Determining which kind of health professional is right for guiding you down the path to healthy living can be a tricky process, though. With all the options out there—health coaches, personal trainers, registered dietitians, physical therapists—it can be confusing to decide which skills are best suited for your personal needs. Do you pick one, a mix or someone completely different? Learning what to expect from some of the most common health and fitness professionals, straight from the experts themselves, could be the key to getting started with the right hype man (or woman) in your corner. When you know how each professional can help and how to make the most of your time with them, you increase your chance of success.
1. What can someone expect from a first session with a physical therapist and from follow-up sessions in the future?
According to Likins, the first meeting with a physical therapist will consist of a discussion of your medical and physical history—including not just your primary complaint but also a review of your overall health and a discussion regarding your ultimate goals and objectives. The therapist will then perform an examination, including a review of your various systems (cardiovascular, neurological, etc.), and examination of things like range of motion, flexibility, strength, balance and overall mobility to identify specific issues you may have. Your therapist will discuss their findings and recommendations for treatment. It is very important that you not only understand what they propose, but that you understand your responsibility in the recovery process.
Follow-up sessions will involve working with your physical therapist (or a physical therapist assistant) to achieve the objectives determined in the initial visit. This may consist of any number of interventions, including therapeutic exercise, neuromuscular re-education, manual or hands-on therapy, or various physical agents (heat/cold, ultrasound, laser, electrical stimulation). A large part of any physical therapy program is instruction in what you should be doing on your own, whether that be specific exercises, activities or self-care.
2. What is the typical cost per session?
Likins says that costs vary tremendously and you should investigate prior to starting care. If it is done through your health insurance, almost all insurers set the rates paid for care, but your out of pocket costs may vary. Find out if the therapist or facility participates with your insurance. If they are out of network, inquire about a discounted rate. If they do not accept your insurance or you don't have insurance, asking how much they charge is you best option—it might still be in your price range. Most facilities will verify your insurance coverage for you as a courtesy, but always double check yourself. If there is an error, you are usually responsible for making it right.
3. How can you find a good physical therapist?
The minimum standard for a physical therapist is a state license to practice, which should be posted on the wall of the office, but every state also has an online license verification system. According to Likins, the best way to find a physical therapist is through word-of-mouth from friends, family, your physician or even online reviews. There is an optional system of Board Certification in many areas of physical therapy. You can search for one in your area through the American Board of Physical Therapy Specialists.
4. Any red flags of which to be wary?
Likins recommends asking if you will work with your own physical therapist every visit. Some facilities rely heavily on "care extenders" such as physical therapy assistants to provide the actual treatments. Other facilities have you see different therapists on a routine basis, which makes it difficult to develop a rapport and for the "new" therapist to know how you are progressing or responding to treatment. Stop in to the office before making a final decision and ask to look around. Are they friendly? Do you see lots of patients and very little staff? If so, this could be an indication they do not spend quality time with their patients during every visit.
5. What are the top three questions someone should ask when meeting with a physical therapist?
- Do you have experience with my type of situation, and what type of special training have you taken?
- Will you be my physical therapist the whole time I'm here?
- How many patients do you see in an hour? There is no right answer to this, but if they are scheduling four patients every hour you will not get much time with your therapist, which is what you ultimately paying for.
Dani Singer is a personal trainer and Director of Fit2Go, a personal training business in the Baltimore area. He says that although you can get fit without one, a personal trainer can help determine your level of success on your healthy living journey. "Google any fitness-related question and you'll get 100 contradictory answers. A knowledgeable personal trainer can clear through the noise and give you the right answer for you," says Singer. He also says that a great personal trainer will help you establish a healthy routine that realistically fits into your unique lifestyle and gives you an additional sense of accountability.
1. What can someone expect from a first session with a personal trainer and from follow-up sessions in the future?
Singer says that most gyms will offer new members one free session or consultation with a personal trainer. A consultation is an important first step in any personal training program. A qualified trainer will assess your body composition, fitness level, health and injury history, and—most importantly—your goals. A consultation is an opportunity for you to meet the trainer, see what he or she has in mind for you, and make sure it’s a great fit before moving forward. In follow-up sessions, you should expect your trainer to be focused on your goals and your progress toward them. If you are not seeing progress, your trainer should be troubleshooting.
