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A Pipeline of New Clients Through Physician Exercise Referrals

“I want to know how good the [fitness professional] is at their art and science of progressing people through exercise.” 

These words were spoken by a physician who regularly refers his patients to fitness professionals. In 2019 and 2020, I spent ten months surveying and interviewing physicians and fitness professionals at a New England healthcare organization. This healthcare organization has had an exercise referral network in place for over a decade, and averages about thirty-five exercise referrals per week. 

As part of the exercise referral network, physicians were able to refer patients to community-based fitness centers and professionals, as well as a hospital-affiliated facility. The hospital-affiliated facility has four programs: an 8-week exercise program for post-rehab (muskuloskeletal, cardiac, and pulmonary); a 13-week fitness, nutrition, stress management and behavior modification program; a 12-month weight management program; and a 3-month cancer recovery program. Its program staff were registered dietitians, personal trainers, and health coaches.

The purpose of my research was to understand physicians’ and fitness professionals’ perspectives on physician exercise referrals and the impact on patient behavior change. Not enough physicians provide exercise referrals to their patients, and my research revealed a clear opportunity to address barriers to referral. In addition, physicians are less comfortable referring their patients to community-based fitness facilities and professionals than they are to hospital-based fitness facilities and professionals. Raising physician familiarity with, awareness of, and confidence in fitness professionals can help build physician trust in their capabilities. This is especially true for fitness professionals who have expertise and experience working with special populations, including people with different injuries, disabilities and diagnoses.

Physicians want to know that [their patients] are exercising in a place where, if anything bad or adverse were to happen, they are in good hands.” ​ –Fitness Professional 

Join me for my upcoming webinar with MedFit, where I’ll speak more on this topic as part. I’ll discuss ten steps that fitness professionals can take to become professionals that physicians trust to take good care of their patients. These steps focus on facilitating communication between physicians and fitness professionals about patients’ progress and outcomes, as well as raising physician awareness of the professionals’ capabilities. Join me as I walk through how to develop A Pipeline of New Clients Through Physician Exercise Referrals.

 


Dr. Amy Bantham has 20 years of experience working in consulting, health & fitness, and healthcare. She is the CEO/Founder of Move to Live®More, a research and consulting firm addressing physical inactivity, obesity, chronic disease, and social determinants of health through cross-sector collaboration and innovation. 

Amy holds a Doctor of Public Health from the Harvard T.H. Chan School of Public Health, with concentrations in Health Communication and Obesity Epidemiology & Prevention. Her doctoral research focused on physician exercise prescriptions/referrals and patient exercise behavior change. She is a certified group exercise instructor, personal trainer, and health & wellness coach. She also holds a Master of Science from Northeastern University, a Master in Public Policy from the Harvard Kennedy School, and a Bachelor of Arts from Yale University.

Trainer-with-senior-client-using-machine

The Roles of a Medical Fitness Specialist: Scope of practice, prevention and interprofessional collaboration

Physical activity has been demonstrated to positively affect over 30 chronic conditions and is considered the best deterrent of chronic disease in primary and secondary prevention. The main goal of a Medical Fitness Specialist (MFS) in the healthcare continuum is to prevent the onset of chronic disease and bridge the gap between clinical intervention and conventional fitness programs. This is achieved by developing exercise programs for those who have or are at risk for chronic disease or dysfunction, have health conditions that may be mitigated or managed by exercise and activity, are newly diagnosed with a disease and need exercise guidance, or have completed a medically supervised rehabilitation program and need to continue to progress. A fitness professional versed in medical fitness protocols, such as an MFS, can work with those who are at risk for chronic disease.

