I love science. I enjoy studying the human body and its amazing ability to adapt, heal, and restore. I love critical thinking, problem-solving, and forward progress, but the practice of medicine is not a science experiment. In medicine, I manage people with heavy burdens and complicated stories. I juggle laundry lists of problems. I stare at suffering, in its many forms, in the face. And despite my greatest desire to be the “fixer” as a physician, I often fix very little. Don’t get me wrong: I am fully capable of managing acute and chronic diseases. I prescribe medication to tackle high blood pressure, diabetes, and cholesterol. I give antibiotics to cure pneumonia. Yet, the root of many problems remains unaddressed, and for many, the unspoken generalized malaise persists. Health coaching has pulled at my strings for years. As I listened to patients and addressed their concerns, the following questions circled in my mind and finally prompted me to take the plunge to become a health coach.

What is the real root of the suffering?

Have you ever noticed that our primary complaint is often not the real issue that brings us to seek care? It is easy to get distracted by individual symptoms rather than the deeper problem that lies underneath. What is the root of the suffering and how do we tackle it?

What barriers are preventing progress?

As a doctor, I suggest actions for improved health, but I seldom devise a specific road map or delve into individual challenges that may arise. Anticipating obstacles and knowing how to navigate around them is critical for success.

How can I empower patients to create a solution and implement it?

Doctors give directive advice in patient encounters, but outside the visit, individuals are the ones who do the problem-solving and leg work. How can I empower patients to create their own healthy solutions and put them into action?

How can help ease the suffering? What is needed for success?

What small step can be taken now to ease suffering? Often achieving a tiny task can change a mindset and build confidence and momentum for further progress. What processes and support systems need to be in place for sustained success?

People need time. We need support, accountability, and community. We need flexibility, healthy mindsets, and permission to fail before succeeding again. We need skills in self-monitoring, self-management, self-care, and self-love. Medicine has an invaluable and irreplaceable role in managing acute and chronic medical problems. I am grateful for infections cured, diabetes and blood pressure controlled, and depression in remission from medication and other legitimate and needed treatment modalities. But as a health coach, I tackle the elephant in the room: Our mundane daily lifestyle choices and beliefs that weigh us down and deplete our vitality. This elephant has been silent but deserves a voice. She deserves freedom and a new path. As a coach, I help set her free.

Michelle Housel is an internal medicine physician and a physician health coach.

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