2. What is the typical cost per session?
According to Singer, personal training rates will vary greatly based on the local market and, of course, the trainer’s experience and credentials. He's seen some as low as $40 per session, and others at more than $100 per session. Because the personal training industry is unregulated, he says it's important not to hire someone solely based on price. Many times, you get what you pay for.
3. How can you find a good personal trainer?
Singer says that finding a great personal trainer can be challenging because the industry is completely unregulated. There are personal trainer certifications, but not all are created equal. Some certifications require nothing more than a weekend workshop, while others include more extensive exercise science knowledge and testing. There are currently 15 nationally accredited certifying bodies, all of which must adhere to a standard of education set forth by the NCCA. The most respected certifications in the country are National Academy of Sports Medicine, American College of Sports Medicine, and American Council on Exercise for the general population, and National Strength and Conditioning Association for athletes. He says that while certifications are a good place to start, they don’t make or break a trainer. Choose the trainer who was referred by a friend over the trainer with the fancy piece of paper.
Singer cautions that the one criteria you should not use to select a trainer is the trainer’s physique. It can be tempting to reason, "If he has a great body, he must know what he’s doing," but this a faulty line of thinking. Physical appearance says nothing about his or her ability to train someone who does not possess his or her exact body composition and overall genetics, nor does it say anything about his or her ability to coach.
4. Any red flags of which to be wary?
Singer says to be sure you have a contract. Read the contract and know exactly what is and is not included before signing up. If you sign up for personal training and your trainer is conducting group sessions instead, say something. This is strikingly common, and it’s 100 percent illegal. Don’t continue paying for individualized attention if you’re not getting it.
5. What are the top three questions someone should ask when meeting with a personal trainer?
- What is certification do you hold?
- What is included in the training package (sessions, equipment, nutrition coaching, phone or email support)?
- How exactly are you going to help me reach my goals, and can you put me in touch with someone similar to myself who you’ve already helped?
Registered Dietitian (RD)
Laura Dilz is a registered dietitian and owner of Lime and Greens Nutrition. She says that a registered dietitian (RD) can work with you to create an eating plan that is safe, will help meet your health and wellness goals, and is tailored specifically to your needs. Registered dietitians can translate the science of food and nutrition into practical advice for you to implement in your daily life. Dilz believes that working with an RD can transform your life by revealing the power food has to prevent disease and improve how you look and feel, both inside and out.
1. What is the difference between a registered dietitian and a nutritionist?
Dilz explains that the title "registered dietitian" requires a minimum of a four-year college degree from an accredited university that includes specific course work, completion of a Dietetic Internship that includes 1,200 hours of supervised practice, passing a comprehensive examination and completing ongoing continuing education. The title of "nutritionist," on the other hand, is not regulated or protected by law, and technically anyone can call themselves a nutritionist. A nutritionist may have completed course work in nutrition, but without acquiring the clinical practice training, they should not be involved in the diagnoses or treatment of any chronic diseases.
2. What can someone expect from a first session with a RD and from follow-up sessions in the future?
Dilz describes an initial consultation that typically consists of a comprehensive nutrition assessment focusing on the client's current nutrition and exercise habits, medical history, current medications and/or supplements, and any other health concerns. The client and RD set goals together, formulate an action plan and focus on sending the client home with resources for implementing changes right away. During follow-up sessions, progress is assessed, clients check in on their goals, address any questions or concerns, and troubleshoot how to make their healthy lifestyle changes sustainable.
3. What is the typical cost per session?
Dilz says the cost of seeing a dietitian varies greatly depending on things like insurance coverage, your geographic location and the professional experience of the RD. If health insurance does not cover a nutrition counseling consult, then a session may range anywhere from $50 to $200.
4. How can you find a good RD?
"Making sure your dietitian has the formal training and proper credentials is important before putting your trust in their hands," says Dilz. The Commission on Dietetic Registration is the credentialing agency for all registered dietitians. Licensure and certification laws vary greatly and are implemented differently in each state. Check to see if your state requires dietitians to be licensed, and if they do, ask your dietitian for their license number. You can find a dietitian at the Academy of Nutrition and Dietetics website by including your zip code or city and state, and the type of service you are looking for to ensure the dietitian specializes in your needs.
