Help Clients and Avoid Medical Liability
This week, John explains how to develop a coaching or consulting business as a health advisor without creating a formal physician-patient relationship. In doing so, he mentions six guests from his podcast who are improving their clients' health or wellness while generating income outside the traditional medical setting. After reviewing each of their businesses, he offers recommendations for launching your own such business.
Each of the physicians offers wellness and health improvement guidance and coaching. Some obtained special training in Lifestyle Medicine, Functional Medicine, Meditation, or Yoga.
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Being a Health Advisor
As professionals, physicians are dedicated to addressing patient health issues. However, at times we'd like to do the same for individuals who aren't our patients. Rather than treating illnesses and injuries, we might emphasize prevention, health maintenance, and well-being.
Lastly, by working outside the formal physician-patient relationship, we avoid certain regulatory and liability threats.
Six Examples
John describes six examples of physicians who focus on health and wellness coaching and consulting. Each of them enjoys the satisfaction of assisting clients in improving their health and preventing illness in their own unique way.
- Dr. Lara Salyer – Episode 120
- Dr. Jessie Bensen – Episode 158
- Dr. Jill Wener – Episode 172
- Dr. Heather Hammerstadt – Episode 185
- Dr. Rachel Beanland – Episode 250
- Dr. Shelly Bhowhmik – Episode 257
Todays Quote About Mentors
…talk to someone who's doing what you would like to do. It gives you a real reality check as to whether it's doable and how difficult it is…
Summary
It is definitely possible to create a business as a wellness coach or consultant, or health advisor. It meets a physician's desire to help clients feel better and improve their overall health and fitness. But the flexibility, avoidance of regulation, and lack of medical liability make for a more enjoyable experience for the former clinician.
John recommends consulting an attorney to be certain that you avoid the appearance of medical care. The health advisor may need to publish formal disclaimers. And in most cases, it is important to remind clients that before adopting any new diet, exercise, or use of supplements, they discuss these plans with their personal physician.
NOTE: Look below for a transcript of today's episode.
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Links for Today's Episode:
- How to Reclaim the Best Parts of Your Career – 120
- How to Be a Life Coach and Professional Artist – 158
- Can Meditation Offer Help for Burned-Out Physicians? – 172
- Can Lifestyle Medicine Help Me and My Patients? – 185
- Find the Fulfillment of a Freelance Remote Yoga and Meditation Teacher – 250
- Why Preventive Medicine and Lifestyle Medicine Make for a Great Career – 257
- Inspiration from the Author of ‘How to Lose Weight for the Last Time’ – 279
- NewScr!pt
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Transcription PNC Podcast Episode 286
How to Become a Health Advisor With No Physician Patient Relationship
John: I would like to spend another 20 minutes or so addressing a question that came up in my nonclinical career mastermind. And the question is this, "How do I create a business that allows me to provide advice to clients without creating a physician-patient relationship?" The question is, "Have other physicians successfully done this?"
Now, the factors that sort of underline these questions are the following. As clinicians, we enjoy and are committed to helping address health issues in our patients, but we'd like to do the same thing to help others, maybe who aren't our patients. We would like to focus more on prevention and health and wellbeing rather than treating illnesses and injuries. And we like to be able to control our hours, work remotely and not be exposed to medical liability.
Let me just put this as a disclaimer. To some extent, these issues, these questions, fall into the area of legal questions. They should be discussed with an attorney. If you're really having a hard time deciding whether the kind of services you're providing fall in the area of physician-patient relationships, then you might want to sort through that with an attorney.
I would suggest to see an attorney anyway if you're going to develop a business like this because you'll need the attorney for other things that I'll talk about in a minute. But let me try and address the issue to some extent by making a few comments and by presenting six physicians that I've spoken with that have created that kind of business. They're all a little bit different. They all have different kinds of things that they promote and teach and advise on.
All of these physicians make it very clear to their clients that this is a business relationship. It is not a physician-patient relationship. And in fact, I think most, if not all of them advise their clients to discuss what they're planning to do with their personal physician if there's going to be, let's say, some recommendations for certain types of foods, certain types of activities and so forth. In some cases, the kind of advice being given is clearly not of a medical nature. But let's say I were to tell you that, "Oh yeah, you should start training for a marathon once we get you healthier." That should obviously be discussed with your own personal physician.
