Do you sometimes wonder how you can reasonably work with your client within your scope of practice?

Are you, like many health coaches paralyzed by the fear of who you can and can not work with and what you can do?

Have you noticed that there really aren’t too many people addressing this because of legal liability?  Especially the people who you feel should be addressing it.  Avoiding this topic loses institutions and organizations the credibility and trust that transparency affords.

Well, this week I am going to talk about it.  I am not giving any legal advice.  You need to study your own state and talk to your own attorney.  Every business is different.  Every niche requires a different approach to the law.

#1  You Need An Attorney

How to Choose an Attorney

The first person I went to was my business attorney.  We have worked together for 30 years now.  We are friends now.  He told me that this was beyond his scope and gave me the name of several large law firms with research departments that were large enough to handle the licensing research that would be necessary.  This field is large enough that I knew there had to be someone who had already done the research.

I talked to several other attorneys.  Some specializing in health care licensing and some not.  So, how do you pick?

1. Choose an attorney who can access the laws without too much time and expense.  It doesn’t make sense to pay the attorney who gets $700 an hour to research when you can go to a little larger firms with law clerks who can do it for less.
2. Give your attorney everything you can assemble to keep their research time down.  There are organizations who have done some of this research for us.  These are the organizations we should be supporting.  (More on that below).
3. Choose an attorney who shows an intellectual interest in your situation.  A really good attorney should listen to what you think you need.  Find out from you why you think you need it and critically analyze the pros and cons and advise you on your options as they see it.  Your attorney should not just throw out a cost and start doing the work.  That is the difference between a legal adviser and someone who is just handling the paperwork for you.  This is really important….be careful of this.
4. The attorney you select should deal with what YOU need…and not from what their “package” includes.  Be a little wary of the package lawyers.  This generalizes the amount of work they are willing to put out versus what you actually need.  It also eliminates #3 – where they are throwing a package at you instead of thoughtfully considering your individual needs…WHICH…is what you are paying them for.  When considering this option I inevitably was spending $1000’s of dollars on unnecessary services.
5. Be clear up front what your fees will be.  The legal system is one place you can not get a reliable “quote”…at least not if they are going to be giving you what you need.  You can know that your attorney is going to charge you in hourly fees of $300 for this, $200 for that.  A good attorney will tell you (in litigation)…all the pros and cons.  You possible cost of litigation and your exposure.
6. Find out what their experience is with instances like yours.

The attorneys I spoke with sounded like they were all approaching the situation differently.  When you stop to think about it …it wall all the same approach, with different attitudes toward the solution.

#1  –  Unified Advice:  Don’t practice in an area that you are not licensed.

#2 – Unified Advice:  Get a clear disclaimer, terms and policies on your website and in your work.

When we discuss license laws, most health coaches are primarily concerned with Nutrition licensing.  That of diagnosing and treating and advising.  Why?  Well, it is kind of like a heart surgeon doing a liver biopsy, they aren’t qualified.  Health Coaches have not been trained to do that.  Really, that is what the health coaching industry is trying to get away from.  Lifestyle changes to prevent the need for treating.

Simple as that.  I think the confusion for health coaches is the line that may be crossed when practicing as a health coach.  It can be very confusing and from what I have seen in the Facebook and Twitter threads – almost paralyzing for some.

If you want to know what is allowed in your state, this website can save you a lot of money in legal research.  They did it all for you.  It is important that you not only check to see the color of your state, but also the specifications of the particular law that has been passed.  In my state, health coaches can not be licensed to provide nutrition advice, however after stating that registered dietitians are exclusively eligible for licensing it states this: “Anyone can also provide general nutrition services without being licensed. General nutrition services includes, but is not limited to: 1) identifying the nutritional needs of individuals and groups in relation to normal nutritional requirements; and 2) planning, implementing, and evaluating nutrition education programs for individuals and groups in the selection of food to meet normal nutritional needs throughout the life cycle.”

Please notice that the licensing is specific to titling and advisory role NUTRITION.  This is not relevant to health coaching practice – this is relevant to the way you practice relating to nutrition.  Clarity in this can give a health coach a lot of freedom.  Freedom to discern what is acceptable practice and what needs to be left to others.

I feel one of the biggest problems is the lack of a clear and distinct definition of what a health coach really is.  The reason for that may be the lack of  accreditation, consistent licensing and blurred purpose. Then you have the fact that some health coaches actually coach and many others do not.  They have chosen public speaking, cooking, information disbursement and group work.  Group work is a little easier because you are providing educational materials, and often not working individually and not tempted to diagnose or treat.

So, the first thing to do is to define what a health coach is and their scope of practice.  We have a Scope of Practice we have adopted that I will share here.  You will want to adjust it by what the laws in your state allow and your particular niche.

The Health Coach Group has hired a dietitian and a personal trainer and we have partnered with physicians for approval on programs for health coaches to work with their clients.  We are pretty excited about the relationships we have established with other health care professionals because it expands us into an area where we can offer more through a network of professionals working together within their individual training, experience and credentialing.

Health Coaching is a collaborative effort between the client and the coach.

The coach asks their clients what type of changes they are willing to make, instead of telling them which changes they should make. By providing the information and education as well as the workbooks to create their own personalized program, the coach stays out of the directive position.

Your Role as a Health Coach

1. Support for client self-management, this includes providing your client with educational resources, questions to provoke thought and clarity as well as help in being able to solve problems.

2. Counseling client to health care system and medical resources. A health coach may help their clients get connected to special organizations like Overeaters Anonymous, American Diabetes Association, and Assistance for the handicapped, etc.

3. Emotional support.

4. Support for client relationship with medical professionals. This may include taking health histories and providing it to specialists like doctors, chiropractors, dietitians, personal trainers, and psychologists. You might advise your clients to get a physical before participating in any weight loss programs.

5. Support health efforts throughout program.

While many people are “certified health coaches”, currently health coaches aren’t licensed as “nutritional advisers” in the United States. Health coaches who want to advise in the area of nutrition are subject to the statutes of the relevant nutrition laws for their state.

Health coaches should not provide medical advice and should not attempt to treat medical conditions or diseases. A health coach should not provide assessment of nutritional needs.

It is your responsibility to understand the licensure laws of your jurisdiction and add or subtract according to your laws. If you are not a licensed dietitian, physician or mental health counselor, you may not offer these services or represent that you can or will offer these services.  In my state I would add a #6  “Provide general nutrition services General nutrition services including, but not limited to: 1) identifying the nutritional needs of individuals and groups in relation to normal nutritional requirements; and 2) planning, implementing, and evaluating nutrition education programs for individuals and groups in the selection of food to meet normal nutritional needs throughout the life cycle.”

Disclaimer: This information is designed to provide interpretation, and cannot be substituted for legal counsel.

We made several adjustments to The Health Coach Group to assist health coaches to operate within their scope of practice.  We are utilizing some of them in our new program; the Physician-Health Coach Weight Loss Program – to your clients, called “Healthy Habits”.  To start with, this program was created in cooperation with and approved by a practicing Physician, Dr. Shaun Altneu.  It has also been approved by our registered dietitian.  We will be making our health care professionals available to our health coaches, and if they get to busy, we will be hiring more.  We will do what it takes to make it easier for our health coaches to satisfy the needs of their clients and stay within their scope of practice. 

Look for our announcement this week on the new webinar with our attorney who will be covering a myriad of legal topics that are important to health coaches.  Opt in on our website to receive information when this comes out.

What have you learned about your state?  What are some of the questions you would have for an attorney?

Please share this with your friends!