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Industry Trends 2023 Report

There has never been a better time for our Industry to position ourselves to be the Health, Fitness and Wellness Experts to fill the gaps that are looming in front of us.  Gaps such as serving the 80 % of our population whose health journey may not begin with exercise but with Stress Management, or Nutrition or Sleep Hygiene.  Gaps such as Burnout now reported as 1 in 2 Americans suffering and becoming more and more comprised in their productivity at work, with their health and suicide on the rise.  Gaps such as the healthcare systems struggling post pandemic with staffing shortages, quality of care issues, burnout, and closures – it all begs the question, “Where does the average consumer start their health and wellness journey?”

It starts with our Industry!

We are the experts, innovators, creators, coaches, trainers, and business sector to reach out and lead the charge of delivering health, fitness and wellness to the people; no matter where they are located – Employers, Churches, Apartment Complexes, Schools, Resorts/Spas, Golf and Country Clubs, Assisted Living and Older Adult Communities, to name a few.

From my lens of corporate wellness, medical wellness, healthcare and fitness industry challenges; I forecast the following trends for 2023:

  1.  Increased interest in activities that promote recovery and the feeling of well-being such as massage, cryotherapy, IV therapy, restorative yoga, breathing and meditation classes, smaller byte size classes for new consumers to try activities at their starting level on their path to health and wellness.
  2. Increased interest in outdoor activities for fitness embracing the great outdoors for fitness experience, this will continue to foster the growth of running, hiking, walking and cycling communities.
  3. Increased interest in fitness activities that bring people together in search of socialization, community and camaraderie.  This will foster the growth of leagues, tournaments, health and wellness programs and in person activities.
  4. Increased interest in the fitness industry from other potential business partners due to the increased interest in Health overall in America.  Example, in Corporate America employee voice = employee choice.  With employees valuing health more than their pay check, employers will need to align benefit plans and offerings with fitness, health and wellness experts to provide what it is that their employees need.  Employers need our expertise.
  5. Increased need for niche services to include programming for chronic conditions which are out of control (diabetes, obesity, hypertension), stress management and anxiety, specialty populations who are currently underserved such as Parkinson’s Disease, Alzheimers Disease and so many more.  What about Niche Clubs for different sectors of the population ie Over 50 years of age who have not returned to the Fitness Clubs at levels pre-Pandemic?  With a growing % of the population forecasted to be over 50, why not?
  6. Increasing Hollywoodization of our Industry with Fitness Influencers leading the way in content on social media platforms.  This can be perceived as a threat to our industry as so much of this content is free, so it is undermining our value.
  7. Consumption of health and fitness will remain multi-faceted with at home, on demand, in person as long -term choices.
  8. Increasing need for fitness to align with healthcare systems and allied health professionals to establish referral systems, credibility in the local community and to support healthcare systems in their need for step down programming and experts.  Physicians do not refer to gyms, they refer to programs and a trusted partner.  We need to work together to create a continuum of care model with all of the key stakeholders investing in improving health outcomes.  Our motivations to engage may be different at the outset but the anticipated outcomes can be the only answer to bend the cost curve of sickness in America.

WHY will these trends occur?

The Pandemic has had a devastating impact on the health of the workforce and its employees which is where we find the vast majority of adults.

Employers are experiencing:

  • a) More than one in four Americans delayed routine health care appointments. 
  • b) Fear and fatigue have had cumulative effects on chronic health conditions.
  • c) High blood pressure and diabetes can develop undetected and so for employees who have missed annual well visits, the future impact on their health can be devastating.
  • d) Benefits Pro reported the cost of care of per employee for health care coverage is projected to be about $13,800 for 2023 with a projected 6.5% increase year over year.

 Employees are experiencing:

  • a) Decrease in mental health (42%)
  • b) Decrease in social well-being (41%)
  • c) Decrease in financial security (32%) and
  • d) Decrease in physical health (29%)

So, why will these trends occur?