And even if some of these I would say coaches or consultants, advisors are making advice about, "Well, maybe you should consider getting on certain medications", they usually are saying, "Talk to your personal physician about using those medicines and getting prescriptions for those medicines."
They definitely, clearly, from what I know, separate those two domains. And so, they can avoid the issue of liability. They cannot have to be on call and still provide very, very valuable, meaningful, and often very successful kinds of consulting services to their clients.
All right. As I said, I want to talk about six specific examples of physicians that have done this. I will say even before I start that I think at least three of them have what you might call board certification. Now, I don't think these boards are recognized by the American Board of Medical Specialties, but they are boards. And so, they're a fairly in-depth type of certification. One is in functional medicine, two are in lifestyle medicine, I believe. I think all of them have some kind of extra training. And so, we'll get into it as I explain each of these physicians and their businesses.
With that, let me go back. The first physician that I had spoken to on the podcast about an issue like this was Dr. Lara Salyer. I believe she's a family physician, and she was searching for something to do just like this that we're talking about. She became interested in functional medicine and I believe she became certified in functional medicine and she set up a solo consulting business.
And I think it was set up initially very much like a private medical practice in the sense that she had a clinic and she had regular appointments. But if I recall correctly, in speaking with her, I found that she did a lot of remote work. She did a lot of work offline. She created a lot of standard written materials. And so, the amount of face-to-face time, either in the clinic or even remotely was limited and once she really got things going.
Now you can find her in my podcast list as episode number 120. But again, I'll put links to all of these in the show notes as well as a link to these different websites. I'm going to mention the two certifications that I mentioned a minute ago but I'll show you that website right now for those on the YouTube channel. This is the Institute for Functional Medicine and it does provide for certification and the program is listed right here for those on YouTube. And again, it's something you might consider in the process of moving towards this kind of a career. Okay, that's the first one.
The second one is Dr. Jessie Benson. Now she's very interesting. She was in episode 158 and she is a life coach. She's also a professional artist, which you might be able to see some things on her website here for those on YouTube. She's also a musician. And so, she obviously does life coaching and she integrates that all into what she does. And again, she is not a practicing physician per se, and she has successfully built this business over a period of years.
The third one I wanted to mention is Dr. Jill Wener. Now her training is in meditation. I think she might actually do some yoga, but her claim to fame and as you can see from her website here, she provides meditation services. She has pre-recorded services, she has live services. She does something called tapping. And so, those of all come out of her training primarily in medicine and meditation.
Now, the next one I want to mention is Dr. Heather Hammerstedt. She created something called Wholist Health. And she has a pretty vigorous program or two. She has a lot of coaching. She employs or engages other coaches to help her. And a lot of what she does is remote. She's also one who is trained in lifestyle medicine.
Let me switch over to that for one second. There's the American College of Lifestyle Medicine in this slide. And you can obtain education, you can get certification. There are some other benefits of membership that you can access including educational programs other than in preparation for certification. So, there is definitely a site to do that. And if we look here on Dr. Hammerstedt's site, you'll see that there's all kinds of programs from weight wellness and personal coaching, fitness mindset. There are some culinary sessions and some dedicated strictly to physicians. That is the fourth example.
The fifth example of a physician who has moved into this kind of coaching or consulting is Dr. Rachel Beanland. She presents The Mindful Doctors Coach. Dr. Beanland is a yoga instructor. Let's see, I'm just looking at different pages here. She was trained as a physician as a public health medicine specialist but she teaches now mindfulness meditation and yoga and other similar health enhancing programs. And again, she's not responsible as a physician-patient relationship, but as a consultant or coach.
And then finally, the sixth one today is Shelly Bhowmik. Oh, by the way, Rachel Beanland was in episode 250. And Shelly Bhowmik is in episode 257. She's trained in preventive medicine and she's also certified in lifestyle medicine. Now she does provide services for wellness, overcoming burnout and so forth. And she really focuses a lot on the corporate side working with medical groups, specialties, societies and specialty groups and health systems and hospitals to bring programs to prevent and overcome burnout in their clinical staffs. So, that's another approach you can take. And again, building on her background in preventive medicine she's able to do that.