Scope of Practice

Scope of practice refers to boundaries set by knowledge, skills, and abilities (KSAs), as well as education, experience, and demonstrated competency, such as a program of study, or an exam to measure proficiency. A basic personal training certification suggests the holder can develop exercise programs for apparently healthy clients. Unfortunately, considering the overweight and obesity rate is near 70%, and 50%-60% of the adult U.S. population has at least one chronic disease, adhering to scope of practice becomes increasingly important, yet at the same time many fitness professionals may be providing services outside their scope of practice, and beyond their level of certification. By accepting a client, the trainer is proposing a safe workout will be developed and implemented, and the client will not be at risk of injury. If advice is given that is not within the trainer’s scope of practice, the trainer and the facility may be subjected to a lawsuit.

An MFS who integrates medical fitness into practice has the KSAs, based on education, experience, and demonstrated competency to conduct pre-participation interviews, perform fitness assessments, and design and implement health and fitness programs for disease management to avoid future injury and to improve activities of daily living. Unlike an MFS, unless otherwise educated, a fitness trainer who promotes medical fitness is not a licensed healthcare provider and does not possess the KSAs to diagnose an unknown condition, suggest supplements, design meal plans, physically touch a client or provide behavioral counseling.

Prevention

In the United States, medical care tends to focus on treatment rather than prevention. Whereas treatment is given for a diagnosed disease or injury, the goal of prevention is to avoid, improve or slow down the progression of a probable or possible disease or injury. Prevention can be categorized as primary, secondary, or tertiary. The goal of primary prevention is to foster a life of wellness and therefore avoid or reduce the chance of disease or dysfunction. Primary prevention includes immunizations, targeted types of exercise, balanced nutrition and wellness, and education programs. Secondary prevention is managing a symptomatic disease in the hopes of slowing down or reversing the progression. Examples include treatment for hypertension, asthma, and some cancer treatments. Tertiary prevention involves the management and treatment of symptomatic disease with the goal of slowing progression and severity, as well as reducing disease-related complications. Tertiary prevention includes treatment for late-stage cancer, coronary heart disease, and some types of rehabilitation to include orthopedic, cardiac, and pulmonary. Physical activity has been demonstrated to effectively treat over 30 chronic conditions, mostly in primary prevention but also in secondary and tertiary, making it the number one intervention against chronic disease.

Interprofessional Collaboration

Due to the growing incidence of obesity and chronic disease, leveraging the skills of various providers who can collaborate to deliver the best possible care, based on clinical needs, is necessary to manage the complex health care demands of a population with an increasing incidence of comorbidities. Due to a worldwide shortage of health workers, in 2010, the World Health Organization (WHO) recognized interprofessional collaboration as means to mitigate the global clinician shortage, strengthen health systems and improve outcomes. Interprofessional collaboration refers to health care teams, made up of trained professionals with various backgrounds, who work alongside patients and their families to provide high-quality care, based on the needs of the patient. Consequently, as medical providers begin to recognize the need to prescribe evidence-based exercise as an intervention in the management of chronic disease, MFSs, who are on the front line of health care, are trained and educated to be part of a clinical team that complements and leverages the strengths of each team member to improve population health. As health science and technology advance, it is imperative for fitness professionals who work with clients who have one or more chronic diseases to remain up-to-date on emerging fitness protocols. An MFS is required to participate in continuing education in areas including cardiopulmonary disease, metabolic disorders, and orthopedic dysfunction.

Although the scope of practice of many allied healthcare fields overlaps, the role of the MFS is to work with the client’s team of other healthcare providers, while staying within the scope of practice, based on KSAs. Regardless of the collaborative health team, the client’s physician is always the center, and as such should be provided regular updates as to the client’s progress.