5. Any red flags of which to be wary?
Dilz recommends reviewing a list of red flags from Colorado State University Extension, which includes:
- Recommendations that promise a quick fix.
- Dire warnings of danger from a single product or regimen.
- Claims that sound too good to be true.
- Recommendations based on a single study.
- Lists of "good" and "bad" foods.
6. What are the top three questions someone should ask when meeting with a registered dietitian?
- How much should I be eating?
- What am I missing from my diet?
- How can I improve my overall nutrition?
Integrative Nutrition Health Coach
Liza Baker's website Simply: Health Coaching offers a holistic approach to health and wellness, helping people learn how to successfully make healthy lifestyle changes. Baker says an integrative nutrition health coach will help you set realistic goals, whether it's weight loss, healthy relationships, a regular exercise routine, a fulfilling spiritual practice, adequate sleep, sound nutrition, soul-satisfying work, or a number of other healthy lifestyle changes. Once goals are established, the coach will help break the larger objective into manageable, incremental steps and support you on your way to reaching them. "My scope of practice does not allow me to diagnose, treat or prescribe; rather, I operate on the principle that deep down, every individual has an intuitive knowledge of what she or he needs to be healthy and whole. I see my role as helping you get back in touch with that inner voice and actually heed it," she says.
1. What can someone expect from a first session with an integrative nutrition health coach and from follow-up sessions in the future?
According to Baker, the first session with an integrative nutrition health coach is usually called something like a "health history." She reviews a questionnaire that delves into your life: your family, your relationships, your career, your physical activity, sleep level, spiritual practice, health issues and more. At this point, she will ask about health goals and, if it seems that you could establish a good client and coach fit, she will point out the areas in which she believes she could be of help. Depending on the coach, there are periodic meetings to review and celebrate progress, adjust your direction as necessary and set goals to work toward until the next meeting. Baker says that by the end of the series, you will have a few new healthy habits and a system for setting and reaching goals on your own.
2. What is the typical cost per session?
Baker says that health coaches charge a wide range of prices depending on their training, experience, location and the program in question. Many coaches offer a range of programs, both individual or group sessions, so it's best to contact them directly for pricing information.
3. How can you find a good health coach?
Baker got her certification from the Institute for Integrative Nutrition. There are also certifications and professional organizations, such as the International Association of Health Coaches, that identify coaches who have gone through accredited programs. She says a great way to determine whether a coach is "good" is to ask whether she or he gets referrals from physicians, chiropractors, physical trainers or other alternative/holistic practitioners. "Increasingly, we are viewed as support staff who can fill in the gaps between appointments with these professionals," says Baker.
4. Any red flags of which to be wary?
"I would say that the single largest red flag for me personally is that the potential coach "has an agenda." By that, I mean that she or he approaches the work with an intent to "prescribe" a certain diet, the workout you should be doing, the form of spiritual practice you must do, etc.," says Baker. She also warns against a coach who badmouths other forms of healthcare. "With all the health issues in our society today, there is a place for everyone at the table, and Western medicine can and should be one of the modalities in the conversation." She says a coach who does not willingly offer references and testimonials is probably someone to avoid, as is a coach who claims, "I work with everyone! My program can help anyone!" Most health coaches have a niche—weight loss, stress reduction, etc.— and while that's not to say they can't help others, it's just that they have more experience with one specialty.
5. What are the top three questions someone should ask when meeting with a health coach?
- What is your experience with clients who [fill in your particular concern here]?
- Tell me about your most successful client and your least successful one.
- I've never been successful with [insert goal here]. How will it be different if I work with you?
Whether your doctor has recommended it or you've decided hiring a health professional is what you need to be successful, do your homework first. Learn about their credentials, style and details about how they can help before deciding whether or not to proceed. Don't be afraid to ask questions and keep looking if your needs aren't being met. These experts can be a wealth of valuable information, and finding the right one can dramatically improve both your health and move you even closer toward your ultimate goals.