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Physical therapist gesturing thumbs up besides senior woman on yoga ball

Medical Fitness – A Win for Professional and Patient

Medical Fitness is a growing trend in health care. Medical Fitness helps extend basic healthcare from the classic and formal model of a person being a patient, receiving treatment and being discharged entirely, to after care professional services. Medical Fitness is the integration of ongoing fitness, wellness and preventive care under the supervision of health professionals such as, physical therapists, exercise physiologists, personal trainers, nutritionists, acupuncturists, chiropractors, massage therapists, mental health practitioners, health and wellness coaches, yoga professionals and more.

Physical therapist gesturing thumbs up besides senior woman on yoga ballMedical Fitness is appropriate for many types of conditions such as arthritis, diabetes, orthopedic conditions, pre and post natal, heart disease, fibromyalgia, stroke, cancer, mental disorders,  and others. When properly implemented, Medical Fitness is a win-win for both patient and health professional.

Medical Fitness Advantages for the Patient

First, after discharge from the formal healthcare world, the patient can be referred to a variety of health professionals educated in the patient’s condition, providing both a continuum of care and a multi-discipline approach. For example, a person discharged from physical therapy after a total knee replacement might be referred to a certified personal trainer facility educated in post-rehabilitation of a total knee to continue to make further functional gains and improvements. If that person needed help with weight loss, perhaps a referral to a nutritionist would be included. If they also had issues with coping with their diminished function, a consult with a specialist in mental health might be provided as well.

Second, many times the medical facility in which care was provided will have a Medical Fitness component associated with it. Direct referral to this type of facility can provide the patient with security and confidence, being familiar with the facility and with the knowledge that the new health professional is familiar with their condition and diagnosis.

Medical Fitness Advantages for the Health Professional

First, by being part of a Medical Fitness community the health professional can refer a discharged patient for follow up care, secure in the knowledge that their patient will be cared for by an ancillary care professional who is trained and certified to provide a proper continuity of care plan along with the appropriate goals and treatments.

senior man with trainerSecond, by referring to a Medical Fitness multi-discipline team, the health professional receives security that if their patient has any other issues, those concerns will be addressed. For instance with the example of the total knee replacement patient needing assistance with weight loss or nutrition consults, (treatments that don’t fall under the umbrella of physical therapy), the physical therapist is assured their patient will be helped to achieve a better transition back into their “non patient” status.

Third, when the health professional refers their patient into a Medical Fitness wellness and preventative care environment, the chance for overall improved outcomes is increased. Patients learn better self-confidence in caring for themselves, taking charge of their own health and lifestyle. If a patient’s condition begins to backslide, the wellness program professionals can help make sure the patient gets referred back to the health professional in a timely manner.

In conclusion, Medical Fitness benefits all involved. Quality of care is improved. Patients receive access to multi- discipline care and can learn to take charge of their life. Health professionals receive security of proper continuity of care and gain improved patient outcomes.


Douglas Feick, PT is a licensed physical therapist in Texas, with emphasis in orthopedics for over 15 years. He is President of BioEx Systems Inc, a software company providing software solutions for physical therapists, athletic trainers, chiropractors, dietitians and personal trainers. His hobbies include scuba diving, raising bees and he is an avid skydiver.

Female-Trainer-and-older-male-client

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 . . .

doctor-and-senior-woman-patient

Opening a Closed Door: How to Gain Access to the Medical Suite

Your passion is to help people maintain or regain optimal health and fitness. Under current law and standards, you are only permitted to work with clients who are already fit and healthy or have been released for independent exercise and have passed your health screening questionnaire. But those are not the people you yearn to work with. The clients you seek must have authorization or approval from a medical provider before you can proceed.

How often have you met with a potential new client, asked them to get clearance from their doctor and then never seen them again? Or, a client develops a new pain or problem and you refer them for consultation and that ends the relationship. Another frequent scenario: Your client has followed through with your request only to be referred by their primary care provider for a cardiac treadmill test, but your concern about their low back pain or shoulder dysfunction was not addressed. Success as a medical fitness professional is dependent upon working relationships with medical professionals. In order to establish those relationships, the aspiring medical fitness trainer needs better understanding of the medical system. What follows are a few insights into the medical system that medical fitness professionals need to understand.