An MFS is uniquely qualified to work with individuals within the healthcare continuum. Some KSAs associated with MFSs are:

  • Knowledge of basic chronic disease pathophysiology
  • The use and side effects of common medications taken by someone suffering from a chronic disease
  • The knowledge to perform and analyze basic assessments related to movement and anthropometry
  • The knowledge to design a safe and effective workout based on information received via assessment results, and the clinical recommendations from other healthcare providers
  • FITT protocols, exercise progressions, and regressions
  • The implications of exercise and activity for individuals with chronic disease
  • Contraindications of chronic disease, and signs and symptoms of distress related to chronic disease
  • Knowledge of signs and symptoms that require expertise outside of the scope of practice for medical exercise
  • The ability to recognize a medical emergency
  • Current CPR and adult AED are required

Personal Trainers & Fitness Professionals: Prevent & Manage Chronic Disease and Collaborate with Clinicians

Check out MedFit Classroom’s 20-hour online course, Medical Fitness Specialist. This course is designed for fitness and health professionals who want to learn more about using exercise as medicine with clients who suffer from one or more chronic diseases. As a Medical Fitness Specialist, you will be able to prevent and/or manage numerous chronic diseases and collaborate with clinicians.


Dan Mikeska has a doctorate degree in Health Science and a master’s degree in Human Movement, as well as certifications from NASM, ACE, the Cancer Exercise Training Institute and the Exercise Is Medicine credential from ACSM. He currently owns NOVA Medical Exercise and Medical Exercise Academy and is adjunct faculty for A.T. Still University’s Master of Kinesiology program. 

This article was featured in MedFit Professional Magazine. Access past issues or subscribe to read more great content like this!

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How to Turn Your Fitness Facility into a Health and Wellness Facility and WHY!

2020 came and went with a pandemic and the resulting crash of our fitness industry as we knew. It seemed like time stopped. Fitness facility doors closed. Staff were furloughed and separated. Fitness delivery models changed overnight – hybrid models of live streaming and on-demand services. Business plans were re-done for a budget year that evaporated.  

The OPPORTUNITY… there has been an increased awareness of the value of good health and the importance of exercise. Much of the research shared post-COVID clearly demonstrated that the sickest were at the highest risk with COVID and that those who were mostly healthy fared much better when diagnosed with COVID.

CDC reported that obesity worsens outcomes from COVID-19. Obesity increases the risk of severe illness, tripled the likelihood of being hospitalized, and is linked to impaired immune function, decreased lung capacity and many other risks. Obesity is forecasted to exceed 50% in Americans by 2030.

How do we go forward as business owners to capitalize on a perfect storm of individuals now realizing and valuing their health as an asset? How do we go forward to create environments in which our facilities feel like a home away from home for new exercisers, de-conditioned, COVID recoveries, overweight, out of shape and scared individuals who now wish to exercise?

American Psychological Association reported recently that Americans’ Physical Health has taken a back seat since the start of the pandemic. It was reported that 47% delayed or canceled healthcare services and that 53% have been less active than they wanted.

How do we fill the gap to provide services and welcome all ages, stages, shapes, sizes into our facilities to capitalize the business opportunity and to support those who need us most to get healthier?

  1. Bring communities together by offering health and wellness programs to non-members that teach good health and prevention. Some examples:
    • Post-hab COVID health program: 30 days to reset your health
    • 8-week weight loss programs/challenges, 8-week pre-diabetes classes, 8-week cardiovascular health and wellness programs.
    • Any program that can target a COVID risk factor that targets a certain element of health: cardiovascular, flexibility, strength, stress management, sleep, etc… or certain disease states such as asthma, obesity, diabetes, hypertension etc. all can be made into health and wellness programs for potential new members.
  2. Consider offering these health and wellness programs (with a nominal registration fee) without requiring a membership to your facility. So, include a membership to your facility for the duration of the program, offer a discounted sign-up fee to convert them to members at the completion of the program, and perhaps a friends and family rate to enroll. Leave a trail of financial incentive crumbs with some skin in the game to get them to value your facility and programs to stay long-term. Show them the value-added they experience by having you at your facility. Let them “try before they buy” — but in the wellness space first.  Not “gym and swim” first…that is too much for some.
  3. Offer intro level and disease-specific type group classes that may group like-minded individuals with common goals. Example: Beginner cardio class, where you clearly accommodate beginners, new exercisers, those who are low-level fitness and who need a shorter duration of work. 
  4. Offer personal training programs that clearly measure pre and post-health metrics to show improvement to give individuals confidence in their improving health and an appreciation of the value of the services they pay for. This also allows for your trainers and your facility to connect their improved health outcomes to their primary care providers so you can get future referrals as a credible source for a patient who needs exercise.
  5. Offer healthier food choices and nutrition education as part of your centers’ offerings. Consider adding a Dietitian to your team.
  6. Partner with local health departments, health care systems to host health checks to promote good health awareness and to get more foot traffic into your center.

