A paper published late last year in the Journal of Integrative and Complementary Medicine makes a case that those of us in the field have been building toward for some time: health and wellness coaching has earned its place in clinical care, and it's time to treat it that way.
The piece — Health and Wellness Coaching in Clinical Care: A Call to Action — was authored by a collaborative team from the Osher Centers at the University of Vermont, Vanderbilt University Medical Center, and the University of Utah, including IBC's Rebecca Weinand, Susan Whitman, and Kate O'Farrell. It was published as part of the Osher Collaborative Column, a platform designed to amplify applied, field-shaping perspectives from integrative health leaders.
The paper's core argument is straightforward: health and wellness coaching (HWC) has demonstrated real value in supporting behavior change, chronic disease prevention, and whole-person health. The evidence is there. What's been missing is the institutional infrastructure — the training standards, care team integration, and equitable access — that would let coaching fulfill its potential at scale.
The authors organize their call to action around three commitments:
Train for clinical excellence. Current certification programs have laid important groundwork, but coaches working in clinical settings need more than general training. They need the skills to function within interprofessional teams, bridge patient-centered coaching with clinical decision-making, and maintain clear scope of practice. Without that, coaches remain peripheral rather than integral. The paper also calls for better reporting standards in research — consistent descriptions of coaching methodology, coach credentials, and outcome measures. That transparency is what makes rigorous evaluation possible, and rigorous evaluation is what makes the case for reimbursement.
Integrate into care teams. Coaching works best when it's embedded — not referred out, not contracted as an add-on, but present as a recognized team member with a clear role. The authors draw on evidence from the VA's Whole Health System, where genuine care team integration produced a synergistic effect on both team function and patient outcomes, including reduced opioid use and improved patient engagement. The lesson is that integration isn't just logistically convenient — it's clinically meaningful.
Expand access for all. Reimbursement remains one of the biggest structural barriers. When coaching is only available to patients who can pay out of pocket, the benefits of the field accrue to those who need them least. The authors call for coordinated reimbursement strategies and value-based care models that make coaching genuinely accessible — not a premium service, but a standard one. They make the economic case as well: a whole-person biopsychosocial approach that includes HWC can reduce healthcare costs by more than $300,000 per patient over a lifetime.
What strikes me about this paper is its tone. It's not speculative. It doesn't hedge around whether coaching works or whether it belongs in clinical care. It takes those questions as largely settled and asks what comes next. That's the right posture for where the field actually is.
The problem isn't lack of evidence. It's fragmentation — inconsistent definitions, variable training standards, unclear job descriptions, and a reimbursement landscape that hasn't kept pace with the science. Those are solvable problems. They require coordination, organizational will, and sustained advocacy. But they're not waiting on proof of concept.
The work the Institute for Behavior Change does — including Susan's ongoing Delphi research on integrating coaches into primary care teams — is directly responsive to this call. Defining what a clinical health and wellness coach actually does, what training prepares someone for that role, and how teams can use coaches well: that work is what moves this from aspiration to infrastructure.
The paper is worth reading in full. It's concise, grounded, and points clearly at the work still in front of us.
