In this interview segment, Kelly Alhooie explains the emerging shift toward providers offering coaching services alongside traditional therapy. She defines a coach as an unlicensed practitioner who can operate across state lines, does not need to keep clinical notes, and is not bound by insurance reimbursement rules. Coaching is presented as a solution‑oriented, flexible approach that can address diet, fitness, or other lifestyle factors without assigning a medical diagnosis. In contrast, therapy is described as a licensed, diagnostic, often manual treatment that may be reimbursable through insurance. Alhooie argues that because coaches are not constrained by insurance or licensing requirements, they can potentially achieve equal or better patient results, especially when delivered online or via tele‑format. The discussion highlights the regulatory, documentation, and financial distinctions between the two modalities and suggests that coaching’s flexibility may drive improved outcomes.
So Kelly, what's kind of the shift that you're seeing with providers now offering coaching services and kind of what is that?
Yeah, great question. So let's just start first with the definition of what a coach is. A coach is not a licensed provider, meaning they don't have the same rules as a provider. They can practice in any state. They don't have to do notes. They can, um, you know, do different recommendations and get people the results, but they don't have to be under an actual license. So let me give you an example of this. This could be an actual student. This could be a health and fitness coach. This could be, um, someone that literally just had a baby yesterday and, uh, become, you know, a postpartum coach. Uh, it, it, it really doesn't have a label and— or it has a label, but it doesn't have something where you have to like go to school to get a degree. Let me say that, that a coach is someone that they feel that they have a solution to a problem and they feel that they can help you with that. That is what a coach is. Yeah. Okay.
So what would be the difference between really coaching and being a treater or a provider for treatment? So does the treatment itself change? How would that adjustment go?
Yeah, so when it comes to a— when it comes to coaching, coaching is where you're going to verbally and visually walk someone through how to actually get a result. When it comes to therapy, how I truly define this is therapy is a lot of touching. Um, doesn't have to be, but that's how I'm defining this right now, is therapy is manual therapy, right? And it's truly actually putting a diagnosis on someone and labeling them as that diagnosis and saying, well, this is what we're going to try to solve. When you're coaching, it's a more broader, general— you may be hitting the diet aspect, you may be hitting the fitness aspect, you may be hitting, you know, yeah, you may be hitting leakage, but you're not diagnosing them with stress urinary incontinence. That's therapy. And therapy also is— could be reimbursable. Coaching is not reimbursable. I think that's also a very clear, uh, defining line as well.
So really, coaching could help get the same or even better results because they're not restricted with insurances either. So let's talk a little bit more about the results. I think that's a lot of concern people have is potentially coaching is seen online as well, or because they're not getting diagnoses, they're not getting the same results somebody would look for or pay a provider to give them.
Yeah, so coaching can give the same results, if not better, than even therapy. And I know that's a bold statement to make, and I'm saying this because I've done it and I've coached other people to do it, and I have seen it. Whether or not it's through teletherapy, which would be under the umbrella of therapy, or whether or not it's through virtual coaching, um, that's under the umbrella of coaching, uh, either way, I have seen people online get the result for patients that they are looking for without even touching them. And it's all through, which most providers do not realize, It's all through using visuals on the screen that they're talking to the person. It's also all through the patient being able to demo back what you asked them to do. That is huge. And then the patient coming back and being reporter, that the patient is more involved, whether or not it's teletherapy or therapy or coaching, anything online, the patient actually has to be more involved. And so what I have found with that is you're actually going to get better results because the patient has to be into it. If they're not into it, then you're not going to get the results. Comparatively, anything in person— because there is coaching in person and there is coaching in, um, in the therapy space, right? And anything in person, it is where the patient can be more passive. So if I do tons of manual therapy, well, are we specifically getting Guys, let's be honest, are we really specifically sometimes talking about the patient issue the entire time we're working on them? No, we're talking about their weekend, we're talking about their kids, we're talking about whatever. So sometimes we get distracted when people are just doing manual, heavy manual therapy because we're focused on other things, because we're just, you know, working on them and going through our routine. So we have to be very mindful, I think, of how we're defining coaching, because there's coaching online, there's coaching in person, there's therapy online, there's therapy in person. So therapy online is teletherapy or telemedicine, right? So I think there's a lot of different labels, and I think being very clear moving forward of what people want and how we're going to administer the result, because all that matters is the result, and if we can get people the result, whether or not we save them time or not, that's up to them. And it's up to us to also get the messaging out there of we actually can get the same result, if not better, online and not touching comparatively if we were touching someone. And I think— I honestly believe it's going to move into that. And if you aren't ready for it, which I believe most therapists are not ready for that, to happen, uh, then you're gonna be like, well, why is no one coming to my, my practice? And I think that's going to be a big disconnect