THINK “A GYM without WALLS” and offer wellness to all – become the health hub of your community!! It makes good business sense for all!


Debbie Bellenger is a skilled presenter, public speaker, TRX Master Trainer and Reebok Master Trainer.  Over the past 30 years, Debbie has been developing and delivering medical wellness programs in an integrated continuum of care model with providers using EPIC as a platform of referrals and communications back and forth. She also successfully developed a new service line for CaroMont Regional Medical Center called Employer Wellness services which sold over $500,000 of corporate wellness programs with coordinators to local companies.

Debbie is the 2014 Medical Fitness Association Corporate Wellness Director of the Year – Employee Wellness. She is the 2017 IDEA Program Director of the Year Award recipient, which recognizes a Director who develops and delivers health, fitness and wellness programs for employees, participants and patients that have successfully changed behaviors and demonstrated positive outcomes of improved health.

male-trainer-female-client-gym

Motivational Interviewing to Drive Sustainable Behavior Change

Clients and Patients come to us because they want something to change about their life. That change could be the removal of physical pain, dealing with emotional distress, changing their nutrition in order to lose weight, or decrease the effect of diagnosed disease on their overall quality of life.

Interestingly, one’s desire to change doesn’t always lead to change. Change is abstract in that the new state of being that is desired doesn’t exist yet. Change is about the future. One’s future is connected to the present, which is the result of the past. Newton’s Laws of Motion give us a reference for thinking about change. In general, a thing will stay the same unless a force or energy acts on that thing. Therefore, change requires energy – and often sacrifice. Change can seem overwhelming and there may be fear of what might happen when change occurs. Old habits are hard to break. Even bad ones.

How can a practitioner from any discipline assist their client or patient to move from wanting to change to actually changing?

Motivational Interviewing (MI) is a communication strategy with tactical aspects designed to help the practitioner encourage the adoption of change behaviors. Change is about learning – learning not just a new way of thinking, but a new way of behaving.

Here is the most current definition:

“MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.”  (Miller & Rollnick, 2013, p. 29).

What is the language of change?

Language (n.) – the principal method of human communication, consisting of words used in a structured and conventional way and conveyed by speech, writing, or gesture. (Oxford Language Dictionary)

Change (n.) – the act, process, or result of making different. (Merriam-Webster Dictionary)

Using the language of change can be as simple as speaking the synonyms for the word change within the questions and statements constructed in a conversation with your client or patient: alteration, difference, modification, redoing, refashioning, remaking, remodeling, revamping, review, revise, revision, reworking, variation

The definition of language includes the use of gestures as a part of the communication process.

Physical gestures reflect ideas that the speaker has about the problem, often ideas that are not found in that speaker’s talk.

“Gesture is an act of the body, and the body has been claimed to play a central role in cognition.” (e.g., Barsalou, 1999Glenberg, 1997Wilson, 2002Zwaan, 1999).

So what part of our physical body can be used to create and display physical gestures?

The face, the eyes, the hands, the trunk, just about any part of your body can be employed.

What physical gestures would be useful to employ when conducting a motivational interview?

Find Out More…

Learn more about Motivational Interviewing! Join Greg Mack for his webinar, Motivational Interviewing to Drive Sustainable Behavior Change. Register Now »


Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease. 

trainer-and-senior-woman-gym

Are You Ready to Swim in the “Blue Ocean”?

You and your business are probably spending too much time competing in the “red ocean”.

