Chronic care management has reached a turning point. While traditional approaches focused heavily on medication adherence and clinical monitoring, physicians are discovering that helping patients change deeply ingrained behaviors leads to sustainable improvements.
Recent data from a Sermo physician poll highlights this shift. Among surveyed physicians, 43% report using behavioral coaching frequently in patient consultations, with another 38% are incorporating it when relevant. “Behavioural coaching is time-consuming but very beneficial when it works,” believes a diabetology specialist from the Sermo community.
As chronic diseases continue to rise globally, the medical community is recognizing that lasting solutions often lie not in the prescription pad, but in the conversation that follows. Physicians are becoming coaches, mentors and partners in their patients’ health journeys.
This transition isn’t without challenges. Time constraints, training gaps and patient engagement barriers create real obstacles for practitioners. Yet, the physicians leading this change are finding ways to integrate behavior change strategies into their practices, often with positive results.
Why behavior change matters more than ever
The statistics surrounding chronic disease management paint a sobering picture. Despite advances in medical treatment, patient adherence rates remain stubbornly low, and lifestyle-related health conditions continue to escalate. Recent estimates claim that around 50% of patients don’t take their medication as prescribed. A physician can prescribe the most effective medication regimen, but without addressing the behavioral components, treatment success remains limited.
It’s worth noting that behavior coaching is a broad term encompassing varying strategies, such as improving medication adherence, encouraging preventive behaviors, and promoting self-management of conditions. It can be defined as a patient-centered collaborative process where clinicians or trained coaches support patients in adopting and maintaining healthy behaviors to improve health outcomes. It integrates health education, motivational strategies, and behavior change theories to help patients set personalized goals, overcome barriers, and sustain progress. Behavior change theories such as self-determination theory (fostering autonomous motivation) and self-regulation theory (supporting self-monitoring and feedback) provide theoretical foundations for effective coaching interactions.
Physicians are learning to ask different questions. Instead of “Are you taking your medication as prescribed?” they might ask “What barriers are you facing with your medication routine?” or “What feels realistic for you this week?” These subtle shifts in language open doors to honest conversations about the unique real-world challenges patients face. “Social and cultural factors often shape a patient’s ability to make healthy choices,” as one family medicine physician on Sermo observes.
Healthcare systems are beginning to recognize this reality. Quality measures increasingly focus on patient outcomes rather than just clinical process indicators.
What coaching looks like in practice
In a Sermo poll, 71% of respondents said they view behavior coaching as an effective clinical strategy. Several practical coaching techniques are commonly implemented:
Motivational interviewing has emerged as a cornerstone technique. Rather than telling patients what they need to do, physicians guide them toward their own conclusions through strategic questioning. “I started asking one question: ‘What feels realistic this week?’ It changed everything,” shares one family medicine physician on Sermo.
This approach recognizes that lasting change happens when patients feel ownership over their health decisions. The physician’s role shifts from director to facilitator, helping patients explore their own motivations and identify personal barriers to change.
“Teach-back” methods enhance patient understanding and retention. Physicians ask patients to explain the information in their own words, revealing knowledge gaps that might otherwise go unnoticed. The technique ensures patients truly comprehend their treatment plans and feel confident implementing changes at home.
Habit stacking represents another practical strategy physicians are adopting. This involves linking new health behaviors to existing routines, making them more likely to stick. For example, a patient might commit to checking their blood pressure immediately after their morning coffee, leveraging an established habit to support a new one.
Self-monitoring involves encouraging the patient to be aware and keep track of their own behaviors to report back on during their next consultation. This may include examples such as keeping a journal recording the number of times a negative behavior such as smoking is indulged in, or utilizing wearable trackers such as pedometers to boost motivation to reach an activity goal.
By incorporating techniques like these into routine care, physicians can help patients overcome barriers and achieve meaningful health improvements.
The biggest barriers to coaching
Physicians face significant obstacles in implementing behavioral coaching. Time constraints seem most problematic, with 48% of surveyed physicians on Sermo citing them as their primary barrier. The pressure of packed schedules leaves little room for extended conversations. “The pressure on my practice leaves little time to practice behavioral coaching techniques,” writes one family medicine doctor on Sermo.
