Medical Fitness Center: A foundational service offering of healthcare systems
Tuesday, August 14, 2012
Posted by: LaNiece Holland
This article is intended to demonstrate
how a medical fitness center can:
an integral component of a health system’s continuum of care.
outcome-based preventive and rehabilitative services.
as an important strategy for success in the era of healthcare reform.
With overwhelming evidence in support of
physical activity’s role in the prevention and care of chronic diseases,
medical fitness centers can be a beneficial and integral part of a hospital or
health system’s continuum of care. This article discusses how the framework of
services the centers offer can be a prominent and compulsory component of care
in the health system model, especially
in light of healthcare reform and a public health crisis caused by physical
When Bob Taylor listened to his doctor
describe the complications that could accompany his worsening diabetes, it
became a "wake-up call” to take action.
"I had reached a point in 2009 where all
the insulin I was taking was no longer enough to keep my blood sugar levels in
check,” says the 68 year-old Taylor, who lives on Stockbridge, Michigan. "I realized I had to do something, or my
health was going to continue to deteriorate.” Taylor’s
internal medicine physician, Steven Yarows, M.D., recommended he participate in
a diabetes education class at Chelsea Community Hospital
in Chelsea, Michigan and join a diabetes exercise program
offered by the hospital’s medical fitness center, The Chelsea Wellness Center.
Through the class, Taylor
discovered more about diabetes and how to better manage the disease, and at the
fitness center he learned how to exercise in ways that would help to bring his
condition under control.
Today, after two years of strict adherence
to his doctors’ orders, including the exercise regime, Taylor has made
significant progress, highlighted in Table 1.
"My diabetes numbers have come down so far my doctor was able to take me
off insulin completely. I lost over 23 pounds during the 12-week program, and
more than 50 pounds overall,” says Taylor. "I’m feeling much better and have
been able to get back to a more active life again.”
Submaximal Chest Press (5RM)
Submaximal Leg Press (5RM)
Upper Body Flexibility
Lower Body Flexibility
30 Second Chair Stand
1.Percent improvement in anthropometric and performance outcomes due to
participation in a 12-week diabetes fitness program at the Chelsea Wellness
Dr. Yarows, who frequently refers
patients to the Chelsea
says, "Evidence-based research has documented the benefits of exercise for
individuals with diabetes, so it made sense to encourage Mr. Taylor to
participate in the program. As his
personal physician, I’m pleased that the center staff has knowledge and
training in fitness for diabetics, and I like the fact that fitness specialists
worked with him to develop an exercise prescription designed to meet his unique
needs. Mr. Taylor’s results
have been outstanding.” What’s also
important is that when patients like Taylor complete the program, they often
join the center and continue working out on a regular basis as members. "It
becomes part of a new, healthier lifestyle,” Dr. Yarows says.
Taylor is a living example of the value
medically-based fitness centers can bring to the communities served and how a
health system’s continuum of care can be complemented and enhanced.
nation in need of medically-based fitness
A Centers for Disease Control and
Preventions (CDC) report2 indicates that more than 108 million
adults are either obese or overweight. This translates to roughly three out of
five people with excess weight. Figure 1 depicts the overwhelming statistics
regarding the dramatic increase in obesity over the past 20 years3.
The CDC report_ENREF_2 on the percentage of adults who engaged
in all leisure-time and vigorous leisure-time physical activities demonstrates
why some researchers describe physical
inactivity as one of the most profound public health concerns of this century4.
1. Obesity trends among U.S. adults as reported by the CDC. The data was
collected in the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) and
represent self-reports of height and weight.
The benefits of physical activity and the
risks for physical inactivity are well documented. The list below from the
Department of Health and Human Services5 illustrates this public health concern:
active, less fit individuals have a 30% to 50%
greater risk of developing high blood pressure.
disease is the leading cause of death among men and women in the United States. Physically inactive people are twice as
likely to develop coronary heart disease as regularly active people.
inactivity has been shown to increase the risk of certain cancers.
lack of physical activity has been found to contribute to feelings of anxiety
opportunity for healthcare providers to make more of a difference
Medical fitness centers provide health
systems with an opportunity to implement a paradigm shift from the
historical emphasis on treating the acute and chronically ill to
becoming a resource for prevention, physical activity and health improvement in
the communities served.