You need to get out of the red ocean and head to safer waters.

I know what you are thinking… What is a red ocean vs. a blue ocean?

This concept comes from the book, Blue Ocean Strategy, and it is important to understand for career growth.

“Red oceans represent all the industries in existence today. This is the known market space.”

This is the market for generally healthy, “fit” clients.

“As the market space gets crowded, prospects for profits and growth are reduced. Products become commodities, and cutthroat competition turns the red ocean bloody.”

Sound familiar in your journey to find clients?

“Blue oceans, in contrast, are defined by untapped market space, demand creation, and the opportunity for highly profitable growth.”

“In blue oceans, competition is irrelevant because the rules of the game are waiting to be set.”

So what does this mean for you?

The red ocean in health and fitness is going after the 15% of the population who is generally healthy and looking for fitness solutions to get fit or lose some weight.

This 15% of the population is looking for great glutes and great abs and benefit from any basic fitness program…

…AND EVERY SINGLE FITNESS BUSINESS IS MARKETING TO THEM.

Hence, it’s the red ocean.

So, What’s the Blue Ocean?

The blue ocean, on the other hand, consists of the millions of people with existing conditions like arthritis, Parkinson’s, or Multiple Sclerosis, for whom the great glutes and abs programs aren’t appropriate

This group is not currently being bombarded with marketing messages about fitness.

These people are in need of fitness services delivered by a specialized professional (which you can become) who understands their condition AND knows how to make programs specific to their needs.

It’s time to start swimming in the blue ocean and get away the “cutthroat competition that turns the red ocean bloody.”

Learn more about the “blue ocean” by watching this free presentation from MedFit Classroom, The New Blue Ocean: Capitalizing on the Opportune Space Between Fitness and Medicine.  Industry veteran Phil Kaplan discusses this important topic and how you’ll benefit from targeting this untapped market.


 

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The Power of Podcasting: Create Your Own Platform & Leverage Your Brand

Podcasts are “where it’s at!” Did you know podcasting is now the most effective and cost-efficient marketing tool on the planet?  Podcasts provide wide-scale visibility to exponentially grow your business and increase brand awareness. In fact, the simple act of appearing on an established podcast as a featured guest can drastically improve your SEO and increase clients. Learning how to use this extremely affordable and far-reaching platform to your advantage may be the key to lasting success!

What do I need to know about podcasting? Here are some quick facts!

The Next Generation of Marketing

Forget spending money on print advertisements, billboards, or radio ads. Podcasting is “where it’s at!” Every business needs a podcast! It is effective, targeted, cost and time efficient, super fun marketing!

On-Demand, Passionate & Targeted Content

At any time, listeners can download, subscribe and like their favorite podcasts. Listeners may break up their shows into multiple sessions or listen all at once. Listeners can also search for podcasts based on their personal interests, hobbies, and more.

It’s FREE

Not only is it relatively cheap to produce your very own podcast, but it is FREE for listeners to download and enjoy your show. Provide value to listeners around the world while also promoting your business and brand without asking for payment or initial “buy-in.”

Accessibility

If you own a smartphone, a computer, a tablet, or have access to Wi-Fi, you can download and listen to FREE podcasts.

Opportunity for Intimate Connection

Podcasts allow you to tell “your story” in “your own words” and promote your business, brand, or values at a personal level. This is an opportunity to show empathy, authenticity, and share “your voice” with the world.  Remember, the most successful businesses and products start with a “story.”

Broad Reach

Unlike television, newspapers, radio stations, and print advertisements, podcasts are available around-the-world and not just specific to certain areas. This platform is a must for anyone who conducts business online.

Instant Authority & Credibility

As a fitness or medical professional, it is important to utilize a platform where you can offer valuable resources or information. Podcasts allow for you to be an instant authority in a specific field in addition to promoting your services on a large scale.

Statistics

Podcasts offer analytics that track the number of subscribers to your show as well as the number of downloads for each episode. The more downloads, the more people are learning about you, your mission, your values, and your business.

