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The Medical Community doesn't get what we do

Originally Posted 09/24/09

The last blog on personal responsibility triggered a small debate concerning how we as an industry can induce a tighter bond between the fitness world and the medical community. We all dream of this partnership and the money it can provide, but there are huge barriers that are preventing this with both sides unable to solve the issues that could bring us together.

Paul Grymkowski, one of the legends in this business who was instrumental in building the Gold's gym brand into an international presence, asked in his response to my last blog how we can get both sides to understand and build a continuum of care that would benefit both the fitness world and the national health of this country.

First of all, the new generation of fitness professional is seeking a wellness solution for their members, which is something the chains have been unable or unwilling to go after in the clubs. This total fitness and wellness solution often contains total body functional training, nutrition guidance and weight management, supplement support, and other keys to a sustainable healthy lifestyle. Our weakness is that few clubs have all these components as part of their normal offering but that is changing, especially in the smaller clubs (3000-12,000 square feet) built upon the premise of providing a complete solution to living a healthier lifestyle.

On the other hand are the clubs that work against almost everything that is right for the client. These membership mills do nothing more than take membership money, turn numbers and rent equipment. Sadly, we are more known for these clubs in the industry instead of the ones trying to move us into this century.

In most clubs, if you actually get in shape walking on a treadmill by yourself a few nights a week after work it is more likely an act of God feeling sorry for your fat ass and lack of social life rather than a solid fitness program. The large majority of people left to their own devices do not understand fitness and simply push a few machines and spend an hour at a very slow pace walking on a tread and watching Oprah. You might feel a little better compared to sitting at home staring at a mind numbing television show but nothing is happening to that forty-pound bag of donuts hanging off your ass and there is definitely nothing happening that would excite a major health insurer enough to pay for you to be there.

But again, we know how to provide fitness today and many clubs are providing a complete solution although it is seldom sold that way to the members. We still do nothing more in most fitness facilities than push low intensity, self-directed activity to lose weight and manage health and don't offer any type of real health and wellness support. Most clubs shy away from this level of sophistication because they simply don't have the skilled personnel to provide this help and others fail the consumer because they are too cheap and can't charge for the service.

What all this means is that while we are weak at offering total support for a healthy lifestyle at many clubs there are a rising number of smaller facilities that would qualify for an insurance boost because they can track attendance, offer weight management, and talk about lifestyle changes that negate fitness in the real world and these clubs would be an ideal blend with the insurance world.

On the other side of the debate, medical people don't get fitness. I was recently diagnosed with a mild case of atrial fibrillation and then sent into the equivalent of medical purgatory, where I have been tested, probed, received three cardioversions, and put on medicine that was supposed to improve my health but did nothing more than make me want to lay under my desk and sleep. After almost a year of chasing rhythm my doctors have decided that maybe all that wasn't really necessary and maybe just an aspirin a day is all I really need.

I did, however, learn things along the journey. First of all, some of the fattest people, most out of shape people I have seen work in the largest cardio specialty clinic on Cape Cod. Out of the large number of staff wandering the halls supporting at least 10 doctors only three would qualify as in shape and the rest would fall into the Wal-Mart Saturday morning Little Debbie crowd. There is also a small percentage of the doctors that are in horrible shape, which you might consider ironic considering their specialty. Obviously most live in the world of "do as I say not as I do”.

The second more frightening thing is their willingness to just prescribe drugs to everyone they meet as patients and most of these drugs are things that they casually prescribe for the rest of your life. This shouldn't surprise me, however, since the calendars in the offices were all furnished by drug companies, the check out person was drinking coffee out of a large cup with the name of a drug on the side and many of the other charts and illustrations on most of the walls were proudly provided by drug companies who splashed their names prominently on each piece.

Lifetime drugs mean lifetime patients and while the doctors may not be thinking that way visiting their offices is sort of like going to a PGA event where the average player has about 7-8 different logos on his shirt. If you are displaying that many logos the perception is that someone must be paying you.
We discussed drugs often but we spent very little time on health and wellness. I was by far one of the youngest patients through their clinic, which is quite amazing at 56, but sadly every solution was a drug to take the rest of your life with a minimal discussion of what those drugs might do to you and the quality of your life.

My experience highlights why we will find it so difficult to build a bond between what we do and what the belief system of a doctor in our country is taught to do. Doctors don't understand fitness, few proscribe anything beyond walking a little and cutting back on whatever is considered bad food in the press, and lifestyle is vaguely discussed because if the doctor learns too much it might get in the way of presecribing the drugs.

In our world, we want to prevent illness. In their world, they only treat symptoms and most doctors don't seem to have the time to find out why things are going bad and how to change things further up the line that might be causing those symptoms.

Every insurance company in the country should be paying for a fitness membership, but how do you verify compliance? Every insurance company should be offering weight management help but no one can agree on what we should be eating or which diet we should be on although why we don't at least go after soft drinks, junk food and high fructose corn syrup is beyond my limited wisdom.

We should also build a new version of BMI and reward people who maintain a lower, healthier weight instead of telling a professional athlete that according to the current system he has an index of 30 and is obese though he is as healthy as he will ever be in his life.

We should be the first thing a doctor prescribes to any patient if we can live up to that responsibility by providing a solid product and support that really works. At this point, too few of us in the industry can provide the verification that fitness as practiced in this specific facility can make a difference in someone's life.

The good news is while not now then soon. The old dogs are dying and the new owners are rising and may they howl at the moon for the next ten years. Modern fitness works, is verifiable and there are owners who provide total support for a lifestyle change. Our time is coming but we have a little dead weight to get off our shoulders first.

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