In traditional marketing to the medical community, personal trainers most often mail flyers or brochures that describe the trainer’s qualifications and what kind of programs they offer. They may even personally drop the promotional material off at the medical office hoping to snag a bit of the medical professional’s time to talk about the program they could offer patients.

Looking first at direct mailings, the average response in 2017 was 4.4% (Pulcinella, 2017), which is actually a bit higher than it has been in previous years. However, mailings can be costly, and you should always consider where your marketing money is best spent.

As for dropping off material and hoping to catch the professional on the fly, not much chance there. Schedules are tight and the likelihood of them having time to chat when you happen in is very low. Even if you try to make an appointment to introduce yourself, you are unlikely to get a meeting. Your best bet may be to get to know the receptionist (this may take multiple drop bys), explain who you are and what kind of results you can offer to patients, and have the receptionist push the idea to the medical professional.

Reverse marketing is a little different. In reverse marketing, you are not going to the medical professional to sell yourself and your services. You are going to medical professional to have them sell you. Picture this, you are a new personal trainer in town. You know the value to your clients when you can refer them to the right professional when they need something that falls out of your scope of practice. You are interviewing doctors, physical therapists, chiropractors, massage therapists, registered dietitians, etc. to find the best people for your clients. In essence, you want to send patients to them. That makes finding time to talk with you a whole lot more interesting.

Now, when you do meet with the medical professional, it’s not a trick to talk about yourself. You should, indeed, interview them with the idea of finding someone you can refer your clients to. Come prepared. Bring a list of questions that you want to ask and take notes as you interview them. Questions might include, “How frequently do you recommend physical activity to your patients?” and “Of those that you do make that recommendation, how many do you think follow through with it and become more physically active?” More than likely, they will be curious about you and at some point will ask what exactly you do with your clients and what you offer. But, even if that doesn’t happen at the moment, when you do send them clients they will be thinking of you, and, when they are in a position to refer a patient to a fitness professional, yours will be the name that comes to mind.

So, as you try to get referrals from the medical community, reverse the standard thinking and build your network by finding the best people for your clients through your own interview process. If you send people to them, they will be that much more likely to send some to you.

Mark Nutting, CSCS*D, NSCA-CPT *D, ACSM HFD, ACSM CEP, is the Owner/Master Trainer at Jiva Fitness in Easton, PA. Mark is the PFP 2016 Trainer of the Year Legacy Award and NSCA’s 2009 Personal Trainer of the Year. He holds 12 certifications in the field, 38 years in personal training and health club management, and has been educating and coaching Personal Trainers for 36 of those 38 years. 

Sources:

Why Direct Mail Marketing Is Far From Dead, Steven Pulcinella, Forbes, 2017 August

Technology is critical and ever-present. Before the shutdown, technology was a part of gym owners’ strategy, but Covid pushed us to use technology more than we ever have in the past.  As we reset and get ready to thrive in 2022, now provides a good opportunity to review your tech stack. What do you have, what do you need, what do you want?  What is the return on investment? 

I believe in a “high tech and high touch” model for health clubs. Our members come to us sometimes 2-5 times per week, if not every day, so we sometimes resist new technology adoption because we are not just changing a system or process for our internal staff, but also for the 100s or 1000s of individuals that interface with our brand regularly. This is the only industry I can think of, other than Starbucks, Peets Coffee, or other affinity-based coffee shops that patrons frequent daily or 2+ times a week. Maybe in some cases, neighborhood bars…

We are not in a transactional business arena but a service-based relationship arena. Even my coffee example is still transactional – get your coffee and off you go. Neighborhood bars may be the exception for those that go multiple times a week. However, consumers still don’t go to the same hotel, restaurant, movie theatre, cruise, or airline 2-5 times a week. It simply doesn’t happen. This leads to an important aspect of data management and quality control that is unique to our industry. Seeing that we are a destination that members interact with more frequently than most other businesses, it introduces an opportunity for more breakdowns in the member journey. Ensuring that this data is consistent across all systems is one way to help mitigate errors and enhance the member experience. 

Like most decisions and processes you implement, you always start with evaluating where the member journey begins. In 2021, the member journey begins online. If your website, social pages, and review sites (google, yelp, etc.) are where members are beginning their journey, then it only makes sense to have a tech stack that’s conducive to having them complete their journey online. Questions that you should be asking yourself are:

• What does your member journey look like from finding you online to purchasing a membership? 
• Can the consumer buy online?  
• Can the consumer enroll in a trial membership online? 
• What other barriers exist between your prospective member and purchasing a membership and how can you eliminate them? 

A common barrier that I hear from clubs is having several systems that fail to “talk” to each other. For instance, if your website doesn’t speak to your Customer Relationship Management (CRM) system, and your CRM doesn’t speak to your Club Management System (CMS) then you are inadvertently creating 3 data silos that you must either sync via API or update manually. 

