I was recently asked to talk about accountability on stage at a health event.

In writing my speech I realized that accountability—like so many other concepts many coaches and clinicians are familiar with—is so often practiced in a way that is not Functional.

So I set the audience straight about what IS Functional. What DOES work. And how to create accountability with your clients in a way that respects both your leadership and their ownership of their bodies and their lives.

Below is an abbreviated version of my speech…

In the new model of healthcare, we need to flip the concept of accountability on its head.

That’s because accountability as we know it, only works some of the time, for some of the people.

And that’s because accountability, as we’ve come to know it, is NOT Functional.

As a Functional Nutrition & Lifestyle Practitioner, teaching thousands of others in the science and art of the Functional Nutrition practice, I’ve often said that I have ZERO interest in being anybody’s Accountability Partner. ZERO.

But why? Isn’t accountability supposed to be a good thing? Helpful? Supportive?

Shouldn’t I be holding people to the change they want to be with their diet and lifestyle modifications?

Does my lack of interest mean I don’t want to help?

No. It doesn’t.

Quite the opposite. I want to help SO MUCH that I believe a new model of accountability is necessary to get us the results we want.

The Current Model of Accountability

Accountability as it’s traditionally used suggests that we either leave someone alone or we (in essence) punish them. Now I know that punishment is strong language—there really isn’t a punishment at stake, but the model is set up so that the person being “held accountable” is avoiding a consequence by “being accountable” to someone or something external to themselves.

Is that a model of health?

Is answering to a ping on your cell phone or to someone you are reporting your activities to effective? Does it work in the short or long term? Does it yield fleeting or sustainable results?

These are the questions I ask myself when it comes to creating a new health model.

“Because I Said So”

I don’t know if you grew up in the generation where parents, particularly dads, would tell you to do something because “they said so” (I certainly did). But I can tell you, as a parent of a teen myself, that in the post-millenial, iGeneration, this approach rarely works.

Besides, is “because I said so,” whether coming from your dad, your doctor, or a coach a reason to “do the right thing?”

Would you do something because I “said so?”

Is this a model we want to advocate in the future of healthcare?

Recommendations without reason?

Sure…we as practitioners have OUR reasons to give prescriptions and recommendations, but to the patient, in the classic accountability model, they are primarily being asked to do something because you “said so.” The checks and balances in the current model value “compliance” over transformation.

And I’ve learned that health and healing happen not because someone follows rules, but because they transform on multiple levels. Their diet and habits transform. Their relationship to their body transforms. Their sense of empowerment transforms. Often the lens through which they view all of life transforms.

But transformation doesn’t happen because I said so.

The Truth About Accountability

The truth is that when we (and our clients) are making decisions in our everyday, we either APPROACH or AVOID.

The question therefore becomes:
How can we inspire patients to AVOID further dis-ease and dysfunction and APPROACH true ownership of their own choices and behavior?

It’s not by giving someone a list of action steps and telling them to follow your recommendations because you said so.

Instead, we need to take a Functional approach.

Functional Accountability

Instead of the old model of accountability that focuses on rewards and punishments doled out by an external authority, Functional Accountability puts 3 critical E’s into practice:

  1. Empathy
  2. Education
  3. Empowerment

Empathy requires that you understand what’s going on in your client’s life—her current situation, her health history, her spiritual and cultural beliefs, her relationship to habit change, and more.

Education means that we swap out “because I said so” for an understandable explanation of how the body works, why it’s in a state of dysfunction, and how, with the Action Plan you’ve created, your client is going to be able to move the needle of her health in the right direction.

Education requires you to answer questions like:
Why is gluten harmful to my particular immune system?
How is my bedtime related to the function of my thyroid?
What effect does eating breakfast in the car have on my digestion?

Once your client truly understands why she’s making changes, and what’s in it for her and her goals, she’ll be empowered with an understanding of how her body works, actions she can take to move her body towards resolution, and a deep knowing that you are not a dictator, but a true partner in her healthcare.

The old model of accountability becomes obsolete. Instead, you have someone who is intrinsically motivated to take action towards her goal.


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Functional Nutrition Alliance provides the comprehensive online Functional Nutrition training in the Science & Art of the Functional Nutrition practice. Learn to address the roots of your clients’ suffering with client education, diet & lifestyle modifications.