Palos Community Hospital in Palos
Heights, Illinois opened its medical fitness center 10 years ago with exactly
that goal in mind, according to Tim Brosnan, vice president for planning and
community relations. "Our facility was
developed as part of the hospital’s mission-based strategy to become a leader
in wellness. We have a responsibility to look beyond the care that’s provided
inside the walls of the hospital and focus on keeping people healthy. The
fitness center helps us fulfill that obligation.”
Members undergo an evaluation performed
by fitness specialists that can include:
and lipid blood test
and endurance assessment
each member is provided an overall center orientation and taught how to
properly use equipment and perform exercises. Members are afforded a customer
service model that offers encouragement and support in an environment that can
Based on evaluation results, the fitness
specialists develop personalized exercise plans. The plans incorporate exercise prescription
and goal development and may include wellness coaching, behavior modification,
nutritional counseling and integrative services such as massage therapy. The results also serve as a baseline for
subsequent evaluations that enable members to track progress and modify plans
over time in collaboration with fitness specialists.
"Our centers take a medically-based
approach to fitness and are intended to complement a health system’s continuum
of care,” says Tom Rhind, president of Power Wellness, an industry leader in
developing and operating medical fitness centers. "The fitness specialists have
degrees and certifications in such fields as exercise physiology, health and
exercise science and personal training.”
Medical fitness centers also offer
exercise programs for people with health issues such as diabetes, obesity,
heart disease, arthritis, cancer, and those with orthopedic problems."
Fitness team members with specialized training work with participants to
develop exercise routines tailored to
meet their specific health and fitness needs,” says Sheldon Solomon, M.D.,
rheumatologist and medical director for the William G. Rohrer Center for Health Fitness in
Voorhees, New Jersey. "The programs function as an extension of a health system
and have been successful in improving participants’ medical outcomes.”
In addition, medical fitness centers have
a multidisciplinary medical advisory committee that typically includes
physicians, physical therapists, registered dieticians, registered nurses and
other health care professionals. The committee provides review and oversight of
the services offered. "This is a major distinguishing factor of medical fitness
centers,” says Dr. Solomon. "The
advisory committees provide an excellent forum for clinicians from a variety of
disciplines to come together to focus on ways to improve the fitness experience
for members, and brainstorm ideas for innovative new programming.”
Medical fitness centers provide a safe
and comfortable environment for exercise, which is important for those who feel
intimidated by commercial gyms and fitness facilities. "When I talk to my
patients about exercise they often tell me they have never been a member of a
fitness center and feel self-conscious about working out in a facility where they
don’t know how to use the equipment and where many members are in great shape,”
says Eric Skye, M.D., a family practice physician on staff at the University of
Michigan Health System. "They need a
place where they can get proper instruction and feel at ease in exercising with
people who are just like them. Medical
fitness centers provide that option,” Dr. Skye says.
health systems prepare for the future
It’s vital for health systems to be
prepared for the coming fundamental changes in the nation’s healthcare system
under health care reform – changes that will require providers to assume a
greater responsibility for the health of their communities. "With the advent of
accountable care organizations and other government and insurer initiatives,
there will be an increased emphasis on offering services that foster
prevention, health maintenance and disease management,” says Rhind. "Medical
fitness centers can play a key role in positioning health systems for success
in this environment.”
That sentiment is shared by Kathleen
Griffiths, CEO of Chelsea Community Hospital who says "a big part of our job in
the future will be helping people stay well, keeping them out of the hospital,
and preventing unnecessary readmissions.
One of the most effective ways to do that is by having a wellness center
where patients and community members can maximize their health.”
revenue and increasing patient referrals
In an age when healthcare providers are
facing heightened financial pressures, medical fitness centers can boost health
systems’ bottom lines through income from memberships and ancillary services
and increased patient referrals for other health system services. "Our center
has generated a halo effect for our hospital in the community,” says Tom
Wright, president of Delnor Hospital in Geneva, Illinois. "People who join the
center and have positive experiences tend to develop a strong affinity for the
Delnor brand and choose our hospital when medical services are needed.”