Ideally, once a member joins online, the data they provided is entered into your CMS real-time. This ensures that they have a seamless member journey. From the moment they sign up, they should be entered into a “Welcome” cadence in the CRM system to provide complimentary workouts to get them started on their new fitness journey. This is just one member journey example that is enabled by having the right combination of technology, or your member journey “ecosystem”. 

When it comes to your return on investment, we need to consider lowering our total cost of ownership. This is achieved by consolidating technology vendors and choosing the right (best in class) technologies that “talk” to each other optimally to achieve a seamless member journey. 

Customer Relationship Management – Member Management (Billing & Collections) – Member Experience – Fitness Engagement – Organizational Data/Dashboard – All are critical to successful operations.  

I’m a big fan of ABC Fitness Solutions, GymSales, Trainerize, Fitness BI, and MXMetrics to handle these critical areas for success. 

Reprinted with permission from Bill McBride.

Bill is the President & Chief Executive Officer of Active Wellness, Active Sports Clubs & BMC3 Consulting. He is a health club industry veteran with over 25 years of experience leading and managing all aspects of commercial health clubs, medical fitness centers, residential, community, multi-tenant and corporate fitness sites. 

Can you accept insurance for medical fitness/exercise therapy? Can your clients use their FSA & HSA (medical savings account) for your services? The answer to both questions is yes, however, it’s not an easy yes. The only way for your clients to do these two things is if you are billing for qualified medical expenses.

What are qualified medical expenses? Qualified medical expenses are expenses that mitigate, treat, or prevent disease per IRS.gov Publication 502. The IRS narrows the expenses that are deductible even more by limiting the qualified expenses to supplies (example: KT Tape) or an action being billed that will alleviate or prevent disability or illness. The catch for medical fitness/exercise therapy is that general health and well-being are not qualified medical expenses.

So, how can your client use their insurance or medical savings accounts for your services? The client needs their doctor to provide them with a prescription that identifies your services as medically necessary. The doctor saying you really need to lose weight is not a prescription.

What expenses or activities are covered per the IRS Publication 502? One example is a weight loss program for a client with a medical need for weight-loss. The weight-loss program becomes medically necessary when the doctor has diagnosed the client with obesity, heart disease, or some other disease and has determined that your weight-loss program or something similar will help the client improve or alleviate the disease or condition. What isn’t covered as a qualified medical expense are the dues for your club, the weight-loss program for a client without the prescription from the doctor, or the sessions to maintain good health after you fixed the problem your client had a prescription. The key is that a doctor or medical professional has diagnosed a disease and given the client a prescription for your services.

Accepting FSA & HSA is as simple as contacting your credit card processor and making sure you are set up correctly in their system. Most of the time this is as easy as answering a few questions about what you do. Making the decision to accept medical insurance at your facility is a much more extensive process, one that will require you to have a NPI (National Provider Identifier) number and a lot of extra time for the processing, filing, and record-keeping that goes along with dealing with medical insurance companies.

In short, if your client has a medical necessity for your services and their doctor has given them a prescription, then your client can use their FSA or HSA for their sessions. They also may be able to submit their receipts back to their insurance company for reimbursement. If your client doesn’t have a medical savings account or an insurance company that will reimburse them for their expenses, they can collect the receipts for the services, that qualify as medically necessary, and submit them with their taxes to their tax preparer. There are minimum limits that clients must reach before they can start using their medical expenses as itemized deductions. Their tax professional can help them with this.

To learn more about exactly what is and isn’t considered a qualified medical expense refer to the IRS Publication 502: irs.gov/pub/irs-pdf/p502.pdf

Heather Nusbaum is a Certified Management Accountant, Exercise Physiologist, Licensed Massage Therapist, MELT Instructor, and Master Trainer with NASM & ISSA. In 2013, Heather created Paws for Fitness a program to incorporate canines in the workout process. Over the years, this program has become a therapeutic modality within the training protocols of her business Nutree Fitness.

How did Heather go from Accounting and Business to Exercise Physiology? At a young age Heather was diagnosed with ‘Dysfunctional Knees’, this was a label that was attached to describe being in pain 24/7. This pain continued for the next 15+ years. After gaining weight due to age and inactivity, she realized that something had to give in her early 30’s. On her own she picked up and modified a box program and within 1 year had completely removed all the knee pain she’d suffered for the last 15+ years. Over the next few years it became apparent that she could help other people do what she had accomplished by accident, improving their quality of life and moving toward a pain free existence.

Every afternoon around 4:00 pm, just outside my study window, I can hear the sounds of outdoor physical activity classes held in a nearby park. Instructors calling, students responding, joyful sounds of activity and movement—the opposite of what I am doing as I start my seventh Zoom meeting of the day.  

Along with the majority of Americans, I am sitting more and moving less during the pandemic. In fact, physical activity levels are down around 32% in a nation where only 23% of us met recommended guidelines for both aerobic and strength training activities before the pandemic. Shockingly, but somehow not surprisingly, 61% of Americans report experiencing undesired weight gain—29 pounds on average—during the pandemic.

The fitness professionals leading those classes outside my window provide an outstanding case study in the value of adaptability and sheer determination to get people moving. 

During the early stages of the pandemic, their studios were closed. Later on, capacity limits were too constraining, and their studios were too small and poorly ventilated to hold their classes indoors. Therefore, they needed to come up with an innovative solution to keep their businesses open. They worked with our city government to secure permits—at an affordable price—to move their classes to an outdoor public park that was accessible to all community residents.

This is not the only example of fitness professionals successfully securing permits or shared use agreements from their local governments. There are success stories from San Diego, Long Beach, Washington, DC, Austin and Boston. However, these stories are too few and far between.  

Our attention over the past year has been almost single-mindedly focused on an infectious disease, yet beneath the COVID-19 pandemic that raged lay the dual epidemics of physical inactivity and obesity that helped fuel it. People with obesity have more than double the risk for hospitalization from COVID-19 and a nearly 50% higher risk of death. The odds of death are 2.5 times greater for people who are consistently physically inactive, compared with people who consistently meet recommended guidelines, and physical inactivity was found to be the strongest modifiable risk factor for severe COVID-19.

Qualified, credentialed fitness professionals have an important role to play in getting people moving. We have worked hard to gain the expertise to provide safe, structured physical activity programming for different types of populations. We are true believers in the mental and health benefits of physical activity and are trained in helping others change their behavior to experience these benefits.  

The American Council on Exercise has launched a grassroots campaign—Moving Together Outside—to support qualified fitness professionals in their efforts to get people moving by expanding access to community spaces. I see it as a win-win-win. For fitness professionals, seeking ways to work with students and clients outdoors during and after the pandemic. For municipalities, seeking safe and affordable physical activity options to offer to residents. For community residents, seeking opportunities for social connection and movement.  

I am proud to be the national spokesperson for the Moving Together Outdoors Campaign. I invite my fellow fitness professionals to become a campaign supporter at advocacy@acefitness.org. Let’s help good ideas spread, so the daily physical activity classes that I hear from the park next to my home are sounds heard daily from parks across the nation.   

Dr. Amy Bantham, DrPH, MS, MPP, is the CEO/Founder of Move to Live More, a research and consulting firm addressing physical inactivity, chronic disease and social determinants of health through cross-sector collaboration and innovation. A certified health and wellness coach, personal trainer, and group exercise instructor, Amy holds a Doctor of Public Health from the Harvard School of Public Health. She can be reached at movetolivemore.com or @MovetoLiveMore

References

• American Psychological Association. Stress in America: One Year Later, a New Wave of Pandemic Health Concerns. 
• Meyer, J., McDowell, C., Lansing, J., Brower, C., Smith, L., Tully, M. & Herring, M. (2020). Changes in physical activity and sedentary behaviour due to the COVID-19 outbreak and associations with mental health in 3,052 US adults. 
• Popkin, B. M., Du, S., Green, W. D., Beck, M. A., Algaith, T., Herbst, C. H., … & Shekar, M. (2020). Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships. Obesity Reviews.
• Sallis, R., Young, D. R., Tartof, S. Y., Sallis, J. F., Sall, J., Li, Q., … & Cohen, D. A. (2021). Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British journal of sports medicine.
• U.S. Department of Health and Human Services. (2018a). 2018 Physical activity guidelines advisory committee scientific report. 

MedFit Classroom (through the MedFit Education Foundation) continues to expand education and specializations for Fitness professionals. However, simply earning a certification does not mean clients will flock to you, or that doctors/therapists will refer their post-medical/rehabilitation patients to you. Most trainers today working with these types of clients did not look for these clients and fewer were referred to them by a medical professional.

However, many trainers fall in love working with these clients, whether they are a stroke survivor, had a knee replacement, or other physical complications. So, how do you find and attract new clients in this growing niche? 

Researching Medical Fitness

I interviewed Brian White, an MBA student at the University of Colorado, a transitioning military veteran, and an expert in messaging and analysis of popular media. After studying the post-medical rehabilitation and personal training industry, Brian had several takeaways focusing on education — of both the medical community and the fitness community, standards, and networking.

Brian observed that in a survey of physicians, only “17% of the respondents have a formal alliance for stimulating activity with an exercise provider.” (Leemrijse, 2015)  In other words, few physicians have a professional relationship with a personal trainer who they would then refer patients to, after completing physical therapy.  Additionally, the main reason for low collaboration was that they did not know any qualified fitness professionals and so could not inform their patients of exercise options, outside of the medical system.