It’s FUN!

This is YOUR chance to create your own platform! Podcasting allows you to talk about the issues, stories, and topics that are most interesting to you! You can interview fascinating guests and use the podcast as an opportunity to cross-promote your businesses. Most of all, you make the rules and create the podcast format that works for you

Learn more about the power of podcasting and how to create your own platform!

Register now for Christine Conti & Brian Prendergast’s free webinar on this topic. This webinar will provide you with a basic overview of the steps needed to create your own podcast or utilize current podcasts to grow your reach, increase your client base and leverage your brand. Step into the new age of marketing through this cost-effective, time efficient platform!


Christine Conti and Brian Prendergast are co-hosts of Two Fit Crazies & A Microphone Podcast and owners of TFC Podcast Production Co. Christine is the founder of Conti Fitness and Wellness, LLC; Brian Prendergast is the founder and head coach of High Five Health and Fitness. 

 

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GETTING TO “YES!”: Marketing Strategies to Help People Invest in Their Health

Bill walked into my client’s fitness studio clutching two things: a book and a small piece of paper.

With a sheepish look, he revealed, “My doctor gave me your book and this script to contact you. That was almost a year ago, and I haven’t gotten it done. Until now.”

After discussing his fitness goals and health concerns, Bill pulled out a pen and inked a check for a full year of private training.

It took months to get him in the door … and just 15 minutes to close the sale.

What happened?

The Long Game

Good marketing is about helping people invest in something they’ll be glad they did. If you are selling a $40 product, the sale is relatively easy. But when you’re offering a lifestyle change, complex emotions are involved.

Bill delayed, but when he was ready, he knew exactly where to go and what to do. My client understood marketing for the long game.

Since our ideal prospects often encounter our message before they’re ready to buy, marketing for the long game focuses on two key strategies:

  • Helping prospects make a decision sooner.
  • Ensuring they choose you.

Inspire: Lead with Story

One of the most powerful devices in your marketing toolkit should be storytelling.

Specifically, storytelling that creates the emotions you want your prospects to feel and associate with your offer: joy, hope, urgency, victory, etc.

It’s these emotions that drive our powerful unconscious mind to make conscious decisions that make us feel good.

What goes into a good inspiring story?

My two favorite books on this topic are Michael Hauge’s Storytelling Made Easy and Donald Miller’s Building a StoryBrand.

The most critical elements shared in these books come down to four key points:

  1. Show your character is a normal person.
  2. Share the crisis that changed their thinking.
  3. Describe their journey with you as their guide.
  4. Show the reward of their victory.

Even a short 5-sentence testimonial can cover all four of these elements and drive your prospects’ desire to get started.

The more you share stories, the more you can inspire your audience with emotions they will associate with your brand for the long-term.

Encourage: Build Their Confidence

As a publisher, I encounter a lot of business authors who are anxious to write a 200-page book filled with overwhelming details.

Features and facts great for a small portion of the population, but the vast majority of buyers get overwhelmed by analysis paralysis and walk away “to think about it for a little longer”.

Good marketing is educating your prospect to the point they’ve got the confidence to begin your process… but not so much that they gain a false confidence they should be able to do a version of it on their own.

If you truly believe your services offer value they can’t achieve without you, then make sure your marketing doesn’t imply they should try.

Build their confidence in the benefits of your proven process, not the details or the data.

Equip: Help Them Start Simple

Overwhelmed people don’t buy, and confused people don’t start so if you want to make getting started easier, make it simple.

My team and I have been doing this for years within the fitness industry, using 100-page books explicitly designed to convert prospects into clients.

The books are lead magnets, turning the authors into fitness authorities and local celebrities.

They educate without overwhelming; giving readers an idea of who they’ll meet at the studio, what to wear, what to take with them, what to eat (or not eat), and what to expect in their workout sessions (and why). Vital details that can close a sale faster.

