#34: Do Your Clients Need Lab Tests?

More and more, health coaches are looking at (and even ordering) lab tests. In this episode, Michelle discusses:

– How lab testing can help or hinder a coaching relationship.
– What to do when a workshop isn’t getting registrants.
– The truth about pain-in-the-butt clients.
…and much more!

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Master Class: Turn Your Health Coaching Business Into a Full Time Salary

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Hello health coaches and welcome to the Health Coach Power Community Q & A. my name is Michelle Pfennighaus. Here’s what I’ve been noticing over the past couple of years. More and more health coaches are looking at and even ordering lab tests, but what happens if you don’t know what lab test to ask for or and you don’t know what to do once you have the results, if you don’t know how to understand or interpret them. And is this even within our scope of practice, does it help or does it hinder the health coaching relationship? So if you’re here with me live and we are streaming at healthcoachpowercommunity.com. Here’s what I want you to do. Tell me in the comment area, do you feel confident knowing what lab tests your client needs and how to interpret them? Yes or no? And while you answer that, I’ll remind you that this episode is brought to you by my free training for health coaches.

It’s called how to turn your health coaching business into a full time salary and you can sign up for free at findyourbalancehealth.com/earn. That’s e a r n. So our first question, our main question of the day comes from Nicole. This is what prompted this whole topic for today’s episode.

Nicole said, I have a client, a 37 year old, female, generally in good health with a history of depression despite eating clean and general supplementing Multivitamin, vitamin D, Omega is can’t lose weight. She’s about 15 pounds overweight and is very low energy and lethargic. She has an appointment with her general practitioner coming up. What tests should I suggest that she ask the MD to run?

And in response to that, there were a lot of different answers. Run a thyroid panel tests for Celiac test for iron levels, you know, the list went on and on and I just thought to myself, wow, things have really changed since I started health coaching because I never even would have suggested anything.

I mean, unless it was a really obvious case of something being awry, I don’t think I ever would have suggested anything to any client, but these days, like I said, things are changing and a lot of health coaches are being trained in a doing labs and ordering labs and interpreting the labs, especially graduates and say FDN or anybody who has any further training of course beyond their health coach certification. Jennifer’s saying no, she’s not always so confident and looking at labs. Yeah, I wouldn’t expect you to be. I’m not particularly confident looking at lab reports. I only this year did an additional functional medicine training and now I feel a little bit comfortable looking at labs and a little bit comfortable suggesting what lab tests might be run, but even then I fear that there is room for knowing a little and thinking you know, a lot.

So I just. I’m not putting this out there to say that we should never talk about labs and we should never run labs and that labs are bad. They certainly have their place, but consider as a health coach, we are uniquely positioned to look at the whole person. We are not burdened by having to sell a pharmaceutical or respond to particular numbers on a lab report. We’re positioned to really be able to work with an individual, their whole person, their whole being, their whole energy, their whole spirit, and sometimes that is a great, great thing. Sometimes I want to suggest to you guys, I’m Becca. I don’t want to suggest that. I want to shout it out loud. It is a wonderful thing to have nothing to do with lab testing. Okay, so if you’re not comfortable with it, Nicole, if you don’t know what tests to ask for when a person can’t lose weight, is very low energy has a history of depression. If you don’t know, that’s okay, and I answered to your question is then don’t ask for anything. This is not part and parcel to what a health coach is. Responsibility is if you have the skills, if you have the knowledge and the training, then yes, by all means make suggestions that will benefit your client, but if you don’t, it’s okay and you may actually be at an advantage. So there’s a great little cartoon. If I can find it, I’ll post it to the group later and it shows a male doctor sort of standing in the room looking at a clipboard. Meanwhile, the woman patient is sitting on the exam table and she’s just like covered in hives or legs broken, you know, clearly everything is wrong with her and he’s just looking eyes right down on the clipboard where the lab tests are going well, it looks like you’re fine and I think that really summarizes a lot of what conventional medicine can be about.

Not all the time, but often and not even just conventional medicine, but anyone who is treating a lab test instead of treating a person right? So even if you are a registered dietitian or a medical doctor who happens to be listening to this episode, this applies to all of us. Sometimes we do our clients a disservice by treating the labs instead of treating the person. So let’s say that your client, Nicole, has very low energy, very lethargic. The question you might ask is not can you get your doctor to run, you know, ferritin levels, but can you tell me what energizes you? What lights you up? These are the questions I’d be asking that client. I would say something like, you mentioned once that you love dancing. When was the last time you went dancing or you mentioned when you hang out with so and so.

