The Business Case for a Coach Approach in Healthcare

Shifting from the “Fixer Trap” to Partnering for Retention and Clinical ROI

Executive Summary

Healthcare faces a “Symmetry of Failure”: approximately 60% of healthcare professionals are considering leaving the profession, mirrored by approximately 60% of patients who disengage from their treatment plans. For too long, these have been treated as separate problems. The research reveals they are one problem—both stem from a dehumanizing biomedical model that relies on an authoritative “fixer” approach rather than partnering with the human being in front of us.

This white paper presents the business case for adopting a Coach Approach in healthcare as a strategic intervention that addresses both crises simultaneously. Drawing on evidence from the biopsychosocial model, professional coaching competencies, and person-centred care frameworks, we demonstrate how shifting from directive to collaborative care produces a “Triple Impact”: superior clinical outcomes for patients, improved psychological sustainability for clinicians, and enhanced leadership effectiveness across organizations.

The paper introduces the Coaching Spectrum Framework™ and the Dive Into a Coach Approach® (DICA) methodology as scalable implementation pathways. Evidence demonstrates that when clinicians move from “fixing” to “partnering,” patient engagement increases through self-selected goals and improved adherence, while clinician burnout decreases through reduced emotional overload and cognitive load. Organizations benefit from reduced turnover costs, with documented savings of up to $133 million in physician retention alone.

For healthcare leaders facing workforce shortages and rising intent-to-leave rates, a Coach Approach is not an additional burden—it is a higher-efficiency method for delivering care that protects both patient outcomes and organizational sustainability. The conclusion is clear: we can continue to pay the high cost of the Symmetry of Failure, or we can invest in a culture of partnership that transforms how care is delivered.

Keywords: healthcare burnout, patient engagement, coach approach, biopsychosocial model, workforce retention, person-centred care, collaborative care, clinical leadership

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Section 1: The Allied Health Exodus

The Symmetry of Failure

The healthcare workforce is bleeding talent—not because clinicians stop caring, but because they care too much without the right tools to sustain it.

We are currently witnessing a “Symmetry of Failure”: a dual crisis where practitioner burnout is mirrored by patient disengagement.

• The Practitioner Crisis: While actual attrition rates fluctuate, the intent to leave is staggering. Approximately 60% of healthcare professionals, with Occupational Therapists reporting the highest intent in some studies, are actively considering leaving the profession (Yeoh et al., 2024).
• The Client Crisis: This is met by a parallel failure in clinical follow-through. Approximately 60% of clients disengage from their treatment plans (Foley et al., 2021; Panovich, 2025; Pruitt et al., 2025). Non-adherence to at-home exercise programs is frequently estimated at 50%, with current clinical data indicating that up to 50–70% of patients fail to complete prescribed home programs.
• The Global Gap: Reports show that only 25–30% of prescriptions are taken as intended, and up to 50% of patients with chronic conditions fail to adhere to long-term therapy.

The Shared Root Cause

The same research identified three recurring categories driving clinicians to leave:

For too long, organizations have treated “compliance” and “burnout” as separate problems. The research tells a different story: they are one problem. The reason 60% of our patients stop is the same reason 60% of us want to quit: Our current medical model is dehumanizing for everyone involved. It relies on an authoritative “fixer” approach that fails to connect with the human being in front of us. As Salazar (2022) notes, shifting toward humanizing healthcare is the path to better outcomes.

The Financial Impact (ROI)

The financial impact of this crisis extends far beyond recruitment costs:

Cost Category	Impact
Allied Health Replacement (OT, PT, SLP, Pharmacy)	$45,000–$150,000 per professional
Physician/Clinical Leadership Departure	$500,000–$1,000,000 (including lost billable revenue)
Mid-Sized Facility Annual Risk (200 staff at 20% turnover)	$1.8M–$3M in recruitment and onboarding

Note: All financial figures are represented in U.S. Dollars (USD) and are based on industry benchmarks from NSI Nursing Solutions, the AMA, and MGMA.