Recognize how busy the medical practitioner might be

“Estimates suggest that a primary care physician would spend 21.7 hours per day to provide all recommended acute, chronic, and preventive care for a panel of 2,500 patients.”1[i]. Today, the average primary care provider is responsible for roughly 2,300 patients, so not quite 21.7 hours of work/day, but more than any individual can possibly provide.

In order to cope with the workload, doctors must rely on their support staff to help whenever possible. Do not be alarmed or offended if your inquiries are met by a nurse or medical assistant. Most providers simply do not have the time to meet with you for introduction or discussion. On the flip side, most doctors would love to have effective, safe and reliable resources for their patients who need to lose weight, get fit, manage diabetes, recover from surgery or cancer treatment etc. They need you.

Understand the current reimbursement rules

In most cases providers cannot bill for services unless the patient is in the room with them. Therefore, time spent talking on the telephone, responding to emails, or filling-out forms is usually unreimbursed time. This means that your client will probably need to actually make an appointment to be assessed and cleared for exercising with you. To streamline the process, send a letter with your client introducing yourself and what you do. Include a form stating your concerns and your proposed training plan. Design the form to be easy to read, with a simple agree or disagree that can be checked or circled and space for the provider’s signature. You might also want to leave room for comments and questions. If you have received a response from a provider, you should consider sending intermittent progress reports updating the provider about your mutual client/patient.

Be familiar with HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 to protect an individual’s medical confidentiality, particularly when changing jobs which at that time meant changing health insurance providers. Unfortunately, the law is complicated and places multiple restrictions on who members of a medical team can talk to about a patient’s medical condition.

As an unlicensed party, the fitness professional is not privy to “protected health information” (PHI) without direct written consent from the patient (your client). Due to these restrictions, the medical providers cannot fill-out or respond to your request for information or clearance without your client’s “written” consent. If the client takes the form and returns it to you, this action implies they have agreed to share the information. If you send the form directly to the provider, that permission has not been granted unless the client has signed a HIPAA release form allowing the doctor to share personal health information with you personally.

The aforementioned are a few reasons why you may have perceived a wall or barrier between you and medical providers. One solution is to ask your client if you might accompany him or her to the appointment to obtain medical clearance or guidance. That way the medical provider would have a specified time and be reimbursed for addressing your concerns. You would be communicating directly with the medical provider and not support staff, and it would be easiest for the client/patient. It is also a way to introduce yourself to the medical provider and initiate a working relationship. Although you will probably not be compensated, it may be well worth your time in the long run.

Once you have made it into the office with your client, now what?

Know your details

Because there are so many different avenues to becoming certified as a personal trainer, there can be large differences in the knowledge base and competence of one trainer compared to another. The aspiring medical fitness professional must have a thorough understanding of the pathophysiology of the conditions they will be working with in order to communicate effectively with medical providers. In addition, you need skill and experience in the programs you design and utilize with your clients. Be able to back up your training plans with published research.

Recognize that a medical fitness professional has a fund of knowledge that the medical provider does not have

Exercise science is not covered in medical school curricula. Medical school is about illness and disease not health and fitness. Generally speaking, the average MD knows very little about exercise science. Most do not know about the effects of eccentric versus concentric loading, how to train for endurance versus strength, what to do to improve stability, balance and core strength. Fitness professionals are not inferior to medical professionals; you have a different knowledge base. Recognize and believe that you have something to offer. You may not know all of the anatomy and biochemistry that the doctor does, but you have a basic understanding of your client’s condition and you know the potential benefits of your interventions. Share this information with the medical providers.

Stay within your scope of practice

Because personal trainers and medical fitness professionals are not licensed by any governmental or legal agency, and because laws vary from state to state, there is no clear definition of the skills and competencies of a medical fitness professional. Working outside of your scope of practice can lead to civil and even criminal penalties[ii]. Therefore, for the time being, if you want to work with clients struggling to manage chronic illnesses, recover fully from injuries or surgeries, etc., you need to work under the wing of medical professionals who have prescriptive authority – those professionals in the medical field licensed to diagnose problems and prescribe treatment.