Now, think about your company.

Remove the fear-of-the-unknown obstacle by showing potential customers exactly what to expect in their first few visits.

If you’re marketing online, demonstrate – screen by screen – the buying and login process before they click the “buy now” button.

When you clarify exactly what to expect and what to do first, you make the process easier.

And that matters.

Take the Lead

When you understand that marketing is a long game, it transforms your marketing strategy.

Spend time developing assets that stand the test of time; particularly those you can build once and reuse over and over.

An inspirational talk (or webinar), a compelling book, and a thoughtful email onboarding campaign are all reusable assets that give you time to inspire, encourage, and equip people to say yes to life-changing decisions.

Join Nicole for an upcoming webinar to learn more, Get Published! Share Your Message & Change More Lives


Nicole Gebhardt loves marketing, books, and key lime pie. She is the CEO of Niche Pressworks, a consulting and publishing services company for experts, speakers, coaches, consultants, and business leaders. Learn more about her 3-book strategies inside “The Ultimate Book Plan” at NichePressworks.com

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Taking Your PT Business Online

With most, if not all health clubs and fitness facilities closed, or in a quasi-opened state, thank God that we live in the age of technology. For many of us, being “quarantined” does not have to stop us from conducting business as usual.

We know for a fact that exercise can help boost the immune system. This should be reason enough for EVERYONE to be moving, not using this time as…

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The Top Big Data Issues – and How Wellness Can Do Them Better

Big data is here to stay within the healthcare profession.  More and more engineers and data programmers are being hired to sift through the myriad of data that consumes the field.  Of concern to executives at the top are certain attributes of healthcare that may need “fixing”.  The aspects of this report are to highlight what are perceived as the biggest concerns in healthcare, and how the wellness industry – if they can stay on track – can supersede all of these types of issues as they transition to the data analytics side of their health offerings.  

#1 – In network utilization.  

This is a very big concern for hospital systems and physician network groups, as patients have a tendency to switch providers if they think they will get better service, better medicine, or better prices.  One of the reasons is that most patient contracts don’t require patients to stay in a network – which puts the responsibility of good care, competitive prices, and follow ups squarely on the doctors.   If patients are unhappy with their doctor or practice for any reason, they can leave.  Now that these organizations are getting bigger and more complex – it’s easier to see why patients may become disgruntled, and try to find a better solution in a private practice, or smaller group or hospital practice. 

From the wellness side – it’s not uncommon for health club members to stay at their club or studio for years.  Prices don’t change that much, and most members have a very personal relationship with their instructors and club owners.  They have group classes, personal exercise programs, child care, plenty of free parking, and clean facilities that provide some of the latest in technology every few years.  So – should healthcare systems look to health clubs to see why people stay in clubs longer?  Perhaps they should be partnering with these health clubs for specific programs for their patients.

#2 – Customer satisfaction.  

This is a priority in most businesses.  Hospitals and physician practices are no exception.  However, most people still associate going to the doctors with being sick.  So there is already an inherent negative connotation to the doctor’s office.  Therefore physicians need more than a lab coat and a prescription to make sure patients are getting what they need.  They need a team-orientated approach that can help with the issue NOW, and use the team to follow up with the patient to make sure the situation and health concerns are taken care of over time.

Again – the health and fitness industry is concerned about customer satisfaction.  With cut-rate gym memberships, and a new club coming into communities almost every month, clubs and owners need to offer clean facilities, professional trainers and instructors, and technologically advanced equipment that doesn’t break down and that is easy for members to take advantage of.  The issue between the two programs – is that although some exercise programs push the body and may be painful – it’s a good pain and the rewards of long term participation should be better health and less risk of using the healthcare system over time.  It’s the old adage of “pay me now, or pay me later” axiom, and more people are willing to put their trust in health clubs – and the risk of injury or illness or death is extremely low compared to even trips to the doctor’s office. 

#3 – Looking at the mounting data to convene the best possible approach to patient care.  