  1.  One in five Americans is suffering burnout, as reported by APA and we now have an ICD-10 code for medical billing of this condition.  It is difficult to find the energy to exercise, take the step to join a gym when exhausted day over day. 
  2. Outdoor exercise has proven for many to be a lower barrier choice and lower cost choice to getting activity with some vitamin D.  It can also be more time efficient when lacing up sneakers to go out the door for a walk or run, and it can encompass family time which no childcare costs needed.
  3. With 1 in 6 now working from home (prior to the Pandemic it was 1 in 67), feelings of isolation, depression, loneliness and despair on the rise.  There is a direct correlation between having quality relationships in one’s life and health outcomes.  We are human beings not human doings are we are meant to be with others.
  4.  We are now only really starting to feel the impact of the Pandemic fall out.  The financial impact of the pandemic payouts to individuals and businesses have created a fall out of our economy with many not wishing to work again and loan re-payments that are arduous.  The health impact of the Pandemic has stimulated rising costs of healthcare due to increased sickness/chronic conditions and shortages in healthcare providers.  Current burnout stats demonstrate the lack of health in Corporate America which is reducing productivity which may be directly related to fiscal performance of a company. 
  5. With the rising sickness in America, the demand for specialized services will only increase.  CDC forecasts that by 2030, over 50% of Americans will have a BMI of over 30.  With increasing BMI’s comes increasing chronic diseases and co-morbidities, increased cost of care both in medical and pharmacy and increasingly complex programming needs for obese individuals.  We must learn as an industry to meet this population where they are and provide specialized programs and services, and talent educated in these disease states. 
  6. Social media influencers will fill the gap in education in health, fitness and wellness knowledge until we do.  We must position ourselves in our communities to be the credible health and wellness experts.
  7. Consumer choice = consumer voice, so with so many Americans working from home, having choice each day on how/where to their workout in and/or health knowledge is not going away.  We must embrace options and hear ongoing consumer needs as they change.
  8. Physicians and allied health professionals need partners to refer their patients to.  It only makes sense that we build bridges with the healthcare system for a long term model of shared successes since we all need numbers to perform year over year.

How the Industry Should Respond?

  1.  Change the lens and language from Fitness to Wellness so that it advocates for more than exercise in our competencies and expertise.  It allows us to explore how we position ourselves to be a holistic provider in our communities and to be more inclusive.
  2.  Hold ourselves to a higher standard of wanting more for the industry in advocacy, credentialling and certification standards and producing quality data outcomes that may be published and shared interdisciplinarily.   Data is king to bridge gaps.
  3. Bring healthcare providers and allied health professionals into our centers to leverage partnerships and services for a win-win long term.  Host MD’s as guests for a Speakers Bureau, a health fair with flu shots and wellness programs – it is a win win strategy.  They know you are in the community and they get to share their expert knowledge and capture potential new market share.
  4. Focus on the outreach in the community to create opportunities for additional partnerships and referrals to your centers ie, join Rotaries, Chambers, Society of Human Resource Managers etc…
  5. Create an Employer Wellness Advisory Committee in your Center to invite and host employers in your center once a month to simply provide solutions to their pain points which are rising healthcare spend, low productivity, low morale and increasing turnover.  Health, wellness, fitness and onsite activities in your center that promote fun, engagement, team dynamics all wrapped in health; can be a great start to increased revenues in corporate wellness activities.
  6. Partner with Brokers who need points of differentiation to sell their product and who have the pre-established relationships with employers.
  7. Embrace partnerships with individuals and organizations to offer a comprehensive menu of services so you that you do not have to carry all the fiscal burden. (i.e., partner with local dietitians, social workers, behavioral therapists, etc.)

Originally printed in Club Industry 2023 Trends Report. Reprinted with permission from Debbie Bellenger.

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.

Personal Trainer At The Gym

Body Language, Self-Awareness and The Client Experience

As a trainer, you wear many different hats during a typical work week. In turn, you are pulled in many different directions among family, friends and clients.  If you are focusing on too many topics at once you cannot be in the moment, which can lead to a lack of client retention.

Being in the moment.

There is a lot of competition in the studio market and potential members/clients like to belong to a gym – and stay with a gym – where they feel comfortable.  That puts the limelight on personal trainers to generate the positive client experience that is so important to retention.

