Health Coaching as a Developing Profession

In the United States, everyone seems to agree that healthcare could do better. Doctors are stretched thin. Patients don’t feel heard or that their concerns are adequately addressed. People feel frustrated by the lack of time spent discussing their health concerns. Even physicians with the best of intentions don’t have much time to spend with their patients and certainly not enough for those with multiple complex conditions. 

Health coaches have stepped in to fill those gaps. A person dedicated to meeting with you regularly to discuss your health goals and concerns sounds great, in theory. But, as I’ve stated before, health coaches are unregulated - anyone can identify as a health coach.

The potential problems around this should be obvious: people lacking real knowledge and training in health can provide guidance and advice under the presumed expertise that a title like “health coach” implies. However, I don’t wish to strictly deal in the hypothetical, so I collected data on this topic.

The Study

In October of 2023, I started collecting data from health coaching websites across all 50 states. I studied health coaches with websites, without considering any connected social media, and collected data on just over 500 people identifying as health coaches. The study was published in the HCA Journal of Medicine. 

The sample revealed some trends that I think are worth discussing. Identifying as a health coach seems to be more popular among women, as the sample was about 90% female. Most were practicing as health coaches without a relevant degree (i.e., either they did not list a degree or had a degree in a field unrelated to health). Very few were certified by the National Board for Health and Wellness Coaching. This certification was a proxy for standardization of practice. Despite this “standard” being quite easy to fulfill, it is the closest we currently have to any standards. 

While collecting data, I noticed that many of the health coaches in their “About Me” sections included personal stories of health struggles. Many of these struggles were with conditions often thought to be specific to women’s health, such as polycystic ovarian syndrome and Hashimoto’s disease. While I did not collect data on the number of women who discussed struggles with autoimmune disorders or other health challenges, it was enough that it caught my attention (perhaps a follow-up study is warranted). This may provide more context for who is drawn to the field of health coaching and how the field is developing.

The Neglected

I suspect there is a connection between those people who identify as health coaches and those feeling neglected and/or left behind by medicine. Those people who feel as though they've been left to fend for themselves and had to navigate difficult and often unsatisfying diagnoses. In some ways, this makes perfect sense. When you feel as though you've had to take your health into your own hands, you want to spread the word about how you did it.

Therein lies the problem. I do not wish to dismiss legitimate frustrations with medicine and experiences with providers that fell far short of what they should be. However, we can agree that having those bad experiences does not qualify someone to dispense health guidance or advice. While it may prepare someone to be more empathetic to similar stories, that experience does not bestow good information about health onto a person. Additionally, I think if we are starting to sense a trend where people wish to help others, but do not seem to have relevant education and training, that is also of grave concern.    

The MAHA Connection

RFK Jr. and the like have been shouting to everyone that will listen that they plan to focus on chronic diseases and will listen to those who have been left out of the conversation in medicine. They've also worked to legitimize all kinds of medically dubious advice and unqualified people. I fear that, given the direction we're heading, anyone will be able to claim health expertise under the guise of “medical freedom” and MAHA. 

In addition to poor medical advice and empowering unqualified people, devastating cuts have been made across science and healthcare. Women's health hasn't been spared. Research into the types of conditions mentioned in many health coaching websites and other autoimmune disorders will suffer. Cuts to the Women’s Health Initiative were announced, and only after major backlash did the administration reverse course. Obviously, we don't know nearly enough about these conditions, and cutting funding to the Women's Health Initiative was only going to exacerbate feelings of isolation and frustration from people who already feel left out and dismissed by medicine. 

Defunding scientific research and firing scientists will worsen the problem of exclusion. People will only be able to rely on their own expertise and that of those who scream the loudest and are the most persuasive. That’s a very bad position for us to be in as a society. 

Healthcare and research have made it so that most people do not need to rely on their own expertise to survive. That’s the point of standards and regulations. We need to put some guardrails around this developing field to ensure people are receiving accurate, reliable health information and guidance. The Financial Times wrote about health coaches across the United States and Europe:

“We need, with these new roles, something that supports regulation, because at the moment, it's all on the GP or the people that actually employ them, to oversee.”

I've spent my career in healthcare and see promise in health coaching as a way to ease patient gaps and provider strain. However, real reform requires accountability, regulation, and evidence, not deregulation disguised as empowerment. Movements like MAHA threaten to replace science with wishful thinking, dismantling the very institutions that safeguard public health. If health coaching is to be a meaningful supplement rather than a harmful replacement, it must be professionalized. Reform isn't about starting from scratch; it's about fixing what's broken without abandoning hard-earned knowledge or costing lives.