The answer to the question "Do these kinds of practices exist?" is yes. They appear to have successfully separated the legal liability associated with the patient physician relationship, reduce or eliminate that while creating more of a client and consultant relationship. I do have a few recommendations if you're thinking about moving into something like that, chances are you already have an area that you'd like to focus on such as meditation, yoga, fitness, lifestyle, maybe we would call it a multi-specialty approach.
But anyway, here's what I would do. First of all, I would really think about what you want to do. And the first step, once you have a good idea what area you're going to focus on, I would consult an attorney to discuss two major questions. First, in your state, can you set up a business like this that does not result in the establishment of a physician-patient relationship, but rather a coaching or non-medical consulting relationship? And the second question would be, what is the business structure for that type of business that you're proposing? In Illinois, it would probably be some type of LLC, but each state is a little different.
Number two, try and consider early in this whole process if you might need additional training and or certifications. You don't have to have those to get started and you can even start doing this while you're working on that additional training and certification. But certainly, if it's something that's going to help from the standpoint of marketing your services, and helping add to your authority, then you should start that early because it might take several months to a year or two to complete that kind of training and or certification.
It's okay to do this sort of as a hobby if you like, but I would say if you're serious, you should prepare a written business plan. It can be pretty high level. You can look at examples of business plans online, but you would definitely want to think about and write down how you might approach these issues. Number one, identifying your intended customers. Who exactly are you going to do this for? Is it a certain age group? Is it a certain gender? Is it a certain background?
Number two, do a financial projection for the business. What do you think you might charge for your services? What kind of services? Will there be all one-on-one? Will they be face-to-face? Online? Remote? Will they be done in group sessions? Will there be anything that you can record ahead of time to provide that can be an ancillary service or even standalone?
And just try and see if this is even something viable. Because then you can do a pilot and try and get some clients and see if it works out the way you think it'll work out. How long does the average client stay with you? Is it something that's one and done or that goes on for three months, six months, a year? And really think through those things ahead of time and do a high-level marketing plan to figure out how are you going to reach out. Are you going to be using social media? Are you going to be using email? Are you going to do word of mouth? Will you be doing presentations, free presentations, paid presentations to try and establish some authority? So, it's good to think through those things before you really spend a lot of time and energy and money on pursuing this.
And then somewhere in that whole mix, and you can do this through LinkedIn, through word of mouth, through going back to old medical school and residency cohorts that you were with. Try to find someone who's a mentor. Try to find someone who's doing what you would like to do. It's a lot easier to envision it and to visualize what it will look like if you've talked to someone who is doing it or has done it in the past.
Even rather than say just contacting a business expert about how to set up your books and set up your business, but actually talk to someone who's doing what you would like to do. It gives you a real reality check as to whether it's doable and how difficult it is, whether the time constraints, what would you do differently? Just remember that with a mentor, usually a mentor is someone that you ask to help you. They usually volunteer. They usually do it for free. So, you don't want to monopolize their time. You just want to learn what you can and little bits here and there as you move along the journey towards your chosen destination.
That's basically what I have to say about answering that question. The question did come from one of my mastermind group members. So, you might consider joining one of my mastermind groups because we do answer these kinds of questions and we also deliver mentorship, encouragement, brainstorming, accountability and a built-in network of other clinicians to speed your career journey. So, if you want to learn more about the mastermind, go to nonclinicalphysicians.com/mastermind for that. I think I'll leave it there for today's episode of Physician NonClinical Careers.
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Transcription PNC Podcast Episode 286
How to Become a Health Advisor With No Physician Patient Relationship
John: I would like to spend another 20 minutes or so addressing a question that came up in my nonclinical career mastermind. And the question is this, "How do I create a business that allows me to provide advice to clients without creating a physician-patient relationship?" The question is, "Have other physicians successfully done this?"
Now, the factors that sort of underline these questions are the following. As clinicians, we enjoy and are committed to helping address health issues in our patients, but we'd like to do the same thing to help others, maybe who aren't our patients. We would like to focus more on prevention and health and wellbeing rather than treating illnesses and injuries. And we like to be able to control our hours, work remotely and not be exposed to medical liability.
Let me just put this as a disclaimer. To some extent, these issues, these questions, fall into the area of legal questions. They should be discussed with an attorney. If you're really having a hard time deciding whether the kind of services you're providing fall in the area of physician-patient relationships, then you might want to sort through that with an attorney.