This is why being in the moment is vital to gaining new clients and retaining current ones. If trainers are distracted this may be apparent through body language. Members may perceive being distracted as receiving bad customer service.

Members decipher up to 93% of what is said through body language.

When you think of excellent customer service, which companies come to mind? What makes them stand out from their competition? The employees that work for these companies are mindful and in the moment. They anticipate the needs of the client and help them accordingly.  Being in the moment means that your body language and what you say conveys the same message. This is important to note for customer service and member retention.

The importance of not ‘zoning out.’

Members are constantly making decisions on how they want to spend their money. When trainers work with clients they should be mentally and physically present for each session. If a trainer zones out the trainer leaves their client wondering if the session is important to them. Trainers also miss out on potential new clients who may have wanted their services.

Clients will typically get your attention first by asking if there is “something else you need to do”. This should be a clue that they know you are not in the moment.  You want to fix this quickly before the client stops training at your facility. Potential clients also watch to see how focused and attentive you are.  I once had a member watch my training sessions for 5 months before deciding that he wanted to hire me. He said that he was looking at my training style, personality and attentiveness. He passed up two other trainers because they seemed uninterested.

When you and/or your staff have better self-awareness you are able to anticipate the needs of your members easier.  You will also notice that more clients would like to train with you. By being in the moment every day your clients feel like they had an experience that they want to share with friends and family.

Do you know what message you’re conveying?

Nonverbal communication involves facial expressions, gestures, eye contact, posture, voice, and touch -and is actually more important then what is said verbally. Trainers are communicating non–verbally with clients and members all of the time and when mixed signals are sent, clients have to try to figure out how you actually feel.  You may be speaking to your client and sound present and in the moment but is your body language  communicating otherwise?


Robyn Kade is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 18 years of experience in medical based fitness.

References

http://www.helpguide.org/articles/relationships/nonverbal-communication.htm

http://www.statisticbrain.com/gym-membership-statistics/

hands-in-circle-connections-teamwork

Cultivate Connections!

Cultivate connections and build relationships within your professional field. There are enough clients and work to go around for all of us. Consider how collaborating with other professionals in your area or the periphery of your field may make you better at what you do. We are better when working together, and I believe our clients are better off. 

As a Fitness professional working in the collegiate realm, this has been of the utmost importance to me and my career. Collaborating on a team to produce the best product has been a great learning experience. And let’s face it, when we work together, it expounds upon the individual ideas and makes them grander. We also get the opportunity to hear other points of view and fresh ideas.

Being able to draw on the knowledge of others is an immeasurable way to learn and grow in your area of expertise. The benefits of mentoring and being mentored by others are also invaluable. Think back to who has mentored you in your profession. How has that experience shaped your practice today? How can you pour into others to share your knowledge?

As a personal trainer, I try to build relationships with other professionals in my area. There will come a time in your career when a client presents with an issue outside your scope of practice. Having a list of reliable professionals, you can refer for your client is wonderful. This often yields better results for the client than searching the internet for a provider. And yes, I even have relationships with other trainers. Not every trainer is suitable for every person. Here is a list of the health professionals I have built relationships within my area.

  • Chiropractors
  • Acupuncturist 
  • Counselors/therapist
  • Group instructors
  • Massage therapist
  • Orthopedic surgeons
  • Personal trainers
  • Physical therapist
  • Registered Dieticians

It has been one of my greatest privileges to work alongside a Physical therapist (PT) to graduate a client from PT to Personal training. I have learned so much about injuries and rehab and have built trusted relationships that I can refer my clients to, AND I have been referred to by those professionals as well. 

An important caveat; work within your scope of practice. If the opportunity arrives to work with another health professional, obtain the proper RFI or Request For Information. This document says that the client/patient has permitted the two professionals to share information on that person. Abiding by all HIPA laws and regulations, use this information to help bring the client/patient to better whole health. 

I know that what I offer as a personal trainer is not the only thing my clients need in their life for whole-body health. Sometimes possibly combining massage with our workouts is what brings their bodies to better health. Another example is counseling. It may be that the stress in life is making it more difficult for my client to reach their full potential; talk therapy may make the physical workout more productive. 