Again – this is a huge concern in healthcare – that doctors can’t read the thousands of new studies that come out in their field each month, so they rely more and more on their clinical experience (which may be a good thing), but they will stick to the tried and true methods they have always been using, and may not prescribe the most effective type of treatment for their patients.  Big data in many instances can do two things – one is look over millions of studies in a particular field, and two – through machine learning, hone in on what may be the best type of treatment plan for a particular patient, based on their age, severity of disease, family history, weight, and other factors.  This is a powerful tool to help doctors prescribe and treat better.

However, it’s still the same paradigm.  They are looking over medical studies, many of which may not be in the best interest of the patient.  One of the most cited studies in medicine came in 2005 when Stanford epidemiologist John Ionnidis reported that the majority of medical research finding are false, because they have inherent bias from their authors, their findings are not statistically significant, they were published by industry officials, and are not relevant, and conclusions may not match the actual results of these very papers.  Ionnidis opened the floodgates for many professionals who have gone after medical research and institutions for publishing false studies.  It is estimated that almost 40% of medical research studies are false, in that their findings do not hold relevance regarding the enhancement of patient care.

In contrast, sports medicine has been methodological in its research for a century – from the basis of treadmill cardiac and performance testing in the 1930s, to the onset of physical activity studies in the 1950s and 60s, to cardiac rehab and exercise safety studies in the 1980s, to the onset of exercise for special population groups in the 1990s.  There are very few reports on sports medicine research fraud, and the foundation of this research usually shows some level of benefit to those who participate.  In almost all cases, no harm is done to subjects while performing these studies.  This has now transitioned into many successful clinical health club programs for persons with cancer (Sunflower Wellness, Cancer Well-fit, Fast Trac Cancer Program), spinal cord injury (Claremont Club), multiple sclerosis, diabetes, hypertension, weight management, bariatric recovery, and medical fitness in general. 

#4 – Cost savings. 

 One of the biggest attributes of big data and population health is to drive policymakers and physicians to deliver the highest quality care at the most competitive prices.  In many opinions, this is a misnomer of sorts, and medicine is continually advancing technology, which is very expensive, and works through a third party reimbursement system — which is many times more expensive than if they offered the service or procedure or product at market value.  Many hospitals are undergoing facelifts (no pun intended) and look more like five-star hotels than medical centers.  All of these amenities cost the patient and insurance pool more money.  This is why healthcare costs usually rise at more than twice the rate of inflation, and have some of the highest costs of any industrialized business model.

As far as health and fitness, the rate of price changes for the average health club has held steady at just below inflation for years.  The prices for café food, personal training, specialty exercise, or apparel has also held steady.  Even with the rush of new technologies for equipment and personal monitoring devices (such as FitBit), prices have remained constant. 

Big data in the health and fitness setting should be concentrated on health outcomes.  There are many software programs in the industry now that look at finances, front desk management, club administration, and human resources.  They do their functions well.

If big data is going to continue to look at all aspects of healthcare, and continue to miss the boat regarding improved patient health and well-being, then no amount of data can help repair the continual dysfunction that exists between an over-burdened and (in many opinions) under caring system, and the continued increase in poor health in the US.  Prescribing more pain meds, vaccines, or antibiotics will not help improve health – and in many cases is making health worse. 

The health and fitness profession is on the mark moving into the realm of special populations at every level.  As the amount of population health and data analytics becomes a more ingrained part of wellness, we will see at many levels how these types of interventions improve health, reduce costs, and vastly improve patient satisfaction and retention to their favorite health club, exercise program, or personal trainer. 


Eric Durak is President of MedHealthFit – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.

 

References

https://www.optum.com/content/dam/optum3/optum/en/resources/gated/Optum_NYUPN_Topic_Spotlight.pdf

Ionnidis, JPA.  Why most published research findings are false.  2005.  PLoS Medicine.  Aug. 30. Doi: 10.1371/journal.pmed.0020124