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!

 

 

 

32 Comments

  1. Paula M. Youmell, RN, MS, CHC

    Wow, thanks for making me think about these things…. I think!

    I need to add back disclaimers on my website and my health history form.

    Blessings, Paula

    Reply
  2. Paula M. Youmell, RN, MS, CHC

    Here is what you inspired:

    I used the words from my newly published book: Hands On Health: Take Your Vibrant, Whole Health Back Into Your Healing Hands.

    I added it to both of my business websites and my health history forms.

    Thanks so much for the inspiration AND butt kick Cathy! Paula

    Reply
    • Cathy

      Thanks for letting me know Paula! Glad to have inspired a step forward!

      Reply
  3. Jennifer Kennedy

    Such great and important information! I’m not a health coach, but this information still applies as anyone beginning a business needs to be aware of the laws and guidelines that regulate their industry.

    The idea of looking for an attorney scares me because I wouldn’t know where to start, but your tips are great. I wonder if it’s a great idea to contact previous clients to understand their experience with the attorney? Not sure if that is information that they provide.

    Thanks for the inspiration to get moving on this stuff!

    Reply
    • Cathy

      Yes Jennifer, that is one of those things that you just hate doing…then when it is done, you feel so accomplished.

      Reply
  4. Anne

    How does the law affect us if we are only coaching online?

    Reply
    • Cathy

      Anne, be sure to opt in on our site. That is the #1 topic that health coaches want to cover. It will be up front.

      Reply
      • Cara

        How do I find out more info on this question. My State has strict Licensing laws and I am looking at getting certifications in holistic nutrition as well as a few others. Will I even be able to use those certifications for online courses?

        Reply
  5. Cathy

    Getting myself more substantially set up in terms of disclaimers, policies and terms of use is on my big-picture list for the year. While I’ll need to figure out how it all works in Canada, the questions and issues you raise are a great starting point.

    Thanks for getting the conversation started, Cathy.

    Reply
  6. Suzanne

    Glad I stumbled on this article.

    Getting started in a business, we tend to think of the “fun” things like web design, but the business basics like these are just as important.

    Thanks for some great info.

    Reply
  7. Christie

    Great post! Lots to learn and think about for both health coaches and other businesses as well. As always Cathy, you’re providing great value for health coaches here.

    Reply
  8. Beth KBedbury

    I’m in a state that has limiting regulations for nutrition. It made me really think about my role as a health coach and how I practice that. In the end I decided my role is not to tell you what or how to eat but help clients build healthy habits.

    Reply
  9. Kristyn Hanquist

    Thanks a ton! This is definitely the most helpful article I’ve found for my health coaching business in a LONG time! Thank you!

    Reply
  10. Leslie Hanft

    Thanks Cathy for this helpful and extremely informative post. I really need to take a closer look at some of my practices and add disclaimers to my website and forms. I can’t thank you enough for bringing all of this to my attention.

    Reply
  11. Cynthia Djengue

    So glad my friend is a lawyer! Thanks for giving a practical outline for health coaching and law.

    Reply
  12. Hayley Hobson

    This is great advice Cathy. I bet a lot of people don’t think about all of this stuff. Thanks for sharing.

    Reply
  13. Ginger

    I live in a restrictive state, too. Getting good legal counsel’s important. I teamed up with a dietician, too. If a client needs nutritional counseling, I’ll send him/her to the dietician. Thanks for the post!

    Reply
  14. Susie Mordoh

    Great unified advice for any business! Thank you for all of the info, Cathy.

    Reply
  15. Tania Mercer

    Thank you for this incredible resource Cathy! I know this has been a source of pain for some…Def a disclaimer is necessary on the website. I also have one in the client contract.

    Reply
  16. Michelle

    Great advice, Cathy!

    Reply
  17. deb

    I am not a health coach. I am an educator with educational and other qualifications. This is the disclaimer I have on my site and I also have more when people sign up for mentoring/Coaching. . I hope it covers me – but I will take another look.

    thanks

    Disclaimer:

    Deborah Lange has professional qualifications including a Masters and Bachelor Degrees, Grad. Diplomas and Certificates in such fields as Human Resource Development, Social Ecology, Coaching, Holistic Human Development, InnerBonding, InterPlay, NLP, Equine Facilitated Learning and more.

    Coaching and facilitation is not to be construed or understood to fall into the category of professional psychological counselling or psychiatric services. Deborah Lange does not purport to be a credentialed psychological therapist, counsellor, or qualified medical or psychiatric therapist or interventionist.

    Coaching and Mentoring is educational in nature and the Client takes responsibility for their learning. The Client agrees that they will not hold Deborah Lange responsible for the surfacing of any emotional or psychological dis-comfort. Deborah Lange will advise the client if she believes the client is in need of psychological or psychiatric services.

    Thank you.

    Reply
  18. april

    very important and valuable information, useful for any coaching specialty. thank you, cathy.

    Reply
  19. Bon

    Cathy this is so clear and well-written. I don’t coach in the health field, but as with all coaching, there is so much territory into which we *can* go over the course of our sessions and this legal protection is very important for all of us. Thank you!

    Reply
  20. Denise Marie Filmore

    So much information!! Thank you Cathy. I am a business coach that happens to be a certified health coach. Although I don’t practice health coaching at this time, the information was valuable in case one day I do pursue this career. But, even as a business coach who teaches marketing and money management, there are disclaimers, terms and policies that I put on my website.

    Reply
  21. Elizabeth MacLeod

    so… WHERE WERE YOU WHEN I STARTED!!!!! 🙂 thank you for all the wonderful and important information in such concise manner… Legal information is sooo important for everyone to know…..

    Reply
  22. Tova

    Is it legal for my employer to make me see a health coach to keep my insurance? They’re telling me it’s mandatory even though I freely participated in the health screening to earn a deduction in rate. If I don’t meet quarterly with my health coach, I loose the benefit of a reduced rate.

    Reply
    • Cathy

      That’s an interesting question. You should ask an attorney. I’m curious enough, I think I’ll ask an attorney. Do you have to pay for it? If not, I would consider it a tremendous gift and take advantage of it. It’s possible that your employer’s health insurance is requiring it to get a reasonable rate.

      Reply
  23. Cynthia

    The central US and the South have the worst obesity rates and guess what…, we are the same states that have the most restrictive regulations on health and wellness. I am, for once in my life, ashamed that our state’s government body does nothing to aid in better health for their residents by allowing a limited restraint on health coaching. The dieticians I have met with give ridiculous and outdated advice on lifestyle eating. They basically wrote my mother a directive for death. I am truly disgusted and feeling striped of power to make a difference in my community.

    Reply
  24. Sally

    What if you are just selling a program instead of actual individual coaching?

    Reply
    • Cathy

      A program makes it easier because you’re providing the same information to everyone and it can’t be confused with diagnosing and treating.

      Reply
  25. Olga

    Thank you Cathy for all these great information!

    Reply

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