Physician exodus—from doctoring to coaching

Two happily retired physicians discuss coaching as a career.

00:00  Ob/gyn-turned-health coach
00:32  Transition to direct pay model
01:15  Health coaching CPT codes
03:30  Avoid being a “generic” coach with a defined niche
06:00  Teaching through storytelling
06:21  Opting out of high-overhead/high-volume model
06:40  The moment you knew you would be a doctor
07:52  How doctors earn more as scribes
08:00  Health coaching laws vary by state
09:00  Group coaching benefits
10:30  Are coaches practicing medicine without a license?
12:25  Cleveland Clinic health coaching corporate model
13:58  Benefits of detaching from the medical board
15:06  Advice for physicians disgusted with their careers
16:37  “If you don’t have a medical license, it’s not like your brain fell out of your head.”
17:10  Benefit of being a health coach—confidential mental health care
18:19  Get loans paid off as a health coach, teacher, even a park ranger!
19:03  Final words of wisdom—don’t choose suicide to escape medicine
19:40  You do not have to be a doctor to be a HEALER
20:06  “If I would have known what medicine would be like, I’d never have done it.”
20:28  Income potential as a health coach

Need more info? Reach out to Bryan Treacy at healthwithoutrisk.com and Pamela Wible here

Tags: , , , , , , , , ,
Add your comment below or scroll down to read 9 comments

Leave a Comment

Your email address will not be published.

*

9 comments on “Physician exodus—from doctoring to coaching
  1. Matthew Karpenko says:

    I love this!!! Define what you want, make your plan and get out!!! It’s that easy! I did it in April and I’m never going back to the cog in whelk assembly line of corporate medicine. There are so many opportunities for physicians to do things on THEIR terms!! Do it!! You know you’ve had enough. Take back your life!!!!

    • Pamela Wible MD says:

      CONGRATULATIONS Matthew, Feels awesome!! I know!

    • Good job Matthew! I’m sure you feel a weight lifted off your shoulders. I wonder what the corporate medicine model is going to do when there are no more physicians willing to follow their narrative. Health Coaching is the fastest growing area in health care. Transitioning from the heath care system to health coaching lends credibility to that facet of health care, as opposed to health coaches with no clinical background. Theoretically, anyone can call themselves a health coach. Yet, I think doctors and nurses have the appropriate background for serving people in this fashion.

  2. Bryan, thanks for sharing your story and the information about working with prescribing physicians as a coach. I had no idea there are CPT codes for coaching. That can make it more accessible to people.

    Pamela, thank you for the energy and commitment you put into helping physicians find out of the box ways to be healers.

    I have a question about the confidentiality of what clients communicate. If the interaction is doctor-patient then their information is protected under HIPAA. But if the relationship is client-coach then is that information more accessible to third parties, say in a divorce, or custody battle or disability claim?

    If anyone has some insight into this please post a comment as I may not be the only one with this question.

    Thanks

    • Pamela Wible MD says:

      Thanks Joe, Good to hear from you. Was away at a physician retreat I was hosting so took me a week to moderate this comment into the feed. I do think that HIPAA may not hold for coaching. In the example above the coach is working on behalf of the doctor so I do think HIPAA may cover his physician-led coacging; however, I would guess a nutritionist coach in say, Florida, could have her records used in a court of law. Though from what I understand many coaches do noy even keep records. Example; I host writing retreats and keep no records on my clients. They write their books, drafts, manuscripts. I give feedback, I keep no records on any coaching clients I have. So no risk here. I think each case is VERY individual.

    • Thanks for your input Joe! As a former physician, if I was ever put in this position to divulge confidential information, I would refuse to do so. That is probably because of my background. I could see other health coaches not feeling this way but I think to get to the issues involved, there has to be confidentiality and clients need to know that their communication is privileged. I don’t know the intricacies of the law on that, but personally I would not be coerced into revealing that information. Medical Boards do it all the time by demanding medical records of patients and physicians without explicit HIPAA permissions. Not divulging confidential information shared with me has been a tenet for me even before there was a federal HIPAA law. I’m not telling.

      • Pamela Wible MD says:

        Yes, med boards do infringe on our confidentiality. See Physician-Friendly States for Mental Health: A Review of Medical Boards

        “I am applying for my Texas license and I feel my rights are being violated,” reports one internist. “I have well-managed depression. I was asked do you have a mental condition—yes, and then I was asked does it affect how you function at work—no. I thought that would be the end of it, but now I need a treating physician statement, a statement from my program director, and I need to justify why I said no to it not affecting how I function at work. I’m required to list all my medications from the past 5 years and all physicians who have treated me. How is this not a HIPAA violation? Why are they still allowed to do this? My application has been flagged as ‘impaired’ and needs to go before the board and people who have never met me will decide if I am a danger to my patients. I have no money for a lawyer. If I fight this it can delay my license and my being able to work. My friends with no medical issues were approved months ago and here I am still waiting.”

        “In residency I had to do a rotation in Alaska,” reports a hospitalist. “The application asked if I had ever been on psychotropic medications or in counseling. I had taken Zoloft 12.5 mg for 90 days due to anticipatory anxiety about starting intern year. Fortunately, my fears weren’t realized, so I stopped the medication when the prescription expired. I had also gone to counseling in my fourth year of medical school for a separate relationship issue. So, I answered both questions affirmatively. This resulted in my having to ‘defend’ myself to a panel of people on the Alaska medical board over the phone. They granted my license, but it was a humiliating experience—and definitely created barriers to my seeking care moving forward—both because I have not wanted to be in a position to have to answer those types of questions affirmatively, and due to financial barriers because I will not use insurance to defray costs of counseling since that may be ‘discoverable.’ What a horrible culture of shame those questions create!”

        “When I applied for my Florida license it was delayed by months,” reports a gynecologist. “I was required to have a psych evaluation by an ‘approved’ doctor due my history of depression which was treated and well managed. It fell under the ‘impaired physician’ program and definitely was stigmatizing. To this day I don’t answer those questions honestly anymore and am hesitant to seek treatment as needed.”

        “After the unexpected death of a patient, I sought counseling. By a stroke of (bad) luck, I picked the only one in town in charge of impaired physician monitoring. He told the board (though stable) I should be ‘monitored.’ I had to defend myself in front of the Florida board. They laughed in my face and then posted in the local newspapers that I was sentenced to 5 yrs of monitoring. I had mandatory Wednesday group therapy. Though I was an exemplary physician, my employers had to be told why I was unavailable for call every Wednesday. Each time I (re)credential with hospitals, I must explain the whole thing again. HIPAA for me does not exist. I have never missed a single day of work for mental health.”

        • Joseph Arpaia says:

          I advise physicians to pay a therapist out of pocket and to make sure that it is labeled as “professional coaching”. If you are self-employed then that may be deductible as a business expense too (though you should check with your accountant about that).

Click here to comment

ARCHIVES

WIBLE WINS NPR AWARD

Copyright © 2011-2022 Pamela Wible MD     All rights reserved worldwide     site design by Pamela Wible MD and afinerweb.com