difference because sometimes people just need someone to listen. They feel like someone cares. For some of our patients, that’s all they need. When they’re having a bad day, sometimes we get patients who are screaming and upset, and they just need that ear. They need someone to listen. Especially my older patients, that’s who I talk to. They don’t always have someone to listen. That means a lot.
|Julie:||Right. Okay. What difference has coaching made in your work life or even your personal life?|
|Teresa:||I have teenagers, so, I use the coaching with my kids.
… to help them make good choices.
|Julie:||A little side perk from your training.|
|Teresa:||Yeah, exactly. It’s so funny because we’ll be in the car … and it’s funny because I’ll use a little bit of that on them. It’s not always “how was your day,”…|
|Teresa:||It’s, “so, what’s going on. Tell me.”|
|Julie:||Right. A few reflections here and there?|
|Teresa:||Exactly. Again, it’s making them feel empowered. It can be … when we talk about professional takeaway from that, it doesn’t always have to be your patients, it can also be your coworkers. Listening to them, as well.|
|Teresa:||Empowering just the people around us, making those decisions, and listening, and finding what is important to them. That’s been huge. Again, we’re so used to people, telling us what we have to do, or telling us what’s important to us. That’s been huge when it came to health coaching, and taking a different approach to working with patients, and care management. I’m coming up on a year now since I took the training. It’s really been a whole year of a different way of thinking. It’s been great.|
|Julie:||How did the training help you or equip you to become a player in the world of population health?|
|Teresa:||It makes me a better advocate for my patients. It really helps me advocate better when I know what their goals are.
When I know what’s most important to them because, again, a lot of times physicians are only able to spend a short amount of time with each patient. When the patient leaves, they walk away and they’re like, “that wasn’t quite what I meant or wanted to do.”
|Teresa:||The physician wanted to do a certain thing and it’s not really what’s most important to them.|
|Julie:||You get to dig deeper?|
Sometimes they may smoke two packs a day. And, getting them down to one pack is better than not cutting back at all. You have to kind of pick and choose your battles sometimes. That’s a little better than, again, not cutting back at all.
|Teresa:||When we’re talking about our diabetic patients, I never tell a patient you can’t have something completely because the minute we tell our patients they can’t have something, they want eat all of it. Some patients drink a twelve pack of soda a day and if you tell a patient they can never have a soda, it won’t work.
Again, you have figure out how to talk to that patient.
|Teresa:||Figure out what’s most important to them, what might be attainable and figure out how to talk to them.|
|Julie:||Do you have a success story that you could share about one of your patients?|
|Teresa:||We gotten quite a few of the patients to the point where they will call us before they go to the emergency room, which is nice. Before they get to the point where they need to go to the emergency room.
We’ve gotten some of our CHF patients to the point where they know to weigh every day. When they start getting a pound or two up, before they get to the point where they’re in that dangerous area, they call.
|Teresa:||Things like that. We do work closely with our diabetic patients. I have a diabetic patient who we had to call every three days, when we were working with her insulin, to get her to titrate.
We’ve gone from an A1C of 13 down to about six, now. Over the course of three months.
|Julie:||How did you motivate her to do that?|
|Teresa:||For that patient, it really was really about her wanting to get better. It was just encouraging her and listening.
It comes down to just being that advocate and being there for those patients. It’s something that I just love. I love working with those patients who are ready to make those changes.
You really can’t ask for better. All you have to do is make those calls, and answer the phone when they call you, and encourage them. I tell those patients, “I’m proud of you.” A lot of times, that’s all you need to do.
|Teresa:||Then eventually, they see the effect of better health.|
|Teresa:||A lot of times, that’s all it takes. Because they feel better, tomorrow they’re gonna make a better change, another change. Each day it gets better and better.|
|Julie:||What advice would you share with healthcare colleagues that may be considering taking the health coach training?|
|Teresa:||I have to say do it. It does take time. It does seem stressful as you’re going through it. Do it. When we were doing it, I think we did it through the fall and through the holidays, and it was a little stressful, but it was so worth it in the end. It has become invaluable, the lessons that we learned. It really has helped. I never would’ve thought that it would completely change the way I do things. Because, again, I’ve been in healthcare for 23 years now. It really has changed a lot of the outcomes we have, it has changed my thinking completely.|
|Julie:||How do you measure those outcomes?|
|Teresa:||They have a way of measuring, but overall, our patients are just doing better. When I talk to my patients each month, we hear them doing better. You can’t argue with that. The patient’s health, overall, is just doing so much better now. Do the training. It really does make a difference, and it really does help your patients.|