Coaching in Healthcare: Moving Beyond Advice-Giving to Transform Patient Care

As an occupational therapist with over two decades of experience, I always sought ways to help my clients create meaningful, lasting change. But no matter what strategies I tried, I kept running into the same frustrating pattern: patients weren’t following through.

I could prescribe the best interventions, provide all the education, and outline the clearest plan, but something wasn’t clicking. My clients weren’t following through, and I was starting to feel the weight of it. I was working harder than they were, desperately wanting to support them. Over time, I wasn’t just exhausted; I was wondering how sustainable working in healthcare was for me. That’s when I discovered coaching.

Rethinking patient care: the role of coaching in healthcare

I signed up for a coaching workshop when I took on a new clinical leadership role. This new responsibility was taken on alongside my clinical work, and I wanted to expand my ability to support my team. 

The course wasn’t designed for healthcare providers: It focused on workplace settings rather than clinical interactions. However, having just completed my Master of Adult Education, I recognized a clear connection. Through studying adult learning and transformative learning theory–which explores how deep, lasting change occurs through a shift in perspective—I realized that the core principles of coaching aligned with what I already knew about how people learn and grow.

That’s why I sat there, mouth agape. Could this be applied in healthcare? Was this the missing piece that could help clients achieve their rehabilitation goals while also preventing my own burnout?

I later discovered the answer was a resounding YES.

I had to trust the theory, and I chose to do so through experimentation. I started applying coaching techniques with my most challenging patients—ones who had been stuck for months, recovering from concussion, PTSD, and severe depression. Instead of telling my client what to do, I asked different kinds of questions. I listened differently. I gave them space to reflect, rather than rushing in with solutions. After a while, I noticed a shift. For the first time, they moved forward—not because I made a recommendation, but because they took ownership of their progress.

That was the moment I knew that coaching wasn’t just for leadership. It had a place in healthcare. However, at the time, I wasn’t aware of any training or framework designed by or for healthcare professionals on how to apply coaching principles with patients and clients.

After trialing these strategies with many clients and recognizing how powerfully they shifted outcomes, I refined my methods into what became Dive Into a Coach Approach®—a model now taught globally to help healthcare professionals integrate coaching into patient care.

Today, it includes a 50-hour accredited certification program and has established a clear definition of coaching in healthcare:

A specific conversational partnership where concrete action plans are co-developed through accessing individuals’ strengths, resources, and creativity with the intent to (a) empower clients to get their (occupational) wants or needs met, and (b) enable sustained change through meaningful, self-directed actions.

Why traditional advice-giving falls short in healthcare

While healthcare has long centered on clinician expertise and patient education, evidence shows that knowledge alone rarely leads to sustained behavior change. Here’s why advice alone isn’t always enough to spark meaningful change:

• Patients often already know what they should do but struggle to do it. A systematic review found that medication non-adherence among patients with multimorbidity is widespread, with a pooled prevalence of 42.6 percent, highlighting the need for approaches beyond advice-giving.¹

• Information alone doesn’t lead to transformation—internal motivation does. Research indicates that intrinsic motivation, driven by personal satisfaction, is often more sustainable and leads to longer-lasting behavior change.²

• The expert-driven model creates a one-way flow of advice, rather than a partnership. Shifting to a partnership model, where patients are actively involved in their care, has been shown to improve health outcomes and patient satisfaction.³

How coaching transforms patient engagement and outcomes

Coaching transforms how clinicians and patients work together, shifting care from advice-giving to collaboration, leading to stronger engagement and better outcomes. Tamara Shih, a physical therapist in California, discovered that a Coach Approach can completely change how patients engage with treatment.

“When I first started learning about the Coach Approach, I started playing with it immediately because it seemed like such a great way to really get to the bottom of why patients weren’t adhering to their home exercise programs or why they weren’t getting to the goals they wanted to reach.”

Rather than simply telling patients what to do, she began coaching them to uncover their own solutions. And the results were profound.

“I’ve just gotten feedback from patients that the physical therapy they get with me is different from any other physiotherapist they’ve had before. They say, ‘You actually hear me. You listen to me. I understand why I have to do these exercises, so I do them.’”

Many healthcare professionals have experienced the pressure of being the expert who has all the answers. However, shifting from a fixer role to a facilitator role can be transformational for both the provider and the patient.

Susan Czyzo, a physiotherapist in Ontario, Canada, described how this shift lightened her mental load while improving patient outcomes.

“Moving out of that ‘fixer’ role took so much pressure off me. Instead of constantly thinking, ‘What solution am I going to provide? What advice can I give?’ I now have space to actively listen. And that leads to more meaningful sessions and stronger connections with my clients, which I truly value—and I know they do too.”

But it’s not just about reducing stress for providers. It’s about activating patients in their recovery process. Tamara shares how this shift fundamentally changed how she approached treatment plans.

“I was working too hard for my patients—constantly trying to figure out when they could fit exercises into their routine. Now, instead of me doing all the problem-solving, I ask them: ‘When do you think this could be integrated into your daily routine?’”

Instead of prescribing rigid solutions, she partnered with patients to co-develop strategies that worked for them. “I’ve had patients come back and say, ‘Oh, I figured out I can do it at this time, and it’s doable!’ That’s exactly what I want—for them to take ownership of their recovery.”