Dr Robert Butler MD, founder of the National Institute on Aging once said: “If exercise could be packaged in a pill, it would be the single most widely prescribed and beneficial medicine in the nation.” There are pockets here and there in the US where medical providers and fitness professionals work together. In many cases there is a visionary medical provider at the helm of an interdisciplinary team. In other cases, fitness professionals have worked hard to become part of a medical delivery model.[iii] The more medical fitness professionals that can take the leap and align themselves with medical providers, the more people will be helped.

This article was featured in MedFit Professional Magazine Winter 2020 issue. Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Mary Hoagland-Scher,MD is a board-certified family physician who practiced medicine for 30 years. When she entered medical school, her goal was to help people stay healthy. As the focus of western medicine shifted away from health to disease management with a strong emphasis on pharmaceutical and or surgical intervention, she became uneasy with her role and decided to discard her prescription pad and learn new tools. Now as a NASM Certified Personal Trainer she is working to shrink the gap between fitness and medicine.

References

  • [i] Estimating a Reasonable Patient Panel Size for Primary Care Physicians With Team-Based Task Delegation Justin Altschuler, MD, David Margolius, MD, Thomas Bodenheimer, MD and Kevin Grumbach, MD Ann Fam Med September/October 2012 vol. 10 no. 5 39
  • [ii] For an excellent discussion of this issue, see: Abbott, Anthony Ed.D, FACSM, FNSCA. Scope of Practice, ASCM Health and Fitness Journal ,Sept/Oct 2018, Vol 22 Issue 5 pp 51-55
  • [iii] Watch MedFit TV webinar by David Rachal III, “Exercise Prescription: Integrating Services with Medical Professionals and Insurance Providers”
med-fit-client-doctor-exercise

Healthcare Through Fitness

A discussion of medical fitness is rooted in an understanding of the health benefits of fitness and exercise. The documented benefits are endless and include management of chronic disease, management and prevention of osteoporosis, improved mood and sleep disorders, stress relief, management and prevention of obesity.

Health agencies across the spectrum of public health and disease-specific organizations recognize and promote exercise and fitness as an integral part of the management of chronic disease; diseases that include diabetes, cardiovascular disease, Parkinson’s, depression, multiple sclerosis, and arthritis, among others.

If fitness and exercise are well accepted as part of the management strategy for multiple diseases, why is it that access to organized exercise plans, and fitness professionals who can help implement those plans, are not a standard part of the medical treatment paradigm? Why is it not a standard benefit covered by common medical insurance policies?

The reasons are multifactorial and a reflection of the overall healthcare conundrum in our country today. Let’s focus, however, on how to make a change. We need to focus on how to integrate fitness professionals into the medical paradigm. A perfect model for this is an integrative medical fitness center.

What is a medical fitness center? It is a fitness facility with a multidisciplinary staffing approach and has the following characteristics:

  • Regular medical oversight by a medical director
  • Practitioners with nationally-recognized certifications and training in the care of chronic disease
  • Comprehensive health assessments and exercise prescription
  • Exercise classes geared toward specific medical conditions

These centers bring together credentialed staff in a collaborative way to provide exercise prescription plans specific to the needs of an individual with chronic disease.

The concept of the medical fitness center is not new; many currently exist in communities throughout the United States. However, an understanding of their importance in the context of the current healthcare environment has grown. The idea of creating “medical homes” that are collaborative across disciplines and provide a comprehensive healthcare approach is now being recognized to provide a high standard of care while simultaneously decreasing overall healthcare costs. This is true specifically for high-risk individuals who suffer from chronic disease.

Further integration of medical fitness centers, and broad access to exercise and fitness resources, will hopefully become standard of care and widely accessible to all individuals, especially those with chronic disease. This integration will inherently bring fitness professionals into the paradigm of healthcare and promote healthcare through fitness.

This article was featured in MedFit Professional Magazine fall 2019 issue.

Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. David Kruse attended medical school at UC San Diego, after graduating from UC Berkeley. He holds board certifications in family and sports medicine. He practices sports medicine with the Orthopaedic Specialty Institute, in Orange, CA. Dr. Kruse is the Chief Medical Officer for the MedFit Network and on the Medical Advisory Board for the MedFit Education Foundation. He is currently a Team Physician for USA Gymnastics, Orange County Soccer Club, and Biola University. Visit his website, krusesportsmd.com

puzzle-collaboration

The Power of Collaboration in the Quest for Cure

Let’s start with four statements I’m willing to call facts:
1. Chronic disease afflicts the majority of American adults over the age of 45.
2. People with chronic disease choose a visit with an allopathic physician (conventional medicine) as their first course of action.
3. A pharmaceutical prescription is the first course of action after linking symptoms and biomarkers to a commonly diagnosed disease (type 2 diabetes, hypothyroidism, hypertension, hypercholesterolemia, etc.).

Prescription for good health diet and exercise flat lay overhead with copyspace.

Medical & Fitness Integration… a HEALTH-E-FIT!

Year after year, the IHRSA Trend Report continues to state that there will be an increase of trillions of spending cost in healthcare spending, with aging Baby Boomers contributing heavily to the total over the next decade. At least 50% of adults between 50-64 years of age live with at least one chronic condition. More than 44% of US consumers take at least one prescription medication daily, and the 50+ age group accounts for nearly 3/4 of spending on prescription drugs. The most commonly prescribed drugs for 40- to 60-year-old adults are for high cholesterol, gastrointestinal disorders, diabetes and hypertension.

As more individuals who actively participate in the US healthcare system seek solutions, the more we need to do for positioning our programs and facilities to address their non-traditional needs. As with any other business, we must change, modify and refocus our service delivery system as our client profile and the associated service needs change.

In April 2017, I made the decision to solely focus on developing a Medical Fitness Service to champion the Exercise is Medicine® (EIM) initiative through HEALTHEFIT. Despite being created in 2007, EIM remains an untapped service that has not only been ignored by fitness professionals but also by healthcare as well. Exercise is Medicine®, a global health initiative managed by the American College of Sports Medicine (ACSM), encourages primary care physicians and other health care providers to include physical activity when designing treatment plans and to refer patients to evidence-based exercise programs and qualified exercise professionals, especially those with the Exercise is Medicine credential.

In reviewing the multiple areas that we could contribute positive health outcomes, we decided to focus on the following:

1. Orthopedic Pathology

  • Acute Low Back Pain, Low Back Pain and Sciatica, Shoulder Impingement Syndrome, Rotator Cuff Pathology, Hip Replacement, Full Knee Replacement, ACL, Meniscus Pathology, Patella-Femoral Syndrome, Osteoporosis

2. Cardiovascular Disease

  • Hypertension, Coronary Artery Disease, Peripheral Vascular Disease, Alular Heart Disease

3. Pulmonary Disease

  • Chronic Obstructive Pulmonary Disease [COPD], Asthma, Bronchitis, Emphysema

4. Metabolic Disease

  • Diabetes Mellitus, Obesity, Blood Lipid Disorders

HEALTHEFIT’s medical fitness services incorporate a Triangle Treatment Protocol® including: EIM, DNA based nutrition, and Behavioral Medicine. Depending on an individual’s employer benefits plans and/or health insurance, either all or part of these medically directed services can potentially be reimbursable. Creditability is very important to the medical industry therefore we had to ensure that we differentiate our staff from the everyday personal trainer.

While credentials are indeed important, the ability to translate this knowledge into patient specific program design and treatment progression processes is the real professional test. Our medical fitness providers are fitness professionals who have a comprehensive knowledge of special populations. I have been able to create a new professional that is gaining the trust of physicians and health insurance. Our recruiting, orientation, and onboarding process has been the difference in separating HEALTHEFIT from other programs and gaining acceptance with Virginia Premier as their exclusive in-network medical fitness provider and out-of-network
status with Anthem and Cigna.

Want to learn more? Join David for his upcoming MedFit webinar on this topic:


David Rachal III is the founder and CEO of HEALTH-E-FIT, a medical fitness based facility in Chester, VA, where he’s created a scalable system that engages, educates, and empowers physicians and medical fitness providers to work together. His facility uses exercise and nutrition as medicine making prevention, treatment, and long-term management accessible for all. David’s contributions to the fitness industry also include training hundreds of private clients to success and educating over 1,000 trainers in the past eight years as a Fitness Presenter and Certification Specialist with nationally recognized organizations. David holds an MBA with a focus in Healthcare Management. He holds many specialty training certifications, including the ACSM ‘Exercise is Medicine’ credential, the FMS Functional Movement Specialist, and NSCA Tactical Strength and Conditioning Facilitator.

doctor-health

Adaptive Health Paradigm: A Principle-Centered Perspective for Medical Fitness

I hope to give you some insights to both how the human body works as well as why medically-based fitness is not only valid, but absolutely necessary to reverse, assist, or prevent various chronic and acute disease conditions.  Wow, that is a “mouthful” to say the least. I feel so strongly about this perspective that I hope to create the Adaptive Health Model as a major “brand” of fitness. My company (Principle-Centered Health) for the past couple of decades has always had a systems-based approach to health and fitness. This approach ties a lot of different facts into a common theme, usually called a theory in science. Even my dissertation looked at how people adapted to the physical, mental and social issues in their lives using exercise, self-efficacy, and social support, respectively, and levels of strain and burnout. How humans adapt to the stresses put on them is very specific and can go in good or bad directions.

What is the Adaptive Health Paradigm?

Like most theories, paradigms or what people consider “original thought”, this “adaptive” paradigm builds on the “regenerative medicine” framework, and some disease models; thus, is not original at all. What may be new, or unique about the adaptive perspective is taking the old phrase from physicist Isaac Newton and his third law of motion, “for every action there is an equal and opposite reaction.” The body will respond to stresses by reacting in a “defensive” manner. If we break something down, the body builds it up (opposite reaction). If we are too low or too high in some function, the body will try to correct this. This negative feedback loop controls most systems in our bodies. I have often described our bodies as fragile but resilient. It is our fragility that signals the resilience to kick into gear!

Luckily for us, fitness is based on this exact principle. If we do endurance training, we are going into a lower oxygen state and there are many mechanisms or functions that kick in (sympathetic nervous system) when we push or stress our bodies. The body is responding to what is known as an “acute insult” by increasing the ability to transport and use oxygen, so that this “insult” doesn’t hurt us next time. The same “specificity of training principle” occurs with resistance training. We breakdown muscle and the body builds it back stronger to tolerate that “insult” the next time. When multiple acute exercise stresses are added up, the body changes and we call this “training”.

If stresses are really high, either too intense, too long, or too often, the body gets injured due to this overload, or it needs a lot more time to heal back up. This is why overload needs to be done gradually and progressively. Even our brains use this idea as a guiding principle. We push our mental capacities to learn more, but if we stress it too much, it will repress memories or shut down (burnout).

This same principle applies when we give our body bad things, or a lack of good things, it adapts with a dysfunctional state or disease state. Chronic inflammatory diseases, diabetes, metabolic syndrome, coronary artery disease, emphysema and heart disease are just a few of the examples of how the “garbage in and garbage out”, or “use it or lose it” works. If we sit and work at the computer too much we develop dysfunctional postures and upper cross syndrome may develop. If we do not constantly stress some system, it reverses the training changes, and goes into the “default” state, which is untrained and unable to respond to daily stresses. We simply need to obey our bodily blueprints, we need to constantly use our bodies to maintain function, and overload it to improve function. We need to have the right nutrients in place to allow this to happen, and then basically – get out of the way!

Intelligence in the Body – Applications the Adaptive Health Paradigm

The perspective being proposed in this article shares much with the more holistic medical practices. The human body is really good at healing itself when is it given the right factors to do so, and when we “get out of the way” for it to do so. I know many people who strongly believe in using alkaline water to “cure their ills”. They believe that the body does not know how to regulate itself with its own pH.  Most of these same people don’t know what pH even stands for! They don’t know that it is actually the inverse log of the hydrogen ion concentration relative to the hydroxide ions, and that the respiratory system and renal system will go into action as soon as blood pH goes 0.05 pH units high or low!

