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EXERCISE IS MEDICINE


If doctors can gain basic health coaching skills, they may better identify which patients are ready for a gym referral


about exercise, and whether to consider referring patients to a medical fitness club or a health club. We talk to doctors about introducing


Physical Activity Vital Signs – a system of asking patients how often in the past week they’ve done some moderate exercise, and for how long at a time. Finally, we teach them how to start to


influence behaviours by using coaching techniques like motivational interviewing. We’re not saying doctors should become health coaches, but if they can recognise a patient’s readiness to change, they’ll know the right time to refer them on to a fitness facility.


Q


What kind of reactions do you get from delegates?


We get all levels of response, right up to doctors saying: ‘I’m fed up with my usual practice, I’m stressed, my patients aren’t getting any better, how can I start my own lifestyle centre?’ But the majority – and this is where


the root of change will happen – say that, although they’re not going to radically change their practices, they will start asking everyone about exercise now However, we have a saying in


medicine: ‘Don’t take a temperature unless you want to treat a fever’. If


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you’ve determined people are inactive, you have to do something about it.


Q


That sounds like a cue for health clubs…


It is. The way doctors are getting paid in the US is shifting. Under the Affordable Care Act (‘Obamacare’), they’re going to be rewarded on the health outcomes of their patients [like QOF in the UK], and how they’re able to improve specific


person in the US costs US$1,500 more each year than an active one. Under this system, health clubs that


can reliably and credibly provide fitness to the full spectrum of patients will be sought out as valuable allies.


“Clubs that can reliably and credibly provide fitness to the full spectrum of patients will be sought as valuable allies”


metrics such as blood pressure and lipid levels. They’ll be paid in part based on patient health outcomes instead of just fee-for-service, which means they’re becoming more focused on keeping their patients healthy. There’s also a new and growing


category of sports and exercise medicine physicians who know a lot more about exercise than regular doctors, and they will naturally be looking for health clubs to partner with. Governments are also now much


more aware of the financial cost of inactivity. In healthcare terms, an inactive


Read Health Club Management online at healthclubmanagement.co.uk/digital


The Atlantic Coast Athletic Club in Charlottesville, Virginia, US. The owner started soliciting physicians in 2005 to get their patients to come into a ‘60-day, US$60’ programme. It’s been really successful and now he’s taking millions of dollars running a very popular Physician


Q Referral Exercise Programme (PREP). Q


How do you see the future?


We need to initiate a new paradigm for promoting health and wellness. We’ve seen a century-long experiment in the US of treating patients with episodic, procedure-orientated, sickness-based care. This ‘clinical trial’ has failed, causing disease, bankruptcy and death. To collectively leave a legacy and


change policy, we must change the environment. In future, if you see your doctor, you must talk about exercise. ●


September 2013 © Cybertrek 2013


Can you give an example of good practice?


© SHUTTERSTOCK.COM/ARTIST’S NAME/ROBERT KNESCHKE


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