The global problem of standards

Further, lack of collaboration between medical providers and fitness professionals was not only a problem of ignorance but also a lack of trust for an industry that has few standards. According to Brian’s research, there is a general lack of credibility “of the medical fitness professionals within the healthcare community” and a need for “better prepare[d] medical fitness professionals for practical application, further education, [and] potential elevating to graduate-level coursework [which] should be implemented to support prevalent chronic conditions.” (White, 2021)

Anyone can use the term personal trainer, legally — whether certified or not. A 2017 fitlegally.com article exposed how in the USA, regulation of the industry is state-by-state and no federal statute concerning who can be a personal trainer, what their education must be, or how they may practice. In Australia, only validly certified personal trainers can get mandated insurance. Brazil demands a bachelor’s minimum education. (Rabe, 2017)

The point is this: medical fitness professionals must be educated on the fitness needs of their clients.  Courses provided by MedFit help ensure that personal trainers have the specialized knowledge to make a world of difference for a client such as a stroke survivor, after physical therapy. Beyond that, medical professionals, as well as potential clients, must have a dependable source of knowledgeable, experienced fitness professionals who can be trusted to address the needs of the client.  Long term, legislation along with education from organizations like MedFit could help to build awareness, validation, and could help to provide a pool of knowledgeable and trustworthy fitness professionals.

MedFit Education Foundation standing in the breach

In the meantime, professional organizations can bridge the gap for personal trainers. MedFit’s board of directors has stacked their medical and education advisory boards with highly qualified experts. Thus, fitness professionals can be confident they are receiving courses with quality content and validation from recognized medical and fitness professionals.  

Furthermore, MedFit is advocating for fitness professionals by actively networking with the medical community and sharing with them information about the organization’s courses and the caliber of professionals taking their courses. MedFit is effectively building the post-medical fitness market.

Building medical fitness

Strategy #1
Besides online marketing, Brian has advice on how to build your own medical fitness network and allow clients to find you.  

Reaching out to introduce yourself to medical/rehabilitation providers is tried and true. You might ask if you could drop a packet off describing your services. You could ask if they would let you put your brochures in their waiting room or add your cards to their business cardholder. A simple one-page flyer about the specific disorder you are educated to help with (i.e. MedFit’s Stroke Recovery Fitness Specialist), will help them have confidence in you and be a ready resource at their fingertips. Speaking directly to a Physical Therapist is likely to be even more successful. 

If you choose the cold outreach method be prepared to face a lot of rejection. 

Strategy #2
Patient support groups and organizations also offer wonderful contacts. In Colorado, for example, there is a Stroke Advisory Board and dozens of support groups that can be found online (https://www.strokecolorado.org/co-stroke-support-group-list). These lists represent opportunities to speak directly with stroke survivors and allied health professionals, who have direct contact with both providers and clients.

Strategy #3
The personal trainer turned marketing guru, Joe Lemon, advises learning about content-based networking. This technique is creating mutual content with people who can influence your market, like potential referring doctors and therapists. This is proving to be one of the most effective strategies for personal trainers to build trust and community with medical professionals. In fact, this can help the private fitness professional boost awareness for their business and drive down client acquisition costs. By collaborating on content, build strategic partnerships with a win-win mindset and allows personal trainers to demonstrate their level of fitness expertise and commitment to their craft.  (Lemon, 2021)

Keep in mind, your network cannot grow unless someone acts—take action and do not overthink it.  

In conclusion, working with special populations like stroke survivors or joint replacement clients is extremely rewarding and very necessary.  Work is still needed to bring awareness to the availability of quality, safe, and effective training provided by educated professionals.  But the payoff for both fitness specialists and clients is great and with MedFit support and education, the possibilities are exciting.  Together, we can change the face of post-medical fitness.

Dr. Grove Higgins is a chiropractor, rehabilitationist, soft tissue injury expert, researcher, anatomy instructor, biomechanist, human performance expert, speaker, and corporate health consultant. In 2015, Dr. Higgins cofounded Neuroathlete with Coach Patrick Marques (LTC, US Army Ret.) and Peter Hoversten. Neuroathlete’s goal is to more broadly deliver neurological training to a global audience.

References

Leemrijse, C. d. (2015). Collaboration of general practitioners and exercise providers in promotion of physical activity, a written survey among general practitioners. BMC Family Practice, 16(1), p1-9.

Lemon, J. (2021, April 5). https://anchor.fm/sales. (G. Higgins, Interviewer)

Rabe, A. (2017, September 5). Do fitness professionals legally need to be certified? (US, Australia, Canada, UK & Brazil). Retrieved from Fit Legally: https://fitlegally.com/2332-2/

White, B. (2021, 4 2). “Untitled”. Monument, CO, USA: Brian White.