In other words, these people believe their own bodies are naïve or incapable of curing itself, and like a young child or baby, their body needs constant care and guidance. Most people are so stressed about “taking care” of their bodies that they are doing more harm than good via the stress hormones, especially cortisol being constantly secreted and their adrenal gland is getting fatigued. In reality, the body is really good at healing itself, when we keep it strong and in good operating condition (via exercise and movement) and when we give it the right components to do the healing (via nutrition), and we get out of the way of the immune system (by managing our daily stress levels).

The mind works very much like a muscle. It must be trained and kept strong and when injured it will react in dysfunctional ways, and fight to protect itself. I recently heard an expert in human behavior change speak on how to keep a resolution. He said, we can’t keep a resolution without changing the underlying behaviors which caused the bad habit or lack of a good habit in the first place. By changing the way we think, we change the way we act, and changing our actions will change the way we think!

“What goes Around, Comes Around”

The quote often stated by Thomas Edison in 1903, which was to give rise to the HMO concept, “The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease.” Medical doctors (M.D.s) upon completing medical school and prior to practicing take the Hippocratic Oath, which is to do no harm. Even back in Ancient Rome, Hippocrates understood the importance of individualized medicine and the power to “get out of the way” (#5) and give the body what it needs to take care of itself. He had five rules that are still relevant in today’s medical practices.

  1. Walking Is Man’s Best Medicine.
  2. Know What Person the Disease Has Rather Than What Disease the Person Has.
  3. Let Food Be Thy Medicine.
  4. Everything in Moderation.
  5. To Do Nothing Is Also a Good Remedy.

Integrative and Functional Medicine – Highly Inclusive and Holistic Perspectives

A philosophy of practice using these practices is integrative medicine. A brand of medicine created or at least popularized by Andrew Weil. The University of Arizona has this “brand” of medical school. Again, the academic requirements are similar to the M.D. and D.O. but expands its scope to other areas. From the website, Integrative Medicine (IM) is defined as a “healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies. many different ways in the patient.
A new type of medicine is emerging from this Functional perspective which is called personalized medicine. Again, the two are basically two sides of the same coin.

Figure 1: A diagram above showing the greater scope of each medical perspective- Integrative and Functional medicines are close in their holistic perspectives, with differing points of emphasis


What is going on within the individual to cause the disease or prolong its existence?

Sometimes disease hits simply because we were genetically predisposed to get it. However, very often if our system is strong and in good operating condition, we resist it from every occurring or overcome it quite quickly. Cancer is a prime example of this. We all have cancers in our bodies all the time. It is the strong immune system that fights it off. This is amongst the reasons that many, many chronic diseases hit us when we are old. The various system have lost their capacity to fight the dysfunction off, or recover from its destruction. Soon cell death (necrosis or apoptosis) or neoplastic (cancer) growth kicks in.

Harnessing the Power of Exercise and Diet to Fight Chronic Disease

Many, many chronic conditions that the MedFit Education Foundation/MedFit Network addresses are helped by exercise and diet because the ability of body to adapt and regenerate itself is enhanced. Most systems in our body fall under the “use it or lose it” scenario. High sugar, alcohol, smoking, and lack of movement are culprits in our health. Our body is not designed for an overload of these factors and across time, many different symptoms will develop because our body can no longer compensate or regenerate.

It is important for the medical fitness professional to understand the power of exercise and nutrition, and the proper application of these tools given the client’s or patient’s current condition. The field of physical therapy developed because many musculoskeletal conditions are helped by movement therapy or exercise. Many chiropractors believe that proper spinal alignment delivers proper neural signals throughout the body, which allows the body to optimize its regenerative capacity.  Thus, an expert in medical uses of exercise to combat disease is critical to a healthcare team.

Join Dr. Mark Kelly at the Medical Fitness Tour in Irvine, CA! Dr. Kelly will be a presenter for the Aging Stronger pre-conference workshop on Friday, February 8, and the session Using Exercise and Diet to Fight Alzheimer’s during the main conference on Sunday, February 10. Click for Event Details


Dr. Mark Kelly Ph.D., CSCS, FAS, CPT has been actively involved in the fitness industry spanning 30 years as a teacher of exercise physiology at academic institutions such as California State University, Fullerton, Louisiana State University, Health Science Center, Tulane University and Biola. He was an exercise physiologist for the American Council on Exercise, a corporate wellness director, boot camp company owner and master fitness trainer.

