Karen Andalman's blog

One of the most identifiable gaps in care is medication adherence. This is an area where Wellness Coaches/ Disease Management Specialists, hired by employers, have the potential to impact the employer’s population to change behaviors.

Because most physician office visits today are limited to fifteen-twenty minute appointment slots, there is just not enough time for each patient. Unfortunately, the physicians don’t take the time to explain each prescribed medication and the potential side effects. Most patients can’t even tell you what condition each medication they are taking is for.

This is where the role of the Wellness Coach/Disease Management Specialist becomes extremely valuable. They have the time to do the patient education that is lacking in the physician’s office.

There are basically three reasons why people are non-compliant with their medications:

• They forget
• Side Effects
• Financial

Pre-disease conditions can be managed before they develop into costly chronic diseases. Most employees with elevated cholesterol, elevated blood pressure or those that are overweight don’t normally incur costs to the health plan. But left untreated, these pre-disease risks can turn into high cost diseases. Because people are working longer today, the workforce and the employers are impacted by chronic diseases.

Statistics on adult Americans from the National Institute of Health are staggering:

As part of a Corporate Wellness Program, one of our clients recently sponsored a biometric screening at no cost to their employees. Not only did the employer pay for the cost of the screening, but they were also offering their employees an incentive for participation in the screening. As an additional feature of the program, the employees were to have a session with one of our Certified Registered Nurse Wellness Coaches to review the results of the screening and hopefully engage those “at risk” in ongoing wellness coaching.

One of my Wellness Coaches reported back that she spoke with an employee that expressed dissatisfaction with the “process”. She was actually “put out” that she was inconvenienced to have to fast the night before and then make time early in the morning for the blood draw. In essence, she was turning a company benefit into a chore. 

Have you been prescribed medications? Are you taking these medications as prescribed?

What is your understanding of their purpose, the best way to take them, and how to manage their impact on your daily routine?

Some of these answers are easy, such as how to keep medications where you will see them. Some of the answers are more difficult, such as how to stay on a regular routine when you have overtime on the job, are traveling, or what to do when you cannot afford the prescription. Lack of this information can make it challenging to stay on the best medication schedule, which can result in an unnecessary decrease in your level of wellness.

Be proactive and take charge of this aspect of your health by seeking answers. Ask your medical provider and pharmacist about the medication when it is prescribed. Read the medication inserts. 

When we hear the word holistic, we tend to project that a less than traditional approach will apply when doing corporate wellness coaching. To the contrary, Registered Nurses have holism as part of their education.

Registered Nurses view patients as more than the sum of their parts, both individually and as members of communities. A Registered Nurse Wellness Coach will provide support and education around the mind, body and have additional education that is complementary to traditional medical care, such as homeopathy (the practice of natural medicine, which usually comes from an organic source. It is believed everybody has a vital force or self- healing response) or naturopathy (a system of treating disease that employs no surgery or synthetic drugs but uses special diets and herbs, vitamins, and massage to assist the healing process).

As we begin the New Year, feeling sluggish and guilty from the holidays, the tendency is to make resolutions for losing weight and getting into shape. Poor weather conditions throughout the country has made it even more challenging, as the inclination is to stay inside, cuddle up on the couch and just watch movies and snack. Now these best intentions are once again sabotaged.

The secret for success is to make resolutions (set goals) that are achievable. In our practice, our wellness coaches have a mantra, and that is “baby steps”. Sometimes it is one small goal at a time, and then when achieved, set another goal. Goals for change have to be realistic and attainable. People have to feel their successes. They need to feel good about themselves.

Possible achievable goals can be:

Lose weight-Lose 5% of current body fat instead of shooting for 15 or 20 pounds. Sometimes this can be accomplished by merely cutting out sugary sodas or energy drinks.

In this age of cost cutting and Employers looking to save money, it seems that they look to the Corporate Wellness Program as the first benefit to cut. Is it because they don’t understand what they purchased? Is it because they are looking for a quick return on investment? Or is it because they don’t see immediate changes in their employee population?

I have seen a number of “Wellness Programs” that are merely “cookie cutter”. They are automated and there is very little, if no, personalization. I don’t see where Wellness Coaches are actively working with participant to set goals and facilitate lifestyle changes.

In a recent conversation with a Client, he expressed an interesting thought, which shows the impact of Wellness Coaching and the Coach/Participant relationship. He had his regularly scheduled monthly coaching session in several days and he was about to reschedule the appointment. Apparently, he had several assignments to complete prior to the Coaching session. He had not completed one of his assignments and he didn’t want to let his Coach down.

Keep in mind; this is a very motivated individual that is very “invested” in his Corporate Wellness Program. He has a very strong relationship with his Wellness Coach. They are constantly evaluating his goals and looking for new and innovative changes to his current nutrition and exercise regimes.

WellChoice, Inc. has been working with a 1000 employee life government account for the past five years. We assigned an experienced Registered Nurse Certified Wellness Coach to be the exclusive Wellness Coach for this account. Over the past five years, the Wellness Coach has worked very hard to establish rapport, gain trust and of course, continually educate the employees and dependents on how to maintain a healthy life style.

This account has gotten no renewal rate increase for the past five years. In fact, the stop loss premium has gone down from $1,000,000.00annually to $600,000.00 annually. This is a group that most carriers wouldn’t even quote on in the past.

Wellness Coaching is a process. Trust is earned. Relationships take time to develop. Results such as this happen over time. The goal is to create a corporate culture of wellness. When this happens, the net result will impact claims costs for the Employer.

We know changing lifestyle behaviors is easier said than done. Our first tendency, especially with family members, is to come down on them (berate) to do things such as quit smoking, lose weight, or simply just get up off that couch and move around. Eventually, they just tune us out, or continue unhealthy behaviors just for spite.

The challenge for wellness coaches is to motivate our clients to make changes. We are trained on motivational interviewing techniques. We assist our clients in identifying areas of possible change and then their willingness to change. We work with our clients to set realistic achievable goals. We are in contact with them on a regular basis to provide support, suggestions, empathetic listening, and work through barriers to changing.