If we keep in mind, as health professionals, that we are working toward the whole-body health of our clients/patients, this style of practice is not complex. If we are honest, it is the same for us. Complete whole-body health has many different facets.  

Cultivate, Build, and Grow! 


Shannon Briggs is a multi-passionate fitness professional and educator. She brings 30-plus years of experience to a long, fulfilling career in the fitness industry. In the past 13 years at the University of Texas at Austin, Shannon has led continuing education workshops in multiple group fitness formats and topics specific to personal training; she also has written the curriculum and manuals for numerous workshops accredited by the American Council on Exercise (ACE). Shannon is currently a monthly contributor to Campus Rec Magazine for Fitness and Wellness.

gavel

Exercise Prescription and the Standard of Care

To minimize injuries and subsequent negligence claims/lawsuits, exercise professionals need to be aware of their many legal duties and risk management responsibilities. When faced with a negligence lawsuit, courts will determine the standard of care (or duty) of an exercise professional. If the court finds that the exercise professional breached a duty and the breach of duty caused harm to the plaintiff (injured party), the exercise professional (and the professional’s employer) may be found negligent and, thus, liable for the plaintiff’s harm and will need to pay monetary damages. The damages can be in the millions of dollars. For example, the jury awarded the plaintiff $14,500,000 in Vaid v. Equinox (1).

Factors Courts Consider When Determining the Standard of Care

Legal scholar, the late Betty van der Smissen, stated: “if one accepts responsibility for giving leadership to an activity or providing a service, one’s performance is measured against the standard of care of a qualified professional for that situation” (2, p. 40).

A “qualified” professional possesses proper credentials and is competent. A competent exercise professional knows how (has the knowledge and practical skills) to design and deliver a “safe” and “effective” exercise program.

As described by van der Smissen,“for that situation” is determined by reference to the following three factors:

  • The Nature of the Activity
  • The Type of Participants
  • The Environmental Conditions

Nature of the activity

The professional must be aware of the skills and abilities the participant needs to participate “safely” in the activity, e.g., the exercise professional must possess adequate knowledge and skills to lead “reasonably safe” exercise programs.

Example: Exercise professionals that lead exercise programs that are considered “advanced” that can increase the risk of injury (e.g., Olympic lifting, high intensity programs) need to have advanced knowledge and skills necessary to safely lead these types of programs, i.e., they need to be fully informed of precautions that must be taken.

Type of participants

The professional must be aware of individual factors of the participant, e.g., medical conditions that impose increased risks and know how to minimize those risks.

Example:  Exercise professionals that design/deliver exercise programs for individuals with medical conditions (e.g., pregnancy, diabetes, back problems) need to possess credentials and competence in clinical exercise by completing clinical academic coursework/education as well as obtaining clinical certifications and experience (3). From a legal liability perspective, it is essential that exercise professionals fully understand any additional or unique risks the medical conditions(s) might impose and how to minimize those risks.  In Bartlett v. Push to Walk (4), the court stated:

Programs like Push to Walk “May impose particular duties that an ordinary health club would not have…What would constitute…negligence would differ    between an ordinary health club and a facility like Push to Walk” (p. 7).

Environmental conditions

The professional must be aware of any conditions that may increase risks, e.g., weather conditions such as heat/humidity, floor surfaces, exercise equipment, and know how to minimize those risks.

Example: Exercise professionals need to have the necessary knowledge and skills to properly implement important safety precautions to help prevent heat injuries. Knowing and implementing precautions to minimize risks associated with slippery floor surfaces and improper maintenance of equipment is also important.

Case Example: Levy v. Town Sports International, Inc. (5)  

A personal trainer had a client, Levy with known osteoporosis, perform a series of jump repetitions on a BOSU ball. After a few reps, she lost her balance and fell fracturing her wrist that required surgery to have a plate and screws inserted into her wrist. She filed a negligence lawsuit against the defendant facility.* The facility filed a motion for summary judgment (request to dismiss the case). Trial court granted the defendant’s motion, and the plaintiff appealed. Upon the appeal, the appellate court reversed the trial court’s ruling. The court stated that the trainer, knowing Levy had osteoporosis, unreasonably increased the risk of harm to her by having her perform an advanced exercise. The appellate court considered the nature of the activity (jumping repetitions on a BOSU ball) and the type of participant (client with osteoporosis) and determined that the exercise professional did not meet the standard of care for that situation.

