Why I Became a Health Coach After Practising Medicine for Two Decades

I spent 20 years wearing a white coat. I diagnosed, I prescribed, I referred. I loved parts of it — the puzzle of a hard case, the relief when a treatment worked, the patients who came back years later to say thank you. I also left parts of it, one by one, because the system wouldn’t let me do what I knew the person in front of me actually needed.

This is the short version of why I’m at Vicaria now.

The seven-minute appointment

Early in my career I saw a woman I’ll call M. She came in tired. Not depressed-tired — she’d been screened for that — but bone-tired, “my labs are fine and I still can’t get out of bed” tired. I had seven minutes of booked time with her. I went nine. I got in trouble for the schedule overrun.

What M needed was an hour. She needed someone to sit with her, take a real history of what she was eating and when, how she slept, what her week looked like between Monday and Friday. The seven-minute visit wasn’t going to surface it. The referral system would give her another seven-minute visit in three months with a different specialist who would order a test and send her home.

She came back a year later. She’d figured most of it out herself, piece by piece, on Google. She was fine. But she shouldn’t have had to do it alone, and she shouldn’t have had to wait a year.

I kept thinking about M.

What medicine is good at — and what it isn’t

I want to be clear: I’m not here to complain about family medicine. Clinicians in Hamilton are working inside a structure that doesn’t pay them to spend an hour with you. That’s a funding and policy problem, not a competence problem. My colleagues are excellent. The system constrains what they can offer.

Medicine is exceptional at:

• Acute problems. A broken ankle. An infection.
• Clear diagnoses with clear protocols. A heart attack. Cancer staging.
• Life-threatening emergencies.
• Medications with well-studied effects.

Where it struggles is the space most of my patients actually lived in: the low-grade, chronic, complicated territory where food, sleep, stress, and habit matter more than any pill. IBS. Prediabetes that hasn’t tipped over yet. Menopause symptoms that “aren’t medical.” Fatigue that doesn’t show up on a blood test.

That’s where I couldn’t help inside a seven-minute appointment. But I could help with time.

What changed my mind

About five years ago I started seeing the same pattern: patients, almost always women in their 40s and 50s, telling me that their family doctor didn’t understand why they felt bad. They’d been referred to me as a specialist. They had charts three inches thick. And what most of them needed was someone to sit with them and slowly, patiently, help them understand their own bodies.

I started doing that, quietly, in the extra minutes I stole from my own schedule. And what struck me was how much of medicine I was still using — the framing, the pattern recognition, the respect for when a lab matters and when it doesn’t — but in a different format. Not prescriptions. Just attention, translation, and a plan.

That is, functionally, what a health coach does. But “health coach” sounded, to my medical training, like something unserious. It took me a long time to see that the seriousness isn’t in the credential — it’s in what you actually do with the hour you have with someone.

Hamilton, specifically

There’s a reason Vicaria is in Hamilton and not Toronto. I live here. Yamilet lives here. Our clients live here. The realities our clients deal with — waitlists at Hamilton Health Sciences, three-hour waits at a walk-in clinic on James Street, specialists with six-month queues — are the realities we deal with too. The plan we build for a woman in Westdale has to survive a bus route, a school pick-up, and a 40-hour job. It has to match her actual grocery store. A protocol designed in an article from California doesn’t do that.

What Vicaria is, in the simplest terms

Vicaria is what I wish I could have offered M twenty years ago.

• An hour, not seven minutes.
• A real conversation about what you eat and how you live, without judgement.
• A plan that belongs to you and that we build together, not a printout.
• Someone to check in with between the big appointments, because the work happens between them.
• Honesty when we aren’t the right fit, and a referral to someone who is.

I’m still a physician by training. I still think like one. But the job I wanted to do is this one.

The difference at Vicaria

If you’ve been told your labs are fine but you don’t feel fine, I understand that sentence personally. I said it to more patients than I’d like to admit, and I watched them walk out knowing they needed something I couldn’t schedule.

If you’d like an hour with me or Yamilet to talk about what’s actually going on, message us on WhatsApp or book a free 15-minute consultation. We’ll tell you honestly if we’re the right fit.

If you want to understand how our approach is different from a dietitian’s, the team is writing about that next.