• Wellcoaches

Coaching in healthcare...it's turtles all the way down



The story goes: a prominent thinker, perhaps William James or Bertrand Russell, delivered a lecture on the nature of the solar system. In response, an elderly woman proposed an alternate theory, that the world is flat, sitting on a turtle, and it is turtles all the way down. Her wacky notion has a kernel of wisdom for leaders in healthcare today.

The emerging profession of coaching in healthcare is well on its way to identifying the “turtles,” the mechanisms of coaching that ignite and foster personal engagement in healthy living (1, 2, 3, 4), giving us the resources to perform at our best. What we wrote in a 2006 white paper: The obesity epidemic, a confidence crisis calling for professional coaches, is standing the test of time. Health and wellness coaches (5), and the deployment of coaching techniques by health providers, are contributing to population health by:

accepting and meeting us where we are today
asking us to take charge, take hold of the steering wheel of our lives
helping us define a higher purpose for well-being
helping us uncover our natural impulse to be well
guiding us in doing the mindful thinking and doing work that builds confidence
helping us tap into our innate fighting spirit
addressing mental and physical health together
helping us draw a personal blueprint for well-being
helping us set realistic goals; small victories lay the foundation for self-efficacy
harnessing our strengths to overcome our obstacles
helping us view challenges as opportunities to learn and grow
helping us build a support team
inspiring and challenging us to go beyond what we would do alone.

Population health is our destiny. It’s time to lead. Let’s go first.


While we have no map yet to guide us toward successful healthcare reform, perhaps better described as transformation, there is no doubt as to our destination. Population health is our destiny. To lead in healthcare then is to coach ourselves and all we serve, including providers and patients, to cultivate personal health and well-being. Going first means that the first population to get healthy is the population of healthcare workers who take great care of those whose health is compromised.


At a recent Harvard Medical School conference for women healthcare leaders, I presented on coaching in healthcare, proposing that population health depends on a coaching culture in healthcare (6) from top to bottom:

A culture where one’s own self-determination is well served by investing in the self-determination of others.
A culture that transforms burnout into full engagement in well-being.
A culture that is accepting and empathetic while inspiring autonomy and heartfelt purpose.
A culture that draws out the intrinsic motivation of leaders, providers, and patients, and pours the energy into building confidence and habits of well-being.
A culture of well-being that unleashes the adventurous and creative forces that will power us toward the transformation of healthcare.

Our best path to the triple aim (7) is not just reform, fixing what’s not working. Let’s unleash a triple aim of human biology. Connect. Grow. Thrive.


At its simplest, the recipe for a coaching culture is based on eliciting that which makes humans thrive, which then unleashes our most innovative, adventurous, and purposeful minds. Start with a genuine “I have your back” (8) connection, then add the ingredients that help people grow and engage in the habits that generate more thriving (9). Leaders, providers, and patients will begin to thrive in more moments, more hours, days, and maybe the rest of our lives. Then we are on the way to transforming healthcare.


Harvard physician Julie Silver, who organized the conference for women healthcare leaders, started #QuoteHer, and called on us to be more visible by contributing our own quotes. Here are three "Coach Meg" quotes, my call to action for coaching in healthcare.

In healthcare, it's coaching all the way down.
Population health is our destiny. It is time to lead. Let's go first.
Engage biology's triple aim. Connect. Grow. Thrive.

Onward and upward.

Coach Meg


References & Resources

Moore, Boothroyd. 2006. The obesity epidemic: a confidence crisis calling for professional coaches. White paper published by Wellcoaches Corporation.


Wolever et al. 2013. A Systematic Review of the Literature on Health and Wellness Coaching. Global Advances in Health and Medicine.


Institute of Coaching, McLean Hospital, a Harvard Medical School affiliate


Moore, Jackson, Tschannen-Moran. 2015. Coaching Psychology Manual. Endorsed by the American College of Sports Medicine and published by Wolters Kluwer.


Press release announcing partnership of National Consortium for Credentialing Health & Wellness Coaches and National Board of Medical Examiners to deliver national standards and national certification of health and wellness coaches and support deployment of professional coaches and coaching competencies across the spectrum: clinical, organizational, and community settings.


Wolever, Moore, Jordan. 2016. Chapter 29. Coaching in Healthcare. The Sage Handbook of Coaching.


Institute of Healthcare Improvement. 2016. Triple Aim of Healthcare - affordable, quality care, optimal health for all


Amy Edmondson, PhD, Harvard Business School. Teaming and Psychological Safety.


Moore, Phillips, Hanc. 2016. Organize Your Emotions, Optimize Your Life. A Harvard Health Book published by William Morrow.Report this