*In a negligence lawsuit, in addition to the exercise professional, the fitness facility is also named as a defendant through a legal principle called respondeat superior, in which the employer can be vicariously liable for the negligent acts of its employees.

Conclusion

Meeting the standard of care when prescribing exercise for individuals with medical conditions begins by exercise professionals obtaining the necessary credentials and competence. It was obvious that the trainer in the Levy case did not have the necessary knowledge and skills to prescribe a safe and effective program for a client with osteoporosis. The trainer failed to take important precautions to minimize the risk of a fall.

Join Joann for her webinar on this topic, Exercise Prescriptions: Linking Safety and Business Success


Information provided in this article comes from: Law For Fitness Managers and Exercise — the only comprehensive resource for fitness managers and exercise professional who want to: PROTECT THEMESELVES, THEIR BUSINESS, AND THEIR CLIENTS! For education programs that accompany the text, go to: Educational Courses (fitnesslawacademy.com)

JoAnn M. Eickhoff-Shemek, Ph.D., FACSM, FAWHP, professor emeritus, Exercise Science at the University of South Florida and president of the Fitness Law Academy, LLC, is an internationally known author and speaker. For more than 35 years, her teaching and research have focused on fitness safety, legal liability, and risk management issues. Dr. Eickhoff-Shemek is the lead author of a comprehensive legal/risk management text, Law for Fitness Managers and Exercise Professionals, and is the co-author of another textbook, Rule the Rule of Workplace Wellness Programs, published in 2020 and 2021, respectively.

References

  1. Vaid v. Equinox, CV136019426, 2016 LEXIS 828 (Conn. Super. Ct., 2016).
  2. Van der Smissen van der Smissen B. Elements of Negligence. In: Cotten DJ, Wolohan JT, eds. Law for Recreation and Sport Managers, 4th Ed. Dubuque, IA: Kendall/Hunt Publishing Company,
  3. Warburton DER, Bredin SSD, Charlesworth SA, et al. Evidence-Based Risk Recommendations for Best Practices in the Training of Qualified Exercise Professionals Working with Clinical Populations. Applied Physiology Nutrition and Metabolism 36, S232-S265, 2011.
  4. Bartlett v. Push to Walk, 2018 WL 1726262 (2018 U.S. Dist. Ct., D. N.J.).
  5. Levy v. Town Sports International, Inc., 101 A.D.3d 519 (2012 N.Y. App. Div. LEXIS 8543).
trainer-and-middle-aged-client

To Spoil or Not to Spoil…That is the Question

Personal Trainers, do you SPOIL your clients?

Do you keep your clients reliant on YOU?

I used to think this was a good practice. I even thought of it as Full-Service Personal Training. But in hindsight, I wasn’t teaching my clients to be responsible for their health and fitness.

I enjoy serving my clients, bringing their dumbbells to them, taking their dumbbells, and re-stacking them. I let my clients get comfortable on the bench before giving them the bells or bar to press. I move Bosu balls and re-adjust TRX straps for my clients constantly. I have spent many hours wiping down equipment for my clients before and after use. I have adjusted weight machine bench heights, placed pins in plates, safety hooks on barbells, and the list goes on and on and on.

I thought this action was being kind and a good service provider. I am willing to bet many of you have also done this with your clients.

Flash forward 30 years in the industry. I am about to have hand surgery on my dominant hand. It is a minor surgery, but surgery non the less, and I will not be able to serve my clients in this same way while I am healing.

I have spent the last month teaching my clients how to load and de-load dumbbells safely from a bench press and how to set each weight machine for their height. Many of my clients didn’t even know how much weight they had been lifting; they just did what I said and trusted me to hand them the proper equipment.

I have spent time explaining the lengths of the TRX straps for different exercises and shown them how to adjust the straps by themselves.