I would suggest to see an attorney anyway if you're going to develop a business like this because you'll need the attorney for other things that I'll talk about in a minute. But let me try and address the issue to some extent by making a few comments and by presenting six physicians that I've spoken with that have created that kind of business. They're all a little bit different. They all have different kinds of things that they promote and teach and advise on.
All of these physicians make it very clear to their clients that this is a business relationship. It is not a physician-patient relationship. And in fact, I think most, if not all of them advise their clients to discuss what they're planning to do with their personal physician if there's going to be, let's say, some recommendations for certain types of foods, certain types of activities and so forth. In some cases, the kind of advice being given is clearly not of a medical nature. But let's say I were to tell you that, "Oh yeah, you should start training for a marathon once we get you healthier." That should obviously be discussed with your own personal physician.
And even if some of these I would say coaches or consultants, advisors are making advice about, "Well, maybe you should consider getting on certain medications", they usually are saying, "Talk to your personal physician about using those medicines and getting prescriptions for those medicines."
They definitely, clearly, from what I know, separate those two domains. And so, they can avoid the issue of liability. They cannot have to be on call and still provide very, very valuable, meaningful, and often very successful kinds of consulting services to their clients.
All right. As I said, I want to talk about six specific examples of physicians that have done this. I will say even before I start that I think at least three of them have what you might call board certification. Now, I don't think these boards are recognized by the American Board of Medical Specialties, but they are boards. And so, they're a fairly in-depth type of certification. One is in functional medicine, two are in lifestyle medicine, I believe. I think all of them have some kind of extra training. And so, we'll get into it as I explain each of these physicians and their businesses.
With that, let me go back. The first physician that I had spoken to on the podcast about an issue like this was Dr. Lara Salyer. I believe she's a family physician, and she was searching for something to do just like this that we're talking about. She became interested in functional medicine and I believe she became certified in functional medicine and she set up a solo consulting business.
And I think it was set up initially very much like a private medical practice in the sense that she had a clinic and she had regular appointments. But if I recall correctly, in speaking with her, I found that she did a lot of remote work. She did a lot of work offline. She created a lot of standard written materials. And so, the amount of face-to-face time, either in the clinic or even remotely was limited and once she really got things going.
Now you can find her in my podcast list as episode number 120. But again, I'll put links to all of these in the show notes as well as a link to these different websites. I'm going to mention the two certifications that I mentioned a minute ago but I'll show you that website right now for those on the YouTube channel. This is the Institute for Functional Medicine and it does provide for certification and the program is listed right here for those on YouTube. And again, it's something you might consider in the process of moving towards this kind of a career. Okay, that's the first one.
The second one is Dr. Jessie Benson. Now she's very interesting. She was in episode 158 and she is a life coach. She's also a professional artist, which you might be able to see some things on her website here for those on YouTube. She's also a musician. And so, she obviously does life coaching and she integrates that all into what she does. And again, she is not a practicing physician per se, and she has successfully built this business over a period of years.
The third one I wanted to mention is Dr. Jill Wener. Now her training is in meditation. I think she might actually do some yoga, but her claim to fame and as you can see from her website here, she provides meditation services. She has pre-recorded services, she has live services. She does something called tapping. And so, those of all come out of her training primarily in medicine and meditation.
Now, the next one I want to mention is Dr. Heather Hammerstedt. She created something called Wholist Health. And she has a pretty vigorous program or two. She has a lot of coaching. She employs or engages other coaches to help her. And a lot of what she does is remote. She's also one who is trained in lifestyle medicine.
Let me switch over to that for one second. There's the American College of Lifestyle Medicine in this slide. And you can obtain education, you can get certification. There are some other benefits of membership that you can access including educational programs other than in preparation for certification. So, there is definitely a site to do that. And if we look here on Dr. Hammerstedt's site, you'll see that there's all kinds of programs from weight wellness and personal coaching, fitness mindset. There are some culinary sessions and some dedicated strictly to physicians. That is the fourth example.
