OSU medical students help patients reach goals
Coaches enable couple to make lifestyle changes.
When Robert Carey vacationed in Italy this past summer, a leg weakened by knee-replacement surgery kept him from some sightseeing.
Missing out on those tours helped spur the 68year-old Hilliard man to undergo physical therapy and make changes to his lifestyle.
It hasn’t been easy, Carey said.
“It’s sometimes tough to get that exercise in every day,” he said. “You tend to want to slack.”
To keep focused on their health goals, he and his wife, Cindy, both retired from Ohio State University, volunteer for a free Ohio State program that pairs each of them with a medical student who serves as a health coach.
The program is part of the university’s updated medical-education curriculum, which has been in place since 2012. In the past, the first two years of medical school primarily focused on book work; patient interaction began in earnest in the third year. Now, medical students are given opportunities to be an active part of a medical team in those first years instead of simply shadowing doctors.
Over a three-month period, the Careys each met three times with their own health coach, who listened and helped them clarify their health goals. The couple have been working to make exercise a part of their daily routines.
“We’ve learned that exercising and maintaining your body is an everyday thing that you have to do for the rest of your life,” Mrs. Carey said. “If you’re going to have a quality of life, you need to do certain things, and you need to do them regularly.”
Medical students are not allowed to give medical advice to patients. Instead, the idea is for the student to work more as a partner with the patient, said Dr. Donald Mack, who directs the healthcoaching program.
“These students are really approaching chronic disease in a new way compared to the way most physicians approach it,” Mack said.
Officials initially intended to measure the effectiveness of the healthcoaching interventions, but they abandoned that goal — at least for now — because of the many other commitments facing medical students.
Key to the approach is identifying barriers that might keep a patient from achieving even some modest momentum in improving his or her health, Mack said.
For example, he said, “The patient might share that they really want to have a better diet, but their spouse is the cook and doesn’t follow that diet.”
Traditionally, students in their second year of medical school coached patients, but this academic year, first-year students are serving as coaches, said Amber Clevenger, who coordinates the program. In the future, only first-year students will serve as health coaches.
Because of the large number of students seeking to match with a patient, university officials are seeking roughly 50 additional volunteers to step forward by mid-January.
Mary Gaugler, a second-year medical student from northeastern Ohio who plans to practice pediatric medicine, served as Mrs. Carey’s health coach. The experience challenged her assumption that a retiree would have plenty of time for exercise. Mrs. Carey was busy remodeling and cleaning her house when Gaugler was coaching her.
Over the course of three meetings, Mrs. Carey’s approach to exercise evolved. At first, she thought a calendar would help her adhere to an exercise routine, but ultimately decided that her best bet was a workout first thing in the morning.
Gaugler said students have to be realistic as health coaches, not prescriptive.
“We would ideally want to have several things change at once,” she said. “But it’s important to recognize that sweeping changes in diet and exercise are not sustainable” or productive.
“The bigger challenge is identifying what small changes a patient can make so that they’ll have small successes,” she said.
Van Don Williams, a second-year medical student from Brooklyn, New York, said his volunteer patient wanted to improve her diet and take her medication more reliably to better manage her diabetes. Making adjustments in her sleep schedule helped the woman’s medication adherence, but the woman’s husband dictated the meals they ate each day.
“What I took away was, as a future health-care provider, we really need to be conscious of being advocates for our patients — try to get their full story on why they’re struggling with a certain health issue,” said Williams, who plans to specialize in primary care. “It really is all based around their story.”
Working as a health coach has shown Antoinette Pusateri, a second-year medical student from Dublin, the importance of having a familiarity with community resources and knowing which ones might benefit patients.
“I focus more on the feeling and the emotion, how we can get her into a habit,” Pusateri said of the patient she coached. “That’s what’s going to serve her over the course of her life.”
Patients interested in volunteering for the health-coaching program should contact Amber Clevenger at 614-2929001 or studenthealthcoa chprojectosumc.edu. Participants must be at least 18 years old and either have a “common” chronic health problem such as diabetes, high blood pressure or asthma, or a desire to exercise more or improve their diet.