You really feel drained by that, you know, do you have to take the bus with so and so every day? Right? So there are so many other ways of addressing the problem that has nothing to do with labs whatsoever. So I’m putting this out there because on one hand I see health coaches who feel defeated before they even begin because they’re like, I didn’t learn this stuff. How am I supposed to be able to help someone pick the right multivitamin and get the right lab tests and find, you know, blah, blah, blah. All these very specific medical issues when I didn’t receive that kind of training, and so I want you to remember why you didn’t receive that kind of training. If you wanted to receive that kind of training, you would have gone to medical school, you would have become a nurse practitioner or whatever.

What health coaches are trained to do is work with an individual, their whole person and put less emphasis on numbers on this is what the scale says. This is what this test said, right? So really use that to your advantage in your work with clients. It can be so wildly valuable beyond anything that anyone else is doing for them, so don’t feel discouraged. The other reason that I want to bring this up is because the more we as health coaches, and this includes me, gets involved with ordering lab tests, interpreting results. Boy, that runs really close to diagnosing that runs really close to practicing medicine without a license and there’s all kinds of shades of gray when we talk about scope of practice, but this one runs close to the edge of any scope of practice at any health coach has. So I want you to be very conscious of that.

Even if you like me these days are looking at somebody’s lab results, lab results and um, and just know that you might be serving them better by kind of putting those aside, you know, look at them, get some information, but let’s not talk about the lab so much. Let’s not be diagnosing. Let’s not step too far outside our scope of practice. So that is my answer for all of you. Do your clients need lab tests? Yes. Maybe. Sometimes. Do you have to suggest exactly which ones and read them? No. No, no, no, no, no, no, no, no, no, no, no, no, no, no, no. So I hope that takes a load off of everybody’s minds and also empowers those of you who are running tests because for those of you who learned to run lab tests, it can be easy to just do that. Meanwhile, you’re missing out on this whole other coaching relationship, not necessarily, but you may be missing out on this whole other coaching relationship. So just be very conscious of that as you work with your clients,

Kathy saying, thank you. This is just what I needed to hear today. Kathy. Good. I am so glad. Really, I see so many health coaches getting discouraged before they even got out of the gate. I never looked at a lab test result in the first nine years of my practice and I have helped women get off blood pressure medication, reverse pre-diabetes, lose weight, have babies. I mean the list goes on and on without ever looking at a single lab and you can do that too. All right, so let’s move on to the next question. And by the way, for those of you who are here live, let me know what questions you have and what you would like me to talk about today, or questions you’d like me to answer. I’m going to read a comment from Alotta.

She says, as an FDN graduate, we are trained in labs and we’re trained to always correlate with the unique clients needs where you’re also very clear that we are looking for imbalances and never diagnosing good info and it can be done. Yes, it can be done well and it can be done poorly. So let’s all be careful. All right.

I’ve got another question here from Brianna. Brianna said, I have not been inspired since I graduated from IIN last March. What programs? Continuing education classes, podcasts, anything really have inspired you lately?

Well, Brianna, I, I love this question because I think it sparks a brain dump from everybody of like, Oh, I’ve been listening to this podcast or I’ve been reading this blog or this book. So if anyone has any suggestions like that, feel free to throw them into the comments because, hey, I love picking up a great new show on my podcasts or reading a new book.

It’s always great to be inspired that way. And in terms of best continuing education courses, um, Brianna back in episode 16, we actually talked about that in depth. So you might want to go back into the archive and the episode 16 and told best continuing education courses for health coaches because sometimes that can be the answer I really felt invigorated or I should say reinvigorated. Um, when I took Aviva Romm’s integrative and functional medicine training this past year, it totally sparked me, came alive with ideas. It’s doing so much for energizing my business. Again, that’s after 10 years of practicing with nothing more than an IIN certification. So there’s totally a way that you can go. But honestly, Brianna, if you just graduated from IIN, I want to ask you, what’s your why? Why did you get into this? Why did you go through IIN? Why did you complete the course?

Why do you want to work with clients? And when we can reconnect with our why, it can be so powerful because it’s easy to look at someone like a health coach on Instagram or on Facebook and it’s like, oh, they’re doing like a juice cleanse. I should do a juice cleanse, or you look at what someone else is doing, oh, they’re running a detox, or they writing about this, I should write about this and we really can get lost. You know, we just get lost along the path. And so sometimes returning to the self and returning to why you’re here, what inspired you in the first place, what you are passionate about and what’s driving this whole Shebang for you. It’s going to be the greatest inspiration that you can have and that might mean talking to a loved one or a friend. It might not because sometimes our family and friends was do not understand what health coaching is all about.

Maybe it’s talking to a therapist about your own life. Sometimes that can be very inspiring and just remembering what led us to this point. Maybe it’s talking to a coach or maybe it’s talking to another health coach. Appear, um, so just to help you verbalize your story and your why and once that starts coming out, sometimes it’s like, it’s like a wonderful diarrhea of ideas that you could just scribble down in a notebook and it can fuel the next six months of your business. So that’s what I wanted to offer you today, Brianna, is to really check in with yourself before looking to outside sources to inspire.