This has been a big lesson for me. Doing everything for our clients only creates a client with a considerable amount of dependency on you, the trainer. This, in turn, produces less self-efficacy outside of your sessions, resulting in less progress towards their fitness and health goals.

As Professional Fitness Trainers, our ultimate goal is for our clients to be healthy. We may not always be there for them. What if you move or they move? What if you have surgery or an accident? Make sure your clients can care for their fitness with knowledge and safety.

Don’t get into the habit of full-service training. If you already have been doing it as I was, begin the de-programming process for your clients. That is the best long-term way to serve them and their health goals.

I know what some of you are thinking – if they can do it all independently, they won’t need us anymore. However, I’m afraid I must disagree. Your job is to program well and continually challenge your clients appropriately for their fitness level and health goals. If you continue to do that while educating them on the how and why of what you are doing, the sky is the limit for their success and yours! Happy Training!


Shannon Briggs is a multi-passionate fitness professional and educator. She brings 30-plus years of experience to a long, fulfilling career in the fitness industry. In the past 13 years at the University of Texas at Austin, Shannon has led continuing education workshops in multiple group fitness formats and topics specific to personal training; she also has written the curriculum and manuals for numerous workshops accredited by the American Council on Exercise (ACE). Shannon is currently a monthly contributor to Campus Rec Magazine for Fitness and Wellness.

Trainer-and-Client-1

5 Steps to Boosting Your Referrals

Marketing is tough, there’s no question about that. Even all the amazing tools of keywords, Google and Facebook algorithms marketing is still like trying to hit a moving target. What worked once, may not work again. Many don’t do marketing because of the costs of acquiring a new client are viewed as too steep.

Is there a way to market effectively, without spending loads of money, and have the leads be highly qualified and likely to buy from you? Yes.

You need to not only build, but to boost your referral network. A referral network is simply people, companies, practices that you can refer your clients to and visa versa. Building an active referral network is a relatively cheap form of marketing that pays huge dividends because even though these leads are from businesses, and other professionals they are essentially still word of mouth referrals. The only difference is that the lead/new client can be traced back to a specific person/company. After all, I think we all know that word of mouth is king when it comes to marketing and advertising. I’m also sure we all wish we didn’t have to work so hard to get more clients/patients.

Wouldn’t it be nice if we could have a steady stream of referrals coming through your door?

Referrals are some of the best leads you can get because they come in already knowing about you, and you have a built-in credibility because of the referring person’s relationship with that lead. If the lead knows, and trusts the person who did the referring, all you need to do is not mess it up and chances are very high that lead will turn into a client. The trust can’t get much higher than if your referrals come from a medical professional.

There are probably more tips and tricks to boost your referrals from your network. Here are the principles I’ve personally used to over double the amount of referrals coming into our facility. Because these are principles or steps, they can be replicated, regardless of whether or not you have the same business model or niche as I do.

Identify

First, you need to identify who you need to talk to. When it comes to professional referrals I would start with your existing clients and who do they see, or visit. Find out the names of the companies, doctors, practices, etc. where they go.

Another way to boost your network is to identify which clients or situations you will most likely come across in your business/practice that you’ll need to refer out to someone else. If you’ve got someone, that’s great. A good goal to shoot for is at least 3 vetted sources for each referring need. For example, if you need to refer to a rheumatologist, you should strive to get 3 different rheumatologists that you’ve talked to, met, and feel like they would take good care of your patients/clients.

Connect

The second step is to connect with these people/companies. It’s easiest to connect with other professionals with whom you share a client/patient. A great phrase to use if it is a medical provider is that you want to ‘collaborate on care’. Keep in mind you shouldn’t disclose the name of your client/patient without a HIPPA release/disclosure. But you can say that you share a patient with xyz and would like to collaborate on care. Once you start having a dialogue you can get your HIPPA release – that’s not the focus here though. The primary objective is to make a connection and talk.

You can email, call, or drop by their office/facility. You may have to do all of them, and more than once. Remember the squeaky wheel gets the oil.