The fifth example of a physician who has moved into this kind of coaching or consulting is Dr. Rachel Beanland. She presents The Mindful Doctors Coach. Dr. Beanland is a yoga instructor. Let's see, I'm just looking at different pages here. She was trained as a physician as a public health medicine specialist but she teaches now mindfulness meditation and yoga and other similar health enhancing programs. And again, she's not responsible as a physician-patient relationship, but as a consultant or coach.
And then finally, the sixth one today is Shelly Bhowmik. Oh, by the way, Rachel Beanland was in episode 250. And Shelly Bhowmik is in episode 257. She's trained in preventive medicine and she's also certified in lifestyle medicine. Now she does provide services for wellness, overcoming burnout and so forth. And she really focuses a lot on the corporate side working with medical groups, specialties, societies and specialty groups and health systems and hospitals to bring programs to prevent and overcome burnout in their clinical staffs. So, that's another approach you can take. And again, building on her background in preventive medicine she's able to do that.
The answer to the question "Do these kinds of practices exist?" is yes. They appear to have successfully separated the legal liability associated with the patient physician relationship, reduce or eliminate that while creating more of a client and consultant relationship. I do have a few recommendations if you're thinking about moving into something like that, chances are you already have an area that you'd like to focus on such as meditation, yoga, fitness, lifestyle, maybe we would call it a multi-specialty approach.
But anyway, here's what I would do. First of all, I would really think about what you want to do. And the first step, once you have a good idea what area you're going to focus on, I would consult an attorney to discuss two major questions. First, in your state, can you set up a business like this that does not result in the establishment of a physician-patient relationship, but rather a coaching or non-medical consulting relationship? And the second question would be, what is the business structure for that type of business that you're proposing? In Illinois, it would probably be some type of LLC, but each state is a little different.
Number two, try and consider early in this whole process if you might need additional training and or certifications. You don't have to have those to get started and you can even start doing this while you're working on that additional training and certification. But certainly, if it's something that's going to help from the standpoint of marketing your services, and helping add to your authority, then you should start that early because it might take several months to a year or two to complete that kind of training and or certification.
It's okay to do this sort of as a hobby if you like, but I would say if you're serious, you should prepare a written business plan. It can be pretty high level. You can look at examples of business plans online, but you would definitely want to think about and write down how you might approach these issues. Number one, identifying your intended customers. Who exactly are you going to do this for? Is it a certain age group? Is it a certain gender? Is it a certain background?
Number two, do a financial projection for the business. What do you think you might charge for your services? What kind of services? Will there be all one-on-one? Will they be face-to-face? Online? Remote? Will they be done in group sessions? Will there be anything that you can record ahead of time to provide that can be an ancillary service or even standalone?
And just try and see if this is even something viable. Because then you can do a pilot and try and get some clients and see if it works out the way you think it'll work out. How long does the average client stay with you? Is it something that's one and done or that goes on for three months, six months, a year? And really think through those things ahead of time and do a high-level marketing plan to figure out how are you going to reach out. Are you going to be using social media? Are you going to be using email? Are you going to do word of mouth? Will you be doing presentations, free presentations, paid presentations to try and establish some authority? So, it's good to think through those things before you really spend a lot of time and energy and money on pursuing this.
And then somewhere in that whole mix, and you can do this through LinkedIn, through word of mouth, through going back to old medical school and residency cohorts that you were with. Try to find someone who's a mentor. Try to find someone who's doing what you would like to do. It's a lot easier to envision it and to visualize what it will look like if you've talked to someone who is doing it or has done it in the past.
Even rather than say just contacting a business expert about how to set up your books and set up your business, but actually talk to someone who's doing what you would like to do. It gives you a real reality check as to whether it's doable and how difficult it is, whether the time constraints, what would you do differently? Just remember that with a mentor, usually a mentor is someone that you ask to help you. They usually volunteer. They usually do it for free. So, you don't want to monopolize their time. You just want to learn what you can and little bits here and there as you move along the journey towards your chosen destination.
That's basically what I have to say about answering that question. The question did come from one of my mastermind group members. So, you might consider joining one of my mastermind groups because we do answer these kinds of questions and we also deliver mentorship, encouragement, brainstorming, accountability and a built-in network of other clinicians to speed your career journey. So, if you want to learn more about the mastermind, go to nonclinicalphysicians.com/mastermind for that. I think I'll leave it there for today's episode of Physician NonClinical Careers.
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