When a single clinician leaves, organizations lose more than a filled position—they lose relationships with patients, mentorship capacity for students, and the tacit knowledge that makes care delivery efficient.

The “Intent to Leave” Premium: These figures represent actual turnover. But with intent-to-leave rates exceeding 60% among OTs and similarly high percentages across allied health professions, this cost is not a static line item—it is an active financial threat to organizational stability. The question for leadership is not if turnover will occur, but how much of that intent will convert to actual departures in the next 12–24 months.

The Leadership Gap

Allied Health Professionals are the third-largest healthcare workforce globally, following nursing and medicine (Eddison et al., 2023). Yet, they hold only 14% of executive board positions (Eddison et al., 2023).

• The Training Gap: Graduate curricula emphasize leadership as administration—policy, strategic planning, and governance structures (Smallfield et al., 2019).
• The Conversational Deficit: Clinicians are rarely taught how to have the conversations that turn around a burned-out team member or guide a patient toward their own insight. We’re trained to lead systems—not conversations (Smallfield et al., 2019). We learn to fix our clients’ problems, but we aren’t taught the human-centered skills required to partner with them (Rutscheke & Fick, 2023; Salazar, 2022).

The Result: Clinicians promoted into leadership often default to what they know: fixing problems for others rather than facilitating solutions with them.

This gap is precisely where a Coach Approach in healthcare creates impact.

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Section 2: The “Backpack” Problem—Understanding Emotional Overload

Why Caring Becomes Carrying

When clinicians enter healthcare, they receive more than a degree—they receive an invisible backpack. Over time, that backpack fills with weight that was never theirs to carry.

The same skills that make clinicians excellent at their jobs can become liabilities when misapplied:

• Empathy becomes emotional overload when clinicians absorb every patient’s struggle as their own.
• Problem-solving becomes the “Fixer Trap” when clinicians solve problems patients never asked them to solve.
• Adaptability becomes self-abandonment when clinicians meet everyone else’s needs but their own.

This is the mechanism behind the Individual-centric driver of attrition. Burnout doesn’t happen because clinicians stop caring—it happens because they care without boundaries.

The Fixer Trap

Healthcare training teaches clinicians to assess, problem-solve, and recommend. This clinical reasoning model works well for medical problems with clear solutions. But when applied to behavior change, goal achievement, and patient motivation, it backfires.

Consider a typical clinical interaction:

The clinician sets the goal. The clinician designs the intervention. The clinician problem-solves obstacles the patient hasn’t even named yet. And when the patient doesn’t follow through, the clinician writes “goal not achieved” and wonders what they did wrong.

In that moment, the clinician just added something to their backpack.

When clinicians operate from a “Fixer” mindset, they unconsciously take ownership of outcomes that belong to the patient:

• The patient’s goals become the clinician’s responsibility
• The patient’s lack of follow-through becomes the clinician’s failure
• The patient’s family dynamics become the clinician’s problem to solve
• The patient’s insurance barriers become the clinician’s obstacle to overcome

There is only so much space in that backpack.

The Research Behind the Metaphor

This pattern is well-documented in the literature. A systematic review of health coaching interventions found that clinician-led approaches—where the provider directs goals and solutions—produce lower patient engagement and adherence than client-led approaches (Boehmer et al., 2023). When patients don’t own their goals, they don’t pursue them. And when clinicians carry goals that aren’t theirs, they burn out.

The connection between this dynamic and clinician wellbeing is equally clear. Clinician-educators who adopt a coaching stance—asking rather than telling, facilitating rather than fixing—report increased job satisfaction and reduced emotional exhaustion (Elster et al., 2022).

The pattern holds across conditions: diabetes management, chronic pain, cardiac rehabilitation, pediatric interventions, and more. When clinicians shift from directing to partnering, patients improve and clinicians sustain.

What Offloading Looks Like

The alternative to the Fixer Trap is not caring less—it’s caring differently.