Real-world applications of coaching in healthcare

On the surface, coaching might seem as simple as asking good questions. One of the most foundational coaching competencies—active listening—is also one of the hardest to master.⁴ Research on doctor-patient communication confirms this, with patients reporting higher satisfaction and better adherence when they feel truly heard.^5,6

Why a Coach Approach works in healthcare

A Coach Approach shifts healthcare professionals from fixers to facilitators, helping patients tap into their motivations, values, and solutions. This shift benefits both patients and providers in meaningful ways:

• Patients become active participants, leading to better follow-through and adherence.

• It supports behavior change more effectively, moving from short-term compliance to long-term lifestyle shifts.

• It helps build stronger therapeutic relationships—patients feel heard, valued, and engaged.

• Providers experience less burnout, as the responsibility for change is shared rather than falling entirely on the clinician.

As Tamara puts it:

“I was getting really burnt out trying to do everything for my patients. Now, by adding a Coach Approach to what I am already doing as a physical therapist, they take on some of that responsibility—because it’s their body, and they need to own that partnership in their care.”

The benefits of a Coach Approach in healthcare

A Coach Approach doesn’t just change outcomes—it can transform the entire care experience. By shifting from directing to partnering, clinicians foster trust, strengthen communication, and create space for meaningful, lasting change.

Research continues to show what many of us experience in practice every day: Coaching empowers patients, improves adherence, and supports clinicians in delivering more collaborative, sustainable care.

Key benefits include:

• Empowered patients: Clients feel more engaged in their care and are more likely to follow through when they feel heard and involved.

• Improved health outcomes: Coaching motivates patients to make lasting changes in their behaviors and lifestyle choices.

• Increased patient satisfaction: Patients report feeling respected, supported, and more connected to their care.

• Better adherence to treatment plans: Coaching strengthens motivation and helps clients navigate barriers to follow-through.

• Enhanced therapeutic alliance: A collaborative, patient-driven dynamic improves trust and strengthens the clinician-client relationship.

• Improved communication and team collaboration: Coaching enhances how we listen, respond, and work together across disciplines.

• Support for chronic conditions: Coaching helps patients manage complex conditions by promoting active self-management and realistic goal-setting.

• Preventive healthcare focus: By empowering clients earlier, we can help prevent complications and support long-term wellness.

The future of healthcare is collaborative

Shifting from advice-giving to a Coach Approach

If you’re a healthcare professional, you don’t have to overhaul your practice overnight. You can start small:

• Ask more, tell less. Instead of leading with advice, lead with questions.

• Partner on solutions. Work with patients to create realistic plans that fit their lives.

• Embrace silence. Patients often need time to process and reflect, so resist the urge to fill the gap.

What a Coach Approach can do for you

Healthcare is changing. Patients want more than just information—they want to be engaged, heard, and empowered. A Coach Approach isn’t just a technique; it’s a mindset that: 

• Creates better patient outcomes

• Reduces clinician frustration

• Strengthens healthcare relationships

I never expected coaching to change the way I saw healthcare. But once I did, I knew I could never go back.

What’s next?

If this resonates with you, take a moment to reflect: How do you currently engage your patients? What would change if you shifted from advice-giving to coaching? A small shift in how we communicate can make a world of difference, for both patients and healthcare professionals alike.

If you’re ready to explore this approach further, I invite you to watch my Medbridge Coach Approach course series, accredited by the International Coaching Federation (ICF). Clinicians who complete the full 12-hour, eight-course series earn 12 ICF coaching credentialing credits—with the final standalone course serving as either an introduction or a deeper capstone experience.

• Coaching Fundamentals in Healthcare

• Building Clarity: Defining the Coaching Process

• Listening and Mindset: Applying the Foundations

• Diving Deeper: Understanding the Client’s Perspective

• Exploration in Action: Guiding Clients Toward Solutions

• Summing Up and Taking Action

• Bringing It All Together: Coaching Framework and Application

• Laser-Focused Coaching

• Using a Coach Approach With Remote Monitoring

References

1. Foley, L., Larkin, J., Lombard-Vance, R., Murphy, A. W., Hynes, L., Galvin, E., & Molloy, G. J. (2021). Prevalence and predictors of medication non-adherence among people living with multimorbidity: A systematic review and meta-analysis. BMJ Open, 11(9), e044987. https://pubmed.ncbi.nlm.nih.gov/34475141/

2. Haynes A, Sherrington C, Ramsay E, Kirkham C, Manning S, Wallbank G, Hassett L, Tiedemann A. "Sharing Success with Someone": Building therapeutic alliance in physiotherapist-delivered physical activity coaching for healthy aging. Physiother Theory Pract. 2022 Nov;38(13):2771-2787. https://pubmed.ncbi.nlm.nih.gov/34324406/

3. Cook, E., Greene, G. J., & Maxwell, J. (2024). Coaching for person-centred healthcare: A solution-focused approach to collaborative care (1st ed.). Taylor & Francis Group. https://www.taylorfrancis.com/books/edit/10.4324/9781003414490/coaching-person-centred-healthcare-elaine-cook-gilbert-greene-joanne-maxwell

4. Miller, W. R. (2018). Listening well: The art of empathetic understanding. Eugene, OR: Wipf and Stock Publishers.

5. Świątoniowska-Lonc N, Polański J, Tański W, Jankowska-Polańska B. Impact of satisfaction with physician-patient communication on self-care and adherence in patients with hypertension: cross-sectional study. BMC Health Serv Res. 2020 Nov 16;20(1):1046. https://pubmed.ncbi.nlm.nih.gov/33198739/

6. Hashim MJ. Patient-Centered Communication: Basic Skills. Am Fam Physician. 2017 Jan 1;95(1):29-34. PMID: 28075109. https://pubmed.ncbi.nlm.nih.gov/28075109/