by Barbara Zabawa, JD, MPH
As a wellness lawyer, I hear all kinds of complaints from all kinds of different stakeholders in the wellness industry. Lately, I have been hearing from people wronged by health and business coaches. These individuals have been hurt emotionally and financially by unethical coaches. This emotional or financial injury may occur because the coach oversteps their scope of practice, or because their business policies, such as refunds or payment policies, are inequitable and unethical.
As I write my next law review article on the wild west of wellness, one of the big questions lingering out there is who will lead wellness out of this unstructured, uncertain, free-for-all environment? There is something to be said for having structure and certainty in a professional practice. Boundaries can give some comfort to the practitioner to know whether they are doing the right thing, and can keep nefarious actors out of the profession. But what should those boundaries look like, and perhaps even more importantly, who can enforce those boundaries?
One idea is to find a wellness organization that is willing to collaborate with other wellness stakeholders to develop and endorse a code of conduct, and then designate that wellness organization to enforce compliance with that code. Stakeholders like liability insurers, employers of wellness professionals, and health profession licensing boards would expect wellness professionals to obey the code in exchange for a job, more affordable insurance, and less risk of a state licensing board taking action against the professional.
So how do we get there? Well, a few organizations have already started the process. A collaboration of wellness stakeholders came together in 2017 to create a Code of Conduct for employee wellness programs. You can read the Ethical Wellness code here. The Wellness Compliance Institute, now part of the National Wellness Institute, created a code of conduct for wellness professionals and wellness brokers, which you can read about here. Finally, the National Board for Health and Wellness Coaches (NBHWC) has developed a code of ethics for health and wellness coaches, which you can read here.
These are all good starts, but the patchwork of ethical codes will be ineffective to capture everyone who identifies themselves as part of the wellness industry. And, each of the existing codes could be strengthened to be more comprehensive in both the substantive part of delivering wellness services and products, as well as the business aspect of delivering those services and products. Luckily, developers of a comprehensive code of conduct and ethics can draw from the many examples from the healthcare industry. Since many consumers use wellness services either as a complement to traditional health care or even as a substitute for traditional health care, it is important to mirror codes of conduct to health care services. See https://www.pewresearch.org/internet/wp-content/uploads/sites/9/2017/02/PS_2017.02.02_Vaccines_FINAL.pdf
To assemble a cohesive, comprehensive ethical code that captures all who identify with the wellness industry, a diverse group of wellness stakeholders must convene and discuss expectations and need for the code, and then appoint a leader. I think the National Wellness Institute, with its longevity and diverse membership, is a good candidate to lead such an effort. Perhaps a convention in 2024 of wellness stakeholders to brainstorm and buy into a code and standards is a necessary next step in this process. Because if the wellness industry does not take action on its own, it won’t be long before government authorities will do it for the industry, however that industry may be defined.
I know that some in wellness will object to this proposal. Specifically, I expect to hear criticism that creating standards and a code of ethics will create barriers to entry for those who may not be able to afford to meet those standards. I recognize that many licensed health care providers embrace the freedom wellness practice brings, mostly because most wellness services are not covered by health insurance. But consumers of wellness are getting hurt, and whether wellness providers want to accept it or not, consumers view wellness providers in much the same way they view health care providers – as fiduciaries of their care, money and information. Those who work in the wellness space must accept that reality and take action to ensure wellness services and products improve the wellbeing of the people they serve.
To my readers, I welcome your thoughts and ideas. Please send me a note on www.wellnesslaw.com. And if you find yourself in need of wellness compliance help, reach out. That is what we are here for.