Offloading the backpack means:

• Asking “What’s the one thing you want to focus on today?” instead of deciding for the patient
• Asking “What have you already tried?” before offering solutions
• Asking “What feels like the right next step for you?” instead of prescribing the plan

These are not passive questions. They are strategic redirections that return ownership to the person who must ultimately do the work: the patient.

When a clinician shifts from fixing to partnering, two things happen simultaneously:

1. The patient becomes more engaged. Research consistently shows that self-selected goals produce higher commitment and follow-through than assigned goals (Levack et al., 2015). Recent data confirms that higher degrees of engagement between health coaches and patients are positively associated with a patient’s perceived ability to manage their own chronic conditions (Benzo et al., 2024). Community health coaching also significantly improves self-management by increasing patient activation and goal-pursuit efficacy (Almutairi et al., 2025).

• The clinician becomes more sustainable. The emotional weight of “goal not achieved” no longer lands on the clinician’s shoulders—because the goal was never theirs to carry. Research shows that different approaches to empathy have distinct impacts on clinician wellbeing. While emotional over-identification with patients (personal distress) correlates with increased burnout, cognitive empathy—understanding patients’ perspectives—is associated with lower burnout and higher professional fulfillment (Wilkinson et al., 2017; Lamiani et al., 2020).

This is the core mechanism of a Coach Approach: it improves patient outcomes while protecting clinician wellbeing. Not one or the other. Both.

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Section 3: The Coach Approach in Healthcare

What It Is (And What It Isn’t)

A Coach Approach is not about becoming a certified coach. It’s not about adding hours to your day or learning an entirely new discipline. It’s about changing how you spend the hours you already have.

At its core, a Coach Approach is a shift in how existing conversations are conducted—with patients, colleagues, and teams—so that responsibility for insight, goals, and action remains with the person who must ultimately carry them out.

What a Coach Approach is:

• A way of asking questions that triggers the other person’s own insight
• A method for facilitating goal-setting that increases ownership and follow-through
• A conversational stance rooted in curiosity rather than immediate problem-solving
• A strategic framework for navigating effective conversations that address the perceptual barriers (fear, low self-efficacy, or limiting beliefs) that often stall patient progress.

What a Coach Approach is not:

• Therapy or counseling
• Abandoning clinical expertise
• Letting patients or staff “figure it out alone”
• Adding time to already-packed schedules

The distinction matters. Many clinicians are not initially familiar with what a Coach Approach looks like in healthcare practice. When they first encounter it, it is often misinterpreted as withholding clinical expertise or stepping back from professional responsibility. In practice, the opposite is true. A Coach Approach integrates clinical knowledge with facilitation skills—allowing expertise to be offered intentionally, while creating space for patients or team members to lead their own thinking and decision-making.

The Shift: From Biomechanical to Biopsychosocial

Traditional healthcare training largely operates from a biomechanical (biomedical) model. This model focuses on anatomical structures, physical diagnosis, and “fixing” pathology (Nakamura & Tanaka, 2023). While essential for acute care, research consistently shows this model falls short in managing behavior change, chronic disease, and patient engagement (Frontiers in Psychiatry, 2021).

Healthcare delivery is often “biological-heavy” but “psychosocial-light.” A Coach Approach provides the practical delivery mechanism for the biopsychosocial model. As Cook, Greene, and Maxwell (2024) argue, person-centred coaching uses dialogic (conversational) tools rooted in neuroscience and humanistic psychology to address the psychological and social dimensions of health that biomedical approaches alone cannot reach. This shift recognizes that a patient may have the correct diagnosis (Biological), but without addressing their mindset (Psychological) or their environment (Social), the clinical intervention will fail.

The Shift: From Clinician-Led to Client-Led

A Coach Approach explicitly activates the biopsychosocial dimensions of care. It reverses the flow of the interaction:

Clinician-Led (Fixer)	Client-Led (Partner)
Clinician sets the goal	Client identifies what matters most
Clinician designs the plan	Client determines their own next step
Clinician troubleshoots obstacles	Client becomes aware of perceptual barriers (with clinician support)
Clinician evaluates progress	Client reflects on their own learning
“Goal not achieved” falls on clinician	Accountability stays with the client

This shift doesn’t reduce the clinician’s value—it redirects it. The clinician still brings expertise, but offers it in service of the client’s self-identified goals rather than in place of the client’s own thinking.

The Discoverer Mindset: The “Being” of Coaching

Professional coaching competencies, such as the International Coaching Federation (ICF) Core Competencies (2025), distinguish between coaching skills (the “doing”) and the underlying mindset (the “being”) that makes those skills effective. In the Dive Into a Coach Approach® framework, we utilize the Discoverer Mindset—one of four key Mindset metaphors—to help clinicians embody this shift.

This stance contrasts sharply with the default clinical stance, which is expert-driven: What’s wrong? What’s the cause? What’s the fix?

The Discoverer Mindset aligns with the biopsychosocial model, asking questions such as:

• What does this person already understand about their situation?
• What have they already tried?
• What matters most to them right now?
• What are they ready to commit to?

These questions aren't “softer” or less rigorous than diagnostic questions. They are differently rigorous. They require the clinician to hold space for ambiguity, tolerate silence, and trust that the person in front of them has resources and insights that a purely biomechanical assessment cannot see.

By adopting the Discoverer Mindset, the clinician moves from being the sole “Fixer” of a biological problem to being a “Partner” in a psychosocial solution.

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Section 4: Evidence—Why This Works

The evidence base for using a Coach Approach in healthcare is substantial and growing. It demonstrates a “Triple Impact”: superior clinical outcomes for patients, improved psychological sustainability for the workforce, and enhanced leadership effectiveness.

Cook et al. (2024) synthesize decades of research demonstrating that solution-focused, person-centred coaching transforms healthcare interactions by honoring the patient’s lived experience and co-creating solutions that are meaningful within their unique context.

For Patients: Activating the Biopsychosocial Model

A Cochrane systematic review found that goal-setting combined with strategies to enhance goal pursuit led to significantly higher health-related quality of life for adults in rehabilitation settings (Levack et al., 2015). The effect was strongest when patients participated actively in setting their own goals.

A 2023 systematic review and meta-analysis of health and wellness coaching found significant improvements in patient-important outcomes across chronic conditions including diabetes, cardiovascular disease, and obesity (Boehmer et al., 2023).

Condition-specific evidence is equally strong:

• Chronic pain: Patient-led goal setting combined with education reduces pain disability and intensity (Gardner et al., 2019)
• Diabetes: Health coaching improves HbA1c, self-management, and quality of life (Racey et al., 2022)
• Pediatrics/ADHD: Parent coaching improves executive function in children and increases parent self-efficacy (Ogourtsova et al., 2019; Pijarnvanit & Sriphetcharawut, 2024)
• Stroke/Brain Injury: Coaching-based transition interventions support successful return-to-work and community reintegration (Lin et al., 2020; Donker-Cools et al., 2017)
• Oncology: “Coach-led” models empower cancer patients to manage psychological distress, reduce symptoms of anxiety and depression, and improve adherence to complex treatment plans (Daniel, R. et al., 2025).
• Obesity: Health coaching is an effective clinical treatment option, with randomized controlled trials showing significantly higher excess weight loss (15.7% vs 2.5%) and increased physical activity compared to standard care (Suminski et al., 2024).
• Palliative Care: Integrating “care coach-led” models significantly increases the delivery of person-centered care and improves patient quality of life throughout the illness trajectory (Tan et al., 2025; ClinicalTrials.gov, 2025).

For Clinicians: The Antidote to Burnout

The benefits extend beyond patient outcomes. Clinician-educators who adopt a Coach Approach report increased job satisfaction and reduced burnout (Elster et al., 2022). A study of healthcare managers found that coaching-based leadership development improved self-efficacy and leadership confidence (Hu et al., 2024).