If after repeated efforts to connect you still haven’t made a connect. Drop it and move to someone else. Not every doctor, therapist, facility will be willing to talk or connect. That’s ok. You want to find ones that care as much about your clients/patients as you do.

Tracking

This is a really important step. I hope it goes without saying that you need to track your results you get with your patients/clients. Objective and subjective measures are important. This is a primary reason we do assessments, right? Get usable data. As you retest, what do you do with that information. You need a place where you can find, see, and have visible the progress your people are making.

We use a software that we can customize all our specific tests/measures. Each time we enter a value it lets us know the percentage improvement from baseline to current, or from the previous measurement to the current. Having hard numbers and percentages look awesome. We also make it a point of writing down all the ‘weekly wins’ our clients have. We write it up on a whiteboard. This lets our prospects that come in see our latest amazing results. It also reinforces a sense of community and connection among our members as they see their achievement and others’ up on the board. It also makes it SUPER easy to know who and what to highlight when it comes to the next step.

The other thing you must be able to track is where your leads, prospects, and clients come from or visit. Most CRM softwares have the ability to track a lead source. If you don’t have one, you can use a simple excel spreadsheet.

Communicate Frequently

Step four is to now communicate frequently with your network. What should you say? Show them the results you are getting with you clients, and specifically the people they’ve referred over to you.

Highlight their progress, and why that’s important to them and to the client. You can let them know what’s going on with your business (new products, recent media coverage, awards, new hours, etc.).

We started sending out a monthly newsletter just to our referral network. I’ve found it keeps us top of mind and tip of tongue. The newsletter is great because there may be people in your network who don’t refer many people to you, but seeing your successes will help them feel like they can, and seeing a specific client story may jog their memory about a specific person they see who they can refer to you.

I also directly email the referral source with an update monthly on all the people they’ve sent or whom we see conjunctively.

Both of these options are designed to build your credibility that they can trust you, and you know what you are talking about. It also opens the door for more communication. I would recommend trying to always make the newsletter and email feel conversational by asking a question. It could be as simple as asking, “is there anything we can do to help you?”. Or if you are communicating directly with one person/facility, ask them about a situation (no personal details) that you’ve just seen or have a question about. Give them your thoughts and ask for theirs.

Think of communication with your referral network like a bridge. The first contact is like a piece of rope spanning a river. With each contact you strengthen that bridge. Soon it becomes a log that can be used to walk across the river. That’s good, it’s a solid way to cross, but only one person can cross at a time. We want to help you get multiple referrals at the same time, or at least more frequently. That comes with more communication and contacts. You want to convert this metaphorical bridge from a log into the Brooklyn bridge. It all happens with the trust and results you communicate frequently to your network.

Repeat

This will be the biggest step that gets glossed over and forgotten. Consistency is key. It’s key in fitness and it’s key with your network. You can’t reach out just once, or send just 2 newsletters. You’ve got to do it consistently. Once your network knows that this is a consistent habit for you, it’s just one more reason to trust you because you are consistent and you follow-up.

The more you repeat the first four steps, the more referrals you will get. It might take a month or three, but you will see an increase in your referrals and an increase in your network as those other companies don’t just talk about you to their patients/clients, but they start talking about you to their network. And before you know it, you are changing the world. Get after it!


Ryan Carver is the owner of Leverage Fitness Solutions where they specialize in helping older adults defy the status quo around aging. Ryan has been training the older adult since 2006. Ryan has published numerous articles on senior fitness and serves on multiple professional boards. He and his wife have 4 kids.

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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.

For a limited time, save 40% on this course by entering coupon code MFNBLOG40 at checkout.


This article was featured in MedFit Professional Magazine. 

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. 

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The Commodification of Medicine and Fitness: The Good, the Bad, and the Ugly

The need for medical and fitness services/products continues to grow. In the United States, and around the world. The corporate and industrialized delivery of medical and fitness products/ services continues to grow to meet increasing demand. Innovations in medical diagnostic technologies, surgical procedures, biomaterials, and medicines help individuals live longer, and with a higher quality of life. Technology and scientific research are propelling fitness product/service innovation with digital activity monitoring apps . . .

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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