We Do What Doctors Can’t
(And Doctors Do What We Can't—That's the Point)
This is happening nationwide: A doctor—or nurse practitioner—is stretched thin across a jam-packed schedule, delivers a diagnosis or a care plan, hands the patient a printout, and moves on to the next room. The patient walks out with instructions they rarely fully understand, lifestyle changes they don't know how to make, and no real roadmap for how to get from where they are to where they need to be. In my opinion, nobody in that exchange necessarily failed. The doctor did their job within the system they operate. The system just doesn't have a bridge. That bridge is what we are.
The Gap Nobody Talks About
Many physicians are highly admirable. The training, the experience, and the drive required to effectively practice medicine are things I actually have deep respect for. But there's a reality that even the best doctors in the world can't escape: they don't have the time—and most weren't trained—to coach patients through the messy, deeply personal process of actual behavior change. They’re also not appropriately trained on diet and lifestyle. A doctor can tell you to lose weight, manage your stress, get more sleep, and cut back on processed food. What they can't do is sit with you over weeks and months, help you untangle why you keep falling back into old patterns, collaborate with you to build a plan that fits your actual life, and hold you accountable in the way that real change requires. That's not a criticism. That's a division of labor. Health and Wellness Coaches—especially those who hold the NBC-HWC credential (National Board Certified Health and Wellness Coach)—exist precisely to fill that void. We are the people who help patients follow through. We're the infrastructure for adherence. We're not here to replace physicians; we're here to make their work stick—and empower patients; boost their health literacy.
What an NBC-HWC Actually Does
I’ll be frank about something: the title "health coach" has a perception problem, and I can’t pretend otherwise. I've felt it myself. Coming from a background as a personal trainer—a field with its own wide spectrum of quality—I understand how easy it is to look at the label and wonder what, exactly, it means. The honest answer is that it depends enormously on who you're talking to. At the highest end, you have board-certified health and wellness coaches credentialed through the National Board of Health and Wellness Coaching (NBHWC)—an organization that partners with the National Board of Medical Examiners specifically to ensure proper integration into the medical system. NBC-HWCs are trained to operate within healthcare, not outside it. We work collaboratively with physicians and care teams. We don't diagnose, prescribe, or override medical guidance. We coach. And the way we coach matters. NBC-HWCs aren't supposed to force anything on anyone. We're supposed to be curious, collaborative, and educational. The entire foundation of our methodology is that plans must be fluid and personalized to each patient’s or client's unique circumstances. A rigid, one-size-fits-all approach isn't coaching—it's instruction. In my experience so far, instruction alone doesn't change behavior.
A Profession Still Coming Into Its Own
Here's something worth understanding about where our profession stands right now: it's young, and it's still earning its place in the healthcare landscape. The VA actually put health coaches on the map in a meaningful way, testing and researching the use of coaches within their healthcare system and demonstrating real outcomes. The NBHWC then took the baton, working to establish the standards, credentialing, and quality control needed to make health coaching a legitimate, consistent, and trustworthy component of care. But the process isn't complete. The NBHWC's standards haven't fully permeated the healthcare system yet. There's no national governing body for everyone who calls themselves a health coach—only the NBHWC, which governs board-certified practitioners. This means that the title "health coach" gets applied to people across a vast spectrum of training, philosophy, and quality. That disparity has real consequences. People have had bad experiences. Some have encountered coaches with rigid, prescriptive approaches—the opposite of what the methodology calls for. Others have encountered practitioners who leaned too heavily on supplements or personal ideology rather than evidence-based, personalized coaching. Those experiences are valid, and they've understandably shaped how the public perceives the profession. It's one of the reasons I believe so strongly in the value of the NBC-HWC credential—not as a guarantee of perfection, but as a meaningful signal of training, standards, and accountability. The quality of care you receive from a board-certified coach is more consistent than what you'd receive from an uncredentialed one. That matters when we're talking about disease management and people's health.
Note: I do want to give credit to many non-credentialed health coaches who far exceed many NBC-HWCs in knowledge and experience. However, they are generally the exception, not the rule.
The Title Problem
If I'm being candid, the term "health coach" is doing us no favors. The word "coach" carries associations—sports, self-help, motivational speaking—that don't quite capture what we actually do in a clinical context. Some have suggested "specialist" or "practitioner" would carry more professional weight, and I agree. I'm personally working toward certifications as a Functional Mental Health Practitioner (FMHP) and Metabolic Health Practitioner (MHP), and I'd be lying if I said part of the appeal wasn't that those titles sound more commensurate with the work. That said, there's something worth preserving in the word "coach" too. It feels human. Approachable. Less clinical. In a world where health-professional fatigue is real—where so many people feel let down by conventional medicine and keep their distance from anything that feels sterile or intimidating—being approachable actually matters. Maybe the answer isn't a perfect title at all. Maybe it's about individual practitioners building enough trust, demonstrating enough competence, and delivering enough results that people stop going by the label and start going by the experience. The title can only carry so much weight. Eventually, reputation has to do the rest.
The Case for Real Integration
Something else I want to be transparent on: I spent time in a place where I saw physicians and health coaches in an "us versus them" dynamic, and I've grown out of it. The framing was wrong; it was limiting, and it wasn’t actually helpful in achieving better health outcomes. What I believe now is that physicians and NBC-HWCs have a special synergy when they operate as partners. Doctors provide the clinical knowledge, the diagnosis, and the medical direction. Coaches provide the health education, behavior change infrastructure, accountability, and sustained support that helps patients actually achieve the positive health outcomes their doctors desire. This isn't about health coaches undermining medicine. It's about completing a circuit that's currently broken for millions of patients. When people fall through the cracks—when they leave a doctor's appointment with every intention of making changes and then find themselves, months later, back to where they started—it's not usually because they're weak or unmotivated. It's often because they didn't have support. They didn't have someone in their corner helping them navigate the hard parts. That's the gap. That's where we live.
On the Road Ahead
Health coaching as a profession is not where it needs to be yet. I say that not to diminish the work being done, but because I think acknowledging the gap honestly is part of working to close it. There are talented, dedicated, highly credentialed coaches doing genuinely important work. There are also gaps in quality control, public trust, and systemic integration that we haven't fully solved. What I know is that the profession is actively working to correct course. The NBHWC continues building the infrastructure for consistent, high-quality coaching within healthcare. More physicians and care teams are beginning to understand what a board-certified coach can offer, and practitioners like me are working every day to build the kind of credibility, trust, and results that shift perceptions—one patient at a time. Health as a whole has lost some of the public's trust. People are tired. They've been let down by a system that often treats symptoms without addressing root causes, that moves too fast to forge real connection, and that sometimes leaves patients feeling more confused than when they arrived. That fatigue is real, and it's driving people away from the help they need. I think health coaches—done right, credentialed or trained properly, integrated thoughtfully—can be part of what wins that trust back. Not by replacing what medicine does well, but by doing what medicine, structurally, hasn't been able to. We do what doctors can't. And they do what we can't. Together, that's the whole patient.
The author is a National Board Certified Health and Wellness Coach (NBC-HWC) with over 2,000 clinical hours of experience to date, placing them in approximately the top 1% of all health coaches nationally.