This dual benefit—better outcomes for patients and better sustainability for clinicians—is what makes a Coach Approach uniquely positioned to address the retention crisis.

From Bedside to Boardroom: Coaching Scales

One of the most powerful aspects of a Coach Approach is that it scales. The same skills that improve patient interactions also transform leadership conversations.

Consider a clinical lead who inherits a burned-out team member. The Fixer response: listen to the problem, offer a solution, move on. The team member leaves with the manager’s answer—but no ownership of what happens next.

The Coach Approach response:

• “What have you thought about doing so far?”
• “What’s worked for you in similar situations?”
• “From your perspective, what feels like the right next step?”

Same time investment. Same meeting. But the team member leaves owning the solution—because they generated it.

When one manager shifts their approach, the ripple effect is significant:

• Team members develop problem-solving confidence
• The manager’s emotional load decreases
• Solutions fit better because they come from the people doing the work
• The organization builds internal leadership capacity

A Coach Approach isn’t just a clinical skill. It’s a leadership multiplier.

Measuring Coaching Culture

Research has begun to operationalize what distinguishes organizations that embed coaching into their culture from those that simply offer coaching as a service. Jenkins (2017) developed the Coaching Culture Inventory, identifying five dimensions: Leadership (leaders modeling coaching behaviors), Coaching Development (training in coaching skills), Context and Strategy (coaching aligned with organizational goals), Coaching Resources (time and support), and Creation of Coaching Opportunities (structures enabling coaching conversations).

The critical finding: coaching cultures are stronger when employees not only know that coaching is valued but see it practiced daily across all levels of the organization (Schein, 2009).

Organizational ROI: The Retention Calculation

The financial case for a Coach Approach is straightforward. As outlined in Section 1, replacing a single allied health professional costs $45,000–$150,000. If a Coach Approach reduces intent-to-leave by even a modest fraction, the organizational return is substantial.

Consider: retaining just 2–3 allied health professionals per year offsets the cost of training an entire cohort in coaching skills. At Cleveland Clinic, peer-based coaching was associated with improved physician retention, yielding a potential cost saving of $133 million (Jansen et al., 2024). Salud Integral en la Montaña credited coaching for increasing patient productivity from 32,000 to 55,000 patients annually within two years—while achieving patient satisfaction rates approaching 100%.

ROI Summary: Who Benefits and How

Stakeholder	Benefit	Evidence
Patients	Higher quality of life, better self-management, resolution of perceptual barriers, and improved adherence	Cochrane review, multiple RCTs across chronic conditions
Clinicians	Increased job satisfaction, reduced burnout, enhanced self-efficacy	Elster et al., 2022; Hu et al., 2024
Leaders	Reduced emotional load, team capacity building, leadership confidence	Jenkins, 2017; organizational culture literature
Organizations	Reduced turnover costs, improved retention, increased patient volume	Cleveland Clinic ($133M savings), Salud Integral (72% productivity increase)

A Coach Approach is not a soft skill—it is a strategic investment with measurable returns across every level of the organization.

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Section 5: Implementation—The Coaching Spectrum Framework™

The most common objection executives raise is time: “Our clinicians are already stretched—they can’t add coaching skills to their day.” This is the “Time Myth.” A Coach Approach is not an additional task layered onto clinical duties—it is a higher-efficiency method for performing them.

To address this, I developed the Coaching Spectrum Framework™. This framework provides clinicians with a clear roadmap for when and how to apply coaching intentionally within their professional scope of practice.

The Four Levels of the Spectrum

1. Level 1: In-the-Moment Coaching (Informal & Responsive): Seamlessly integrated into real-time clinical conversations. It relies on presence and curiosity to recognize “micro-coaching moments.”
2. Level 2: Laser-Focused Coaching (Targeted & Efficient): A brief, 10–15 minute structured conversation focused on a single topic.
3. Level 3: Blended Coaching (Integrated Clinical Practice): Coaching methodology used simultaneously with medical or rehabilitative interventions.
4. Level 4: Extended Coaching (Formal & Structured): Scheduled, multi-session engagements (30–60 minutes) for deeper exploration of habits and barriers.

Developmental Integration: The DICA Journey

Through the Dive Into a Coach Approach® (DICA) accredited certification, healthcare professionals learn to navigate this spectrum ethically:

• Level 1 – Core Fundamentals: Foundational competencies and Laser-Focused Coaching for immediate clinical application.
• Level 2 – Results & Technical Mastery: Supervised peer coaching and mastery of Blended methods.
• Level 3 – Live Implementation: Adaptation of skills into real-world clinical contexts.
• Level 4 – ICF Readiness: Advanced mentorship for Extended Coaching roles.

Scalability: The “Train-the-Leader” Strategy

Implementation must start at the leadership level. When executives and department heads utilize a Coach Approach, they create a “Psychological Safety Bridge.” This top-down modeling allows clinicians to feel safe shifting away from the “Fixer Trap.”

Integration with Quality Improvement (QI)

A Coach Approach is most effective when mapped to existing organizational goals:

• HCAHPS/Patient Satisfaction: Improving “Communication with Providers” scores by moving from directive to collaborative care.
• Length of Stay (LOS): Using coaching to address psychosocial barriers that often delay discharge.
• Productivity: Reducing the “emotional drag” of burnout for more focused clinical hours.

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Section 6: The Spectrum in Action—Three Clinical Scenarios

Case Study 1: “In-the-Moment” Coaching in Acute Rehabilitation

The Scenario: A physiotherapist is working with a patient recovering from a concussion. The patient expresses frustration and begins to disengage.

The Traditional “Fixer” Response: The therapist attempts to “fix” the frustration by explaining the medical timeline, taking on the emotional burden.

The Coach Approach (In-the-Moment):

• The therapist shifts to a Discoverer Mindset: “I notice that you appear frustrated—I can appreciate that.”
• Followed by: “What has been working well in your recovery so far?”
• Outcome: The patient feels heard and re-engages without adding time to the appointment.

Case Study 2: “Laser-Focused” Coaching in Primary Care

The Scenario: A nurse practitioner supporting a chronic pain patient overwhelmed by lifestyle recommendations.

The Coach Approach (Laser-Focused):

• 10 minutes focused on a single target: “If we focus on just one small change this week, what would be most helpful for you?”
• Outcome: The patient identifies a manageable step and completes it—breaking a six-month cycle of non-adherence.

Case Study 3: “Blended” Coaching in Neuro-Rehabilitation

The Scenario: An OT working with a client with ADHD feels tension between clinical expertise and client ownership.

The Coach Approach (Blended):

• The OT begins: “Let’s begin with a quick coaching conversation to get clear on what matters most for today.”
• Outcome: Clinical intervention is highly targeted and aligned with the client’s own priorities.

The ROI of Narrative Proof

In each case, time spent was identical to a traditional session. The ROI is in the results:

• For the Organization: Higher patient follow-through and improved outcomes.
• For the Clinician: A lighter “backpack” as accountability returns to the patient.

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Section 7: Overcoming Barriers to Adoption—Addressing Executive Concerns

1. The “Time Constraint” Barrier

• The Reality: A Coach Approach is a conversational efficiency tool, not an additional appointment.
• The Shift: “In-the-Moment” techniques are fast, seamless, and integrated into existing care interactions.
• The ROI: “Laser-Focused” coaching identifies a single, high-impact goal in 10 minutes, avoiding the “Fixer Trap.”

2. The “Scope of Practice” Barrier

• The Reality: The Coaching Spectrum Framework™ helps clinicians apply coaching within their professional scope.
• The Shift: Coaching does not replace expertise; it enhances the delivery of that expertise.
• The ROI: In “Blended Coaching,” intervention begins after coaching has clarified the patient’s goals.