References

Center for Integrative Medicine, Univ. of Arizona (n.d.). What is IM/IH? Retrieved from: https://integrativemedicine.arizona.edu/about/definition.html

Science Daily (n.d.). Personalized medicine. Retrieved from: https://www.sciencedaily.com/terms/personalized_medicine.htm

Good Reads (n.d.). Retreived from: https://www.goodreads.com/quotes/13639-the-doctor-of-the-future-will-give-no-medication-but

Kalish, N. (2018). Hippocrates’ Diet and Health Rules Everyone Should Follow. Reader’s Digest. Retrieved from: https://www.rd.com/health/wellness/hippocrates-diet/

heart-stethoscope

Aligning with Medicine

I’ve been to the mountain. Yes, I’ve been in the world of medicine. I’ve run my programs in hospitals, collaborated with physicians to address chronic disease, and spoken at medical conferences on topics ranging from “emotion and the patient” to “the healing powers of synergy.”

Between you and me, I’ve been to nicer mountains. While I have nothing but praise for doctors, when we lift up the medical curtain, the overall system, the collective mindset, and the impotence of the treatment of chronic disease provide an open door. For who? For fitness professionals, and I say that with qualification.

The challenge in great part is a naivete. Our “industry” is not well versed in the living dynamics between medical institutions, health insurance, and pharmaceuticals, so these lobbying giants are viewed by personal trainers as purely corrupt, as the evils that plague our population. Yet, when the mirror of honesty is confronted, the limitations of conventional exercise and eating are not by any means the panacea trainers profess them to be in the midst of a population struggling with health compromise.

YES, THERE’S AN OPPORTUNITY BUT . . .

. . . it requires a re-education, an enhanced skill set.

Physical therapists are not thrilled with the idea of personal trainers working to address muscular imbalances and injury recovery. Nutritionists approach trainers who coach their clients nutritionally with caution. The trainer is not deemed a player on the Allied Health Care Team.

We therefore hear assertions from “trainer island” with limited foundation.

“Insurance should pay for our client sessions, after all, it pays for medical treatments that don’t work.” Wow, is that a slippery slope, one I wouldn’t approach if it showed up in my backyard and I was equipped with anti-slip cleats.

“Doctors should refer clients to us.” That is best responded to with a simple, “why?”

“Doctors don’t care about their patients.” There’s a globalized bias that fails to account for a system that makes “exploration of the client condition” one of the greatest challenges in the field, regardless of the physician’s heart.

* * * * * * The opportunity lies in humility, in a willingness to step up and learn, and in providing a true complement to the system that is flawed. It isn’t an “us or them,” but it also shouldn’t be a one way street of elusive referrals. It’s a recognition that we have the per-session time to invest. We can gain the trust of clients. We can see clients regularly and facilitate programs that require joint responsibility.

The most important piece of creating an industry wide recognition of the trainer’s power is perhaps the dismissal of ego, the acknowledgement that trainers deemed competent in prescribing safe and effective exercise, have not learned to address metabolic imbalance, hormonal disruption, and inflammatory issues that underlie the most common conditions.

It’s in the spirit of betterment that I’ve committed to learn and teach, to isolate practices fully within the trainer scope of practice that address the sources and causes of the plagues that impact 65% of our adult population. It’s time, not to urge doctors to respect trainers, but for trainers to create a legitimate platform of respect, one where chronic dis-ease is treated as a self-induced condition with patient / client empowerment as the greatest vehicle for true opportunity, as the vehicle for collaborative respect, a vehicle for the trainer to serve as a bona fide health catalyst.


Phil Kaplan has been a fitness leader and Personal Trainer for over 30 years having traveled the world sharing strategies for human betterment.  He has pioneered exercise and eating interventions documented as having consistent and massive impact in battling chronic disease.  His dual passion combines helping those who desire betterment and helping health professionals discover their potential.  Email him at phil@philkaplan.com