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MEDICAL REFERRALS: Is Your Facility Linked to the Health-Care Community?

Harris, Amanda M.Ed.

doi: 10.1249/01.FIT.0000298452.47932.7d

LEARNING OBJECTIVE • Discover how developing your brand and creating strategic alliances within the medical community can transform your facility from "fitness facility" to "preferred treatment option."

Learn how your health and fitness facility can win the support of health care professionals and become the preferred "treatment option" of medical providers in your community.

Amanda Harris, M.Ed., is the vice president of fitness and wellness for ACAC Fitness & Wellness Centers. She has been in the fitness industry for 15 years as a group exercise instructor, personal trainer, and manager. She helped implement ACAC's Physician Referred Exercise Program (PREP) in 2004. The PREP program generated more than 600 new memberships for ACAC in 2006.

With obesity and chronic disease on the rise, physicians and other health-care providers encourage their patients to exercise and eat healthy foods. As a health and fitness professional, you are able to teach individuals how to incorporate health and nutrition principles into their daily routines, encouraging them to adopt healthier lifestyles. So why aren't medical professionals referring their patients to you?

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First, think about your facility's brand. When a physician thinks of your facility, what image comes to mind? Big sweaty body builders pumping iron? Thin ultrafit people running around in spandex? Or are there people of all ages, shapes, and sizes? The marketing image of your facility has a lot to do with whether a physician will consider referring a diabetic, hypertensive, overweight, or otherwise challenging patient to your facility. Images used on your company's postcards, promotional items, and TV commercials show to whom your business caters. If the images you use are always of young, thin, and fit people, a physician may not consider your environment to be the most appropriate for his or her patient.

Branding is accomplished by more than marketing, however. Offering programs and services that help people with conditions such as prenatal/postnatal, arthritis, multiple sclerosis, and other groups with specific needs helps identify your facility as a wellness center rather than just a "gym." If you want to offer programs for special populations, you will need to employ professionals who are trained to work with those populations. Another option is to provide training for your existing staff. The American College of Sports Medicine's (ACSM) Health/Fitness Instructor® credential and the American Council on Exercise's (ACE) Clinical Exercise Specialist credential are outstanding resources for fitness professionals who want to learn how to program for special populations. Specific organizations, such as the Arthritis Foundation, also offer training courses and specific guidelines on exercise programming.

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Many fitness and wellness centers struggle with physician referral programs because they expect physicians to advise their patients to purchase personal training sessions or enroll in a full facility membership. Health-care providers tend to be reluctant to recommend expensive treatment options to their patients. Is the cost of a personal training package or annual membership likely to be a stumbling block? One solution is to package your services in the form of a short-term wellness program that offers a sampling of what your facility has to offer. Create a clear and compelling description, so that physicians and patients know exactly what the program entails. Create structure and a high-touch environment that will enable the patient to experience some degree of success. This low-pressure cost-effective "treatment option" creates a natural progression into an annual membership and/or fee-based services, such as personal training, nutrition coaching, and therapeutic massage.

Photo courtesy of ACAC Fitness & Wellness Centers

Photo courtesy of ACAC Fitness & Wellness Centers

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Are you a good community partner? Becoming more involved in your local community is another way to raise public awareness of your organization's wellness mission. Most communities host walks, runs, or rides for a variety of important medical causes. Organizations like the American Heart Association, Arthritis Foundation, American Diabetes Association, National Multiple Sclerosis Society, and American Cancer Society enjoy partnering with health and wellness facilities for many annual events. Consider being a title sponsor, donating T-shirts, leading the warm-up, or, at least, raising a team to participate. You can even market these fundraisers in house to increase member awareness and recruit your members to participate in these events. Member involvement leads to more word-of-mouth advertising for your club within the community. In time, people will begin to see your facility as an organization that cares about the health and wellness of your community.

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Community involvement may be a natural segue into building relationships with local medical professionals. A great place to start is with your own membership base. Who among your members is a physician, nurse, or allied health-care provider? These members can be your strongest advocates. If they exercise in your facility regularly, they know your product well and can help you "sell" it to their friends and colleagues. If you don't already have a relationship with them, make it a point to build one. Find out how these professionals counsel their patients about lifestyle habits and physical activity. Do they actively promote exercise to their patients? Do they believe that your facility offers services that could benefit their patients? Acquiring feedback like this sets the stage for creating an advisory board, a step that can greatly impact your ability to attract physicians' patients.

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The Medical Fitness Association (MFA) urges facilities with medically integrated programs to create strategic alliances with health-care professionals. In fact, "Standard One/Medical Oversight" of the MFA's Medical Fitness Model: Facility Standards & Guidelines is to create a medical advisory board. Having a strong advisory board can bolster your facility's professional image and build credibility among area hospitals, physicians, and patients.

If you have begun to reach out to physicians and other allied health-care providers, you may be in a good position to recruit board members. The right professionals can provide valuable input on your facility's medical programming, marketing materials, and other initiatives geared toward influencing their patient populations. The key is to select individuals who have a sterling reputation for providing quality health care to their patients. These people should ultimately want to be a part of the board to help your facility offer programs and services that lead to better outcomes for their patients-not for monetary rewards, free memberships, or other forms of payment. This is a crucial point: physicians who insist on payment or free memberships may not provide the support you want or need. If you want to offer board members something for their commitment, consider waiting until the honeymoon is over. What does their commitment look like over the long haul? Are they still referring their patients to your programs and services 6 months later? A year later? Are they attending board meetings? Are they staying in touch? These factors should all be carefully weighed when considering offering reduced membership dues or other types of rewards to participating physicians.

Photo courtesy of ACAC Fitness & Wellness Centers

Photo courtesy of ACAC Fitness & Wellness Centers

So how do you motivate physicians to come to board meetings? Advisory board meetings should take place at least three times per year, but quarterly meetings may suit you better when you are starting out. It is important to remember that most physicians are short on time, and they see patients all day. For this reason, inviting board members to a nice dinner with their spouses is highly successful. In exchange for a little advice and brainstorming, board members get to enjoy a special night out. Now that pharmaceutical companies are unable to invite physicians' spouses to dinners, board members particularly appreciate events that include their significant others.

In addition to providing you with feedback about your program objectives and practices, these dinners allow you the opportunity to get to know board members personally. Building a relationship beyond casual conversations in your facility can be very useful when you need help on initiatives between board meetings.

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The best way to keep board members and other potential providers engaged in the referral process is to stay in regular contact. Consider hiring a 20-hour-per-week medical outreach coordinator who visits medical offices to distribute brochures, referral forms, and articles on health and exercise. Select materials that will interest the physician, his or her staff, or even the patients. The medical outreach coordinator should be outgoing, personable, and polite. It is important to remember that the physician's staff members, particularly nurses and receptionists, interface with the patients on a regular basis. Often, it is the nurse or receptionist who is responsible for faxing the referral to your facility, so it is in your best interest to build great relationships with the entire medical office staff. If you don't have the budget to hire a designated outreach person, look for someone in your facility who understands how to market and sell your wellness center by networking and building relationships. Be sure that they are armed with relevant information and that they stay abreast of current developments in health and fitness, wellness, and medical research. Even visiting medical offices just a few hours a week can help keep your facility's programs and services front of mind.

Success in generating medical referrals does not happen overnight. You must do more than simply offer a product or service that makes people healthier. Your facility must have the right brand image, provide a simple solution for patients, build relationships with health-care providers who can become advocates and advisors, and constantly work to remind those providers to refer their patients.

Your company's mission should encompass more than just fitness. You also must provide wellness solutions. We all know that there is no magic pill that can replicate the positive effects of exercise and good nutrition. Patients in medical offices need your facility's services more than anyone, and health-care providers are in the position to reach these individuals.

Make it easy for health-care providers to help patients connect the dots between their health needs and what your facility has to offer. Build a welcoming and nonintimidating brand image. Create or adopt specialized programs that are geared toward the medical populations you wish to recruit. Become a good community partner and show support for the groups you wish to serve. Build a medical advisory board of like-minded health-care professionals who can offer sound advice on building programs and services that their patients want to purchase. Finally, keep your facility on the doctors' radar by reaching out to them between board meetings and keeping them apprised of any developments in your medical programming. With persistence, you can reach the people who need your services the most while simultaneously creating a viable membership stream.

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Medical referral presents a unique opportunity for fitness and wellness facilities to gain access to potential new members. Even if your facility is not connected to a hospital, you can build a thriving medical referral business. The key lies in forming strategic alliances with health-care providers and creating programs that address their patients' needs.


Short-term Wellness Program; Medical Advisory Board; Special Populations; Medical Program; Brand Image

© 2007 American College of Sports Medicine