3. The “Culture of Resistance” Barrier

• The Reality: Most clinicians already use some coaching techniques intuitively; the framework makes them intentional.
• The Shift: DICA micro-credentialing provides a structured, evidence-based pathway.
• The ROI: As clinicians experience reduced “emotional load,” resistance typically shifts to advocacy.

Quick-Start Checklist for Leadership

• Identify 2–3 clinical leaders to pilot DICA Level 1 training
• Map coaching competencies to one existing QI metric (e.g., HCAHPS communication scores)
• Schedule a 90-day review to assess clinician feedback and patient outcomes
• Expand based on early wins

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Conclusion: Breaking the Symmetry of Failure

The healthcare exodus is not an inevitability—it is a symptom of a broken model. When 60% of healthcare professionals consider leaving and 60% of patients disengage from their care plans, we are witnessing the “Symmetry of Failure.” These are not separate problems. They are the same problem.

The patient becomes a passive recipient who “fails to comply.” The clinician becomes an overloaded fixer carrying weight that was never theirs to carry. Both burn out. Both disengage. The 60% won’t change until we change the model that created them.

A Coach Approach provides the delivery mechanism for the biopsychosocial model. It shifts clinicians from directive expert to collaborative partner.

Investing in a Coach Approach through the Coaching Spectrum Framework™ and DICA Certification delivers a “Triple Impact”: superior clinical outcomes for patients, improved psychological sustainability for clinicians, and measurable organizational ROI. Cleveland Clinic’s peer coaching yielded $133 million in potential retention savings (Jansen et al., 2024). The math works.

For the modern healthcare executive, the choice is clear. We can continue to pay the high cost of the Symmetry of Failure, or we can invest in a culture of partnership that protects our most valuable asset—our people.

To explore how the Dive Into a Coach Approach® methodology can support your organization’s retention and clinical outcomes, contact Function First Coaching at helene@functionfirstcoaching.com.

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Appendix: Executive Toolkit

Projected ROI of a “Coach Approach” Implementation

This table illustrates the potential cost savings for a mid-sized facility (approx. 200 staff):

Category	Baseline Cost (Current)	Projected Outcome (Post-DICA)	Annual Savings (Estimated)
Staff Attrition	20% Turnover ($1.8M–$3M)	15% Turnover (5% Reduction)	$450,000 – $750,000
Patient Adherence	40% Non-adherence rate	25% Increase in Engagement	Increased Billable Outcomes
Clinician Burnout	70% Intent to Leave (OTs)	Reduced Emotional Exhaustion	Decreased Agency/Locum Spend
Leadership Capacity	Directive/Fixer Burden	72% Productivity Increase	Scaleable Management Culture

Final Executive Checklist: 90-Day Implementation Strategy

• Phase 1: Financial Audit. Calculate the specific cost of turnover in your facility over the last 24 months.
• Phase 2: Cultural Assessment. Identify “Fixer Trap” hotspots—departments with high burnout and low patient satisfaction.
• Phase 3: Leadership Buy-In. Enroll senior clinical leads in DICA Level 1 to establish the “Psychological Safety Bridge.”
• Phase 4: Pilot Integration. Pilot the Coaching Spectrum Framework™ in a “High-Impact” unit.
• Phase 5: Metric Alignment. Map coaching outcomes to existing QI goals (HCAHPS, LOS metrics).
• Phase 6: Scaling. Expand the DICA micro-credentialing pathway to broader clinical staff.

APA Reference: Thériault, H. (2026). The business case for a “coach approach” in healthcare: Shifting from the “fixer trap” to partnering for retention and clinical ROI [White paper]. Function First Coaching. /the-business-case-for-a-coach-approach-in-healthcare/

Acknowledgments

Artificial intelligence tools (Claude by Anthropic and Gemini by Google) were used to assist with literature review, reference identification, citation formatting, and drafting portions of this white paper. All content was reviewed, edited, and verified by the author to ensure accuracy and alignment with the evidence base and the Function First Coaching methodology. The author takes full responsibility for the final content and conclusions presented in this work.

