Deep Dive: Building Your Referral Network¶

Reading time: ~6 minutes
Prerequisite: Chapter 1.5 (Scope of Practice & Medical Collaboration)

The Big Picture¶

Longevity coaching doesn't happen in isolation. Your clients have physicians, sometimes specialists, therapists, dietitians, and other healthcare providers. The question isn't whether you'll need to collaborate with other professionals. It's how well you'll do it.

A strong referral network isn't just good for your clients. It's good for your practice. Physicians who trust you will send you referrals. Smooth collaborations lead to better outcomes, which builds your reputation. And knowing when to refer protects both your clients and your license.

The Triangle of Care¶

The most useful framework for thinking about collaboration is the Triangle of Care: a three-way partnership between client, coach, and clinician.

         CLIENT
          /\
         /  \
        /    \
       /      \
    COACH ---- CLINICIAN

Each point has a role:
- Client: The center of care, actively participating in decisions
- Coach: Behavior change support, accountability, lifestyle implementation
- Clinician: Diagnosis, treatment, medical management

The magic happens in the connections:
- Coach ↔ Client: Deep, ongoing relationship; understanding of daily life and barriers
- Clinician ↔ Client: Medical expertise, diagnostics, prescribing authority
- Coach ↔ Clinician: Information sharing, coordinated care plans, appropriate referrals

When this triangle works well, clients get better outcomes, coaches stay in scope, and clinicians get support for the behavior change work they don't have time to do.

Why Physicians Want to Work With You¶

Here's something many coaches don't realize: most physicians are looking for partners like you.

The Time Problem

Primary care visits average 15-20 minutes. That's barely enough time for acute concerns, let alone the sustained behavior change conversations that drive health outcomes. Physicians know lifestyle matters. They just don't have time to coach it.

The Evidence

Research shows that when health coaches are integrated into medical teams:
- Quality of life improves significantly (effect size 0.62)
- Self-efficacy improves (effect size 0.38)
- Depression symptoms decrease substantially
- HbA1c decreases by about 0.30 percentage points
- Total healthcare costs can decrease by 10-15%

Physicians who understand this evidence are eager to find coaches they can trust.

The Burnout Crisis

Clinician burnout is at epidemic levels. Team-based care that includes coaches can expand capacity, improve population health metrics, and reduce clinician workload. You're not just helping clients. You're helping healthcare systems function better.

Building Your Network: Practical Steps¶

1. Start With One Relationship

Don't try to build a network all at once. Identify one physician or practice you'd like to work with and focus on building that relationship first.

Good starting points:
- Your own primary care physician
- A practice known for integrative or lifestyle medicine
- A clinic serving populations you want to work with

2. Lead With Value, Not Sales

Your first conversation shouldn't be "I need referrals." It should be "I want to understand how I can support your patients."

Questions to ask:
- What are the biggest challenges your patients face with behavior change?
- What conditions would benefit from more lifestyle support?
- How do you prefer to receive information about shared patients?

3. Make Collaboration Easy

Busy physicians won't jump through hoops. Make it easy to work with you:

• Provide a one-page summary of your services and scope
• Offer a simple referral process (phone, email, or form)
• Send brief, relevant updates (not lengthy reports)
• Be responsive and reliable

4. Demonstrate Results

Nothing builds referral relationships like outcomes. Track and communicate results:
- Client progress summaries (with permission)
- Aggregate outcome data from your practice
- Case examples (de-identified) that show your value

5. Respect Boundaries

Nothing kills a physician relationship faster than overstepping. Be scrupulous about scope:
- Never diagnose or interpret labs
- Always defer medical questions back to the provider
- Communicate immediately if you see red flags
- Keep your language firmly in coach territory

Who Should Be in Your Network?¶

Beyond primary care, consider building relationships with:

You don't need deep relationships with every specialty, but you should know who to refer to when needed.

Communication That Works¶

Progress Updates

Keep clinicians informed without overwhelming them:

Subject: [Client Name] - Monthly Progress Summary

- Current Focus: Increasing activity, improving sleep habits
- Progress: Walking 30 min/day (up from 10); sleep improved to 7 hours
- Adherence: High engagement with weekly sessions
- Concerns: None at this time
- Next Steps: Adding resistance training; continuing sleep hygiene work

Please let me know if you'd like any additional information.

Referral Requests

When you need to refer out:

Subject: [Client Name] - Request for Evaluation

I'm working with [Client] on lifestyle behaviors for longevity. During our work, 
[he/she] mentioned [symptom/concern]. This is outside my scope to assess.

Could you please evaluate and let me know if there are any considerations 
I should incorporate into our coaching plan?

Relevant background: [brief, relevant context]

Handling Information Sharing¶

Get Consent

Before sharing any client information with providers:
- Explain what you'll share and why
- Get written consent
- Keep records of consent

What to Share

Focus on information that helps coordination:
- Current goals and behavior change targets
- Progress toward those goals
- Any concerning symptoms or red flags
- Questions for the medical team

What Not to Share

• Interpretations of lab values
• Diagnostic impressions
• Anything the client hasn't consented to share
• Personal details not relevant to care

What This Means for Coaches¶

• Collaboration isn't optional: Longevity coaching requires working with medical providers. Build these skills intentionally.
• Start small and grow: One solid physician relationship is worth more than a dozen superficial ones.
• Value first, referrals follow: Build trust by being useful before asking for anything.
• Make it easy: Busy providers need low-friction collaboration. Streamline your communication.
• Stay in scope: The fastest way to destroy a referral relationship is to overstep your boundaries.

Key Takeaway¶

A strong referral network transforms your coaching practice from isolated lifestyle advice into integrated healthcare, making you more effective for clients and more valuable to the medical providers who want partners they can trust.

References¶

1. Boehmer KR, et al. The impact of health and wellness coaching on patient-important outcomes in chronic illness care: A systematic review and meta-analysis. Patient Educ Couns. 2023.
2. Gierisch JM, et al. The Effectiveness of Health Coaching: A Systematic Review and Meta-Analysis. VA Evidence Synthesis Program. 2017.
3. Fortmann AL, et al. Dulce Digital-Me: A Randomized Controlled Trial of a Digital Diabetes Care Program. J Gen Intern Med. 2020.
4. Denneson LM, et al. Interdisciplinary team perspectives on health coaching integration. J Gen Intern Med. 2023.
5. Gastala N, et al. Health Coaching Training in Family Medicine Residencies. Fam Med. 2018.
6. Care Learning. What is the Triangle of Care in Health and Social Care? UK. 2023.
7. American Academy of Family Physicians. Building Team-Based Care. AAFP. 2024.
8. Thies K, et al. Implementing health coaching in primary care: A learning collaborative approach. J Prim Care Community Health. 2025.