All right, what questions do you have for me today? I have one here from Sandra and Sandra said my dearest colleagues. Oh, isn’t she polite? My dearest colleagues. I just want to vent here and I know this is a safe space. I am struggling to keep my cool. I just planned my first workshop and only one person has confirmed. I guess I’m asking two things from you to either just read and nod, maybe let me know if this has ever happened to you or that I’m doomed. And number two, how much longer would you wait for people to confirm before canceling? It’s nine days from now.

So Sandra, I’m going to answer those questions in reverse order. So for starters, when you are hosting any kind of event, an online event, in-person event, doesn’t matter anything where people have to sign up, most people are going to sign up on the very last day at the very last minute and sending emails even after the fact. Can I still sign up? Right. So it’s always going to be the last minute. I would never cancel unless it is very close to the event starting and you still have absolutely no one and no one even expressed any shred of interest and that even then I might wait and see.

I know one of the comments that you got on the Facebook group was from somebody who said, I never cancel an event because you just never know who’s going to walk into the room and truthfully you don’t need numbers. You need the right person, even one right person to walk in the room and you can change a life forever. Truly. A few episodes ago, no, when did I tell this story? Oh Gosh, I forget, but in this group a couple of weeks ago, I shared a story about a client of mine who was really lost in her early twenties and now she’s really come into her own and is teaching yoga at like the highest level and it’s been really amazing to watch and I know what a difference it made in her life. I met her at a workshop where I only had a handful of participants, so don’t underestimate that one sign up that you have and definitely don’t cancel when you’re nine days out.

The other thing I think you’re just really looking for some comradery here. I’m really happy to provide, and I know a lot of people gave you this feedback as well, but this happens to all of us. Everybody has gone through this once, twice. Many times it happens. It is par for the course, so don’t get too discouraged. Maybe the workshop was at the wrong time, you know, like let’s say it’s a workshop for moms of toddlers, but you hold it at 2:00 PM in the afternoon when all their toddlers are napping. I’m not saying that’s what you did, I’m just saying you might look back and say, hmm, is there anything obvious going on here as to why more people aren’t signing up? Maybe it’s location, maybe it’s the topic isn’t compelling enough, isn’t specific enough? Maybe it sounds like just another one of those healthy eating, 101 workshops, so all things not to beat yourself up over.

I know it can be hard for always the most critical of ourselves, but to learn from this past weekend I was in the Berkshires at Kripalu assisting a weekend workshop with Aviva Romm for those of you who are familiar with Dr. Aviva and the workshop was full. There was 100 people in that room and at the end of the workshop we had lunch together and I said, so how do you think it went? And Aviva said the exact same thing that I just said to you. You know what? I’m always looking for ways to improve. I’m always thinking about what can I learn from this? What can I do differently next time? So it’s really not about like, oh, I did this wrong, or oh, I picked the wrong topic or any of that, just what can I learn for next time? Because there’s always going to be a next time, right, Sandra, right? It’s consistency and that stick sticktoitivenessism, is that a word? No, that sticktoitivenessism that leads health coaches to success or anyone in any field to success. So stick with it and learn and do not give up because your first workshop only had one signup.

Okay. What else do you guys want to talk about today? Get a great question coming up, but if there’s any coming in live, I will take those first. Alanna’s of saying, and this is back on the topic of being inspired, she said, I love listening to summits. There are a ton on so many topics and they go deep. Oh my gosh, that’s true. Although I get stressed out with those summits, I’m like, how am I supposed to listen to all these things and like 10 days and then they always want you to buy them at the end. But anyway. Yes, I agree. On occasion when I signed up for those, you get a million emails, but it can be worth it for all the information that you get. Great idea. So here’s a question from Janell. Janell says, this group is such a great resource.

I’m so grateful for it. Oh, thanks Janell. She says, I’m currently going through IIN’s program and I’m at the six month mark. Module 22. I have no idea what that module is. Maybe some of you do. She says, I’m stressing out and completely overwhelmed by trying to figure out how to set up an email list, manage social media, figure out how to start networking. Then my community, figure out my state’s laws regarding health coaching, setup a website. Oh, and still be present and take care of my, wait for it, six year old, four year old and three month old. She says, I’m a chronic overthinker. Should I dial it back? Will IIN guide me through all of this? Should I just take a chill pill? Thank you so much for suggestions. Janell.

You had me right up until the three month old. I knew exactly what I was going to say until I saw three month old and I had to go back and make sure it didn’t say three year old because I have found with my babies, it took me about three years to really get back fully in gear after each baby was born.