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About the Author

Hélène Thériault, BScOT, MAdEd, MCC

Hélène Thériault is the founder of Function First Coaching Inc. and creator of the Dive Into a Coach Approach® (DICA) methodology—an ICF-accredited training system that equips healthcare professionals with coaching competencies designed specifically for clinical practice.

With a background as an occupational therapist and a Master’s degree in Adult Education, Hélène brings over two decades of experience bridging clinical expertise with evidence-based coaching. She holds the Master Certified Coach (MCC) credential from the International Coaching Federation—the highest certification in the profession—and has trained healthcare professionals across North America, partnering with organizations including Medbridge and Providence Health.

Hélène’s work is grounded in a simple premise: the skills that make clinicians effective can also lead to burnout when misapplied. The DICA methodology provides a structured pathway for shifting from a “Fixer” mindset to a “Partner” stance—improving patient outcomes while protecting clinician wellbeing.

Her mission is to train over 150,000 clinicians worldwide by 2030, transforming healthcare conversations one interaction at a time.

Contact
/
Email: helene@functionfirstcoaching.com

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References

Section 1

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Section 2

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Section 3

Aung, H. L. (2025). Adapting the Biopsychosocial Model in Myanmar’s Healthcare System.

Cook, E., Greene, G. J., & Maxwell, J. (2024). Coaching for person-centred healthcare. Taylor & Francis Group.

Darlow, B., et al. (2012). The association between health care professional attitudes and patient outcomes. European Journal of Pain, 16(1), 3-17.

Engel, G. L. (1977). The need for a new medical model. Science, 196(4286), 129–136.

Halvari, A. E., et al. (2022). Dental hygienists’ biopsychosocial beliefs. International Journal of Dental Hygiene, 20(2), 193-202.

International Coaching Federation. (2025). ICF core competencies.

Nakamura, K., & Tanaka, A. (2023). The entrenched dominance of the biomedical model. Journal of Clinical Medicine, 12(4), 112–125.

Oostendorp, R. A., et al. (2015). Manual Physical Therapists’ Use of Biopsychosocial History Taking. The Scientific World Journal, 2015.

Pincus, T., et al. (2013). Twenty-five years with the biopsychosocial model. Spine, 38(24), 2118–2123.

Section 4

Boehmer, K. R., et al. (2023). Health and wellness coaching systematic review. Patient Education and Counseling, 117, 107975.

Cook, E., et al. (2024). Coaching for person-centred healthcare. Taylor & Francis Group.

Daniel, R., et al. (2025). The case for integration of health coaching within integrative oncology. Current Oncology Reports.

Donker-Cools, B. H., et al. (2017). Prognostic factors of return to work after TBI. Brain Injury, 31(2), 165-177.

Elster, M., et al. (2022). Does being a coach benefit clinician-educators? Perspectives on Medical Education, 11(1), 45-52.

Gardner, T., et al. (2019). Combined education and patient-led goal setting in chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation.

Hu, Y., et al. (2024). Coaching-based leadership development in healthcare. BMC Health Services Research.

Jansen, N., et al. (2024). Peer coaching and physician retention at Cleveland Clinic.

Jenkins, A. (2017). The development and validation of a Coaching Culture Inventory.

Lin, N., et al. (2020). Coaching-based transition interventions in stroke rehabilitation.

Ogourtsova, T., et al. (2019). Coaching as an intervention for pediatric occupational therapy. Occupational Therapy International.

Pijarnvanit, S. & Sriphetcharawut, S. (2024). Parent coaching for ADHD executive function. Asian Journal of Occupational Therapy.

Racey, M., et al. (2022). Health coaching and diabetes self-management. Diabetes Research and Clinical Practice.

Schein, E. (2009). Organizational Culture and Leadership.

Suminski, R. R., et al. (2024). Health coaching as a clinical treatment for obesity. Obesity.

Tan, J., et al. (2025). Care coach-led models in palliative care. Palliative Medicine.

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