18% of respondents highlighted patient engagement barriers. “This kind of coaching is greatly impacted by the quality of relationship between doctor and patient,” notes an OB/GYN on Sermo. “If there’s a relationship, it’s much more effective.” Physicians are required to read and understand their patients’ preferences. “Some patients are not interested in hearing your ‘philosophy’ of things,” writes a dermatologist on Sermo. “Others are eager to hear & want to please their physician.”
Training gaps present another challenge, with 17% of physicians feeling underprepared to implement coaching techniques effectively. Medical schools and residency programs may still emphasize clinical knowledge over communication skills, leaving practitioners to develop these abilities independently. Workshops to train health professionals on behavior change techniques have resulted in significant improvements in knowledge, norms, perceived behavioral control, and intention to use such techniques in practice.
That being said, formal training isn’t always necessary to begin incorporating coaching principles. Simple changes in question phrasing or appointment structure can yield significant improvements in patient engagement and outcomes. Beginning with small, manageable adjustments allows doctors new to coaching to build confidence and gradually expand their skills. These principles foster a more collaborative and empowering relationship, encouraging patients to take an active role in their health. Moreover, such approaches are flexible and can be tailored to fit various clinical contexts, making them accessible and sustainable for busy healthcare environments.
Limited resources and support tools affect 10% of physicians, highlighting systemic issues within healthcare organizations. Without institutional support, individual physicians must create their own coaching frameworks and accountability systems.
Rather than seeking perfection, physicians successfully implementing behavioral coaching emphasize sustainability and progress over dramatic transformations. They recognize that even small improvements in patient engagement and behavior can yield meaningful benefits over time.
Support physicians are looking for
More physicians recognize the value in behavioral coaching, there is growing demand for support to be able to use it effectively. In a Sermo poll, 51% of respondents said additional training and resources would help them implement coaching—depending on the quality of that training—and 33% said such support would definitely help.
Time constraints remain a significant barrier. “Training physicians to do behavioral modification counseling is great,” says an internal medicine physician on Sermo. “Lack of time to utilize those skills is the main problem.”
One Sermo member believes that behavioral coaching isn’t something that all physicians should dedicate their time to. “Patients should be referred to individuals trained to handle this,” they write. “The average physician doesn’t have time anyway and will not get paid.”
Many physicians on Sermo emphasize a need for ongoing support. “It’s not enough to have been taught motivational interviewing once, it needs to be taught and supported (with time, training and resources) throughout our working lives given how pertinent it is to our work, our patients and populations,” writes a general practice physician.
Small changes, big results: tips from peers
Even subtle shifts in communication style and appointment structure can be effective. Physicians on Sermo who have successfully integrated these approaches share practical insights that colleagues can implement immediately.
A common theme is the importance of making patients comfortable. “By fostering a non-judgmental and supportive environment, we help patients take ownership of their health, improving adherence and outcomes,” writes one family medicine physician.
Physicians on Sermo have recounted success with helping patients establish goals by getting specific. “It helps to make S.M.A.R.T (specific, measurable, attainable, reasonable, time-specific) goals,” notes one internal medicine specialist.
Ongoing communication and motivation prove essential for sustained change. “Open communication must happen first…and motivation needs to be repeatedly encouraged,” another family medicine physician noted. Physicians can focus on progress and self-efficacy rather than strict adherence to prescribed behaviors.
Key takeaway
The integration of behavior change strategies into chronic care is part of a larger shift toward patient-centered medicine. The physicians leading this transformation understand that sustainable health improvements emerge from collaboration, not compliance.
Based on feedback from physicians in the Sermo community, when patients feel heard, understood and supported in their health journey, outcomes improve dramatically. This doesn’t happen through perfect implementation of coaching protocols, but rather through authentic connections between physicians and patients working toward shared goals.
Even small adjustments in communication style can create significant impact. Asking “What feels realistic this week?” instead of “You need to stop smoking” opens entirely different conversations. Using teach-back methods ensures patients understand their care plans. Setting S.M.A.R.T goals transforms overwhelming lifestyle changes into manageable steps.
The barriers physicians face, such as time constraints, training gaps, patient engagement challenges, are real and significant. However, solutions emerging from the medical community demonstrate that meaningful behavior change support can happen within existing healthcare structures.
As healthcare continues evolving toward value-based models emphasizing outcomes over procedures, these skills become increasingly valuable. “Coaching helps patients set goals, overcome barriers, and take ownership of their health,” writes a radiation oncology specialist on Sermo. “It’s essential for modern, patient-centered care.”