I mean certainly I worked prior to three years, but not really completely sleeping through the night myself and feeling like myself again until about three years out. Just to be realistic for everybody. That’s how long it took me. Anyway, you’ve gone through this before with having kids. You know how long it’ll take you, but I don’t know any mother of a three month old who is also ready to start setting up our business in a big, big way, so I want you to cut yourself a whole, whole lot of slack on that. I think wherever you are is exactly where you needed to be right now and breathe. My goodness so much that we take on, don’t we? Having babies running a household, working probably another job. Then we take on the health coaching bit. How are we any of us? How are we supposed to get it started?

How are we supposed to make time for this? So Janell, when your baby is sleeping well and you were getting good rest and you were feeling replenished after going through such a transition in your body and in your life, here’s my advice for you. You do not need to manage social media. I’m just going through the list that you put out. You don’t need to manage social media. You do not need to set up a website right away, okay? You don’t need to even register a business or do any fancy paperwork to become official in your state. Now, I’m not saying that you should entirely ignore your state laws because I know someone’s going to ding me. I’m like, well, maybe she’s in a red state and Blablabla, but the point is, I didn’t even have a business registered for years and years. I was just working as a sole proprietor.

As long as you pay your taxes, that is, that’s the minimum and I encourage you to work at the bare minimum for a while because you were doing so much else with your life. You were raising small humans, so if you can get a client or two and they pay you and you set aside a third of that for taxes and you pay your taxes on the income that you make, like that’s it. That’s all you got to worry about. Okay. If you don’t, don’t, don’t worry about getting the LLC set up or any of those things. So in some ways, yeah, I do want to tell you to just take a chill pill. Maybe you work with one client in the next six months, year or a year. I mean, my goodness, give yourself a break and don’t worry about having all the bits and bots intact. Like if you don’t have a Facebook fan page, that’s okay. You don’t even need a mailing list. I mean, I’m sorry. You don’t even need a website. If there’s any one thing that I would have you set up, it is a mailing list. I got that backwards set up the mailing list. Janell, if you’re going to do anything and take it easy, your health comes first. Okay.

Now we have a question from Em and Em says, I feel like I totally changed the life of a client and she does not appreciate it. I don’t know if I can deal with clients or should I do groups, cooking classes, et cetera. instead? And then later down in the thread Em said, now suddenly she’s saying she went to the doctor and is going to go to a nutritionist instead and my client recommended me to her mother and paid for her mom’s program. Now I guess mother will drop out as well.

Oh lordy. Can I just tell you, as a health coach, there are two things that you don’t expect. One is the sheer amount of marketing and self promotion that it takes to get clients and actually do the work. Right? So there’s the whole marketing and business piece that most health coaches don’t anticipate getting into and that’s huge.

On the other side, once you have the clients, it’s the customer service and it’s the people and even we’re not talking about clients. Maybe you hire a virtual assistant or you hire some other kind of help. Right? It’s all of the HR stuff. So much people management that goes into running a business. So like a few weeks my husband came home with these shoes from banana republic and he opened them up and I’m like, dude, those look exactly like these shoes that I just ordered you from Zappos for half the cost. And he’s like, well, I already wore these, but I’ll try to return them to banana republic. How many times a day does banana republic gets some jerk? Like my husband walking in and going, hey, I already wore these shoes all over New York City, but can I return them? Like you’re going to get all kinds of scenarios, questions, people asking unreasonable things from you people in a bad mood.

I’ve had people write scathing scathing reviews of a, like a program that they did with me just to turn around the next day, an email and apologize and say that they were just in a really bad mood and took it out on me. So this is going to happen in any line of work and you do need to be prepared for that. Um, even if you do groups, even if you hold a cooking class, you cannot make everybody happy and you should kind of come to terms with that now. So you have to decide what your style’s going to be like. For example, I think it’s been, you guys can correct me if I’m wrong, but LL Bean has like a really great return policy. You can return anything to them for any reason for like a year. And then before that it used to be lifetime. Um, so maybe you’re like that.

Maybe you are, like super chill, like the customer’s always right, you know, just make people happy so that they walk away with a good taste in their mouth. Like that is totally one way to do business. Another way to do business is just like, ah, I’m not walking, I’m not going to work with you. You’re kind of a pain in the neck. Here’s your money back by, and it kind of sounds like that’s what you’re dealing with here. Um, if you have a client who is waffling and this goes for anybody, somebody is waffling. Somebody who’s not showing up, somebody who is just being a P.I.T.A., I suggest you refund them whatever money feels appropriate. You know, if you’ve already done half of their sessions and refund them the other half their money and send them on their way so that you don’t have to waste a single ounce of energy on that person and you can save it for somebody else or for your own self care. Alrighty guys, we’re at 3:30, so we’re gonna stop here. Thank you so much for joining me today and for asking great questions. You continue to do that and I’ll continue to answer them. I’ll see you next time.