The same principle holds true when it
comes to health systems driving memberships to medical fitness centers. "Our
decision to house hospital outpatient services such as physical therapy in the
Chelsea Wellness Center has worked out extremely well for us,” notes Griffiths.
"Not only does the center provide a great setting and facilities for these
programs, it also enables us to transition many patients to members after the
completion of therapy.”
relationships with physicians
Medical fitness centers are supported by
physicians who recognize the impact the facilities can make in improving the
health of the community. The centers provide an additional resource for primary
care physicians whose patients can benefit from increased physical
activity. "I encourage sedentary
patients and those who are overweight to consider joining a medical fitness
center, where the staff may have a higher level of education and training, and
where I know they’ll be in a safe and medically integrated environment,” says
Physician specialists appreciate the
medical exercise programs that are offered.
"These programs can be integrated into a comprehensive care plan that
orthopedists, cardiologists, oncologists and other specialists prescribe for
their patients,” notes Dr. Solomon. "It’s one more way health systems can
strengthen their relationships and collaboration with physicians on staff.”
Medical fitness centers can also serve as
an effective tool in recruiting and retaining fitness-minded doctors. "I like
the convenience of being able to go to the fitness center on the hospital
campus where I practice,” says Dr. Yarows. "It’s a great stress reliever for me
and I have the flexibility of fitting in my workouts before or after work, or
even during my lunch hour. It’s
especially beneficial for those times when I get paged and have to immediately
go back to the office or to the hospital
to see a patient.”
to a healthier workforce
Medical fitness centers can be a valuable
addition to a health system’s employee wellness strategy, demonstrating the
organization’s commitment to the well-being of its workforce, and providing a
high-quality facility for staff to exercise and participate in health programs.
Delnor Hospital offers employees half
price on the cost of membership at its Health and Wellness Center, and rebates
100% of dues back to staff who exercise at the center a minimum of
twice-a-week. "Offering this benefit is an excellent way for the hospital to
‘walk the talk’ when it comes to our commitment to being an employer of
choice. It emphasizes the importance we
place on prevention and wellness for those who work here,” commented Wright,
who regularly exercises at the center himself. "We actually incorporated this
concept into our benefits package, and the response among our staff has been
In addition to being the "right thing to
do” for employees, health systems have an opportunity to improve worker productivity, lower
absenteeism, enhance employee satisfaction and control their medical costs by
incentivizing employees through subsidized membership based on participation.
Public Perception and Brand Preference
A medical fitness center can become a new
"front door” for a health system – enhancing public perception of the
organization as an innovative leader in wellness, and building brand
preference. Tim McKevett, senior vice president for Beloit Health System in
Beloit, Wisconsin, which operates the North Pointe Wellness Center in Roscoe,
Illinois, says: "When someone walks into our center they immediately notice it
has a progressive, non-institutional design that’s very different from
traditional medical facilities. As a
result, we’re no longer viewed as being ‘just a hospital.’ Community members now think of us as a
comprehensive health system that’s dedicated to keeping them healthy in
addition to caring for them when they’re sick or injured.”
The shift in
perception is evident in Beloit Health System’s latest consumer market
research. Prior to opening the North Pointe campus in 2007, McKevett says the
system was preferred by only 26% of consumers surveyed in that portion of its
service area. In a follow-up study
performed in 2010 that percentage increased to 48%. "There’s no question the
decision to add a medical fitness center has greatly enhanced our brand in that
market,” states McKevett.
As increasingly sedentary lifestyles put the
health of Americans of all ages at risk, medical fitness centers provide health
systems with an important opportunity to address this trend and enhance their
continuum of health services for the era of health care reform.
It also provides healthcare organizations
with the ability to empower people like Bob Taylor to take a more active role
in their health and wellness. "The staff at the wellness center showed me what
I needed to do and helped me along the way, but I knew it was up to me to do
the work and keep up with my exercise routine,” says Taylor. "I feel great
about what I’ve accomplished, and, to be honest, I’m not sure I’d be here today
if I hadn’t adopted a healthier lifestyle.”
RE, Jones CJ. Senior Fitness Test Manual.
Champaign, IL: Human Kinetics; 2001.
2. Pleis J, Ward B, Lucas J. Summary health statistics for U.S.
adults: National Health Interview Survey, 2009. National Center for Health
Statistