Is the RN Health Coach the Bridge Between Sickness, Wellness and Fitness?
A few years ago, I had decided to follow a Nurse on social media because I was intrigued by the content he posted. Obviously I had worked with Nurses before, but something about his posts were a bit different. I had wanted to bring in an RN to the practice and I had worked with Nurse Health Coaches before, but I thought it was really interesting that there was an RN that was so passionate about fitness as well. Shortly after I followed him, I received a social media message from him letting me know that he has been trying to “bridge the gap between health care and fitness.” Paul quickly became our Nurse Health Coach, bringing in his background as an RN and blending the world of health and fitness.
To me, it had always made sense that a Nurse was an educator. Yes, the Doctor had their area of expertise, and was the leader of the team, but often times it was a Nurse who executed on that plan, who held those patients’ hands in sickness, and who were their cheerleaders in their journey of recovery.
But what if we could take that to another level? What if the role of the Nurse was indeed to help to “bridge the gap between healthcare and fitness,” as Paul likes to say, drawing inspiration from the work of CrossFit founder Greg Glassman’s Sickness-Wellness-Fitness continuum.
As I’ve watched Paul grow over the years, I have found a true believer in the direct primary care model. I have seen a young Nurse relatively recently out of school evolve into someone who not only gives vaccinations to prevent illness, who triages patients to be able to get the right resources, who helps patients with multiple medical issues navigate their complexities, but is also someone who serves as a guide and teacher in optimizing their health, in the pursuit of wellness between health, and optimal health, fitness.
I reflect sometimes at the role of the Nurse and the frustration many Nurses feel, where they have in essence been reduced to clicking on a mobile computer while dispensing medications. I hear them tell me their longing to actually bring forth their desire to care for patients, which leads many of them to leave Nursing completely to pursue advanced degrees, such as Nurse Practitioner.
But I think what’s really interesting is that when more Nurses are trained to work with people in the full spectrum of sickness, wellness and fitness, you begin to see the spectrum of change happen. You begin to witness a patient’s journey as they go from troubleshooting red flags to learning how to remain active to anticipating changes and focusing on prevention.
As a Physician, I always learn from every team member. They challenge me, they make me question my own beliefs, they push me to really look at scopes of practice and try to figure out how we can make it all work. And a healthy team is one that pushes each other.
The magic of the direct primary care model is that we can bring various talents together, gain inspiration from each other’s skill sets, and help patients in that continuum from sickness to fitness.
What started off as a sheer happenstance in our practice with meeting Paul has led to a core pillar in our care model.
And the one most important thing I have learned is that in surrounding yourself with good people, somehow somewhere that begins to change you as a doctor — for we know that we ourselves are not perfect — as you begin to move along your own spectrum from sickness to fitness.
This post is dedicated to my friend, team member, and Nurse, Paul, as he launches his gym… and we sit back, knowing that the mission of the direct primary care movement carries in the lives of all who we touch.
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Sad that the doctor didn’t feel like he could, or should, be the one to do this for his patients.
I think just like medical school doesn’t teach us much about nutrition it also doesn’t teach us much about exercise. So we learn on our own and we bring in different people with different skill sets. Sure I think the doctor could do it… but not all doctors are good at making meal plans. Not all doctors are good at making exercise plans. But a good doctor helps ensure the patients get the resources to make it happen.
None of us learned how to be a specialist in medical school. That occurred post grad, in residency and/or fellowship. There are plenty of opportunities now for us to learn, post grad, about meal plans and exercise et al – IOW be the ‘health coach’ primary care was always meant to be now and was…years ago. DPC is a break away from current structures of being a mere manager of others doing what we can or should be doing ourselves. So, this article seemed to be written from the lens of a person still stuck in corporate medicine mindset.
There are many challenges within the healthcare system, but one of the more disheartening aspects is how the expertise of nurses is often undervalued in today’s world. Nurses are highly trained professionals with degrees and licensure, yet we are frequently restricted in utilizing our full potential without external oversight.
For example, while nurses are equipped to educate patients about diagnoses, medications, and treatment plans, starting a business as a nurse without a specific “health coach” certification often leads to unnecessary barriers. Obtaining such a certification can cost thousands of dollars for a brief program, and the job market for these roles is oversaturated. Positions advertised as “health coach” roles often receive hundreds or even thousands of applications, with compensation averaging around $20 an hour—a stark undervaluation of the expertise nurses bring.
This shift has led to the commercialization of roles traditionally aligned with nursing practice. Tasks that nurses are uniquely qualified to perform—such as creating and implementing nursing diagnoses based on evidence-based practices—are being diluted. Nurses are trained to integrate clinical judgment, personalized care plans, and accurate documentation, all grounded in a holistic approach to patient care.
In contrast, while a physician’s diagnosis focuses on identifying physical conditions through signs, symptoms, and assessments, a nursing diagnosis emphasizes the individual’s overall well-being, considering physical, emotional, and psychosocial factors. Nurses play a pivotal role in improving healthcare education and empowering communities to make informed, health-conscious decisions.
It is commendable that there are efforts to spotlight the diverse contributions nursing expertise can bring to community education and care. However, there remains a significant gap in recognizing and supporting the unique value nurses provide, especially in a healthcare system that urgently needs broader educational outreach. Nurses have the ability to make the world a healthier, more informed place if given the opportunities and respect that align with their skills and training.
Warm regards,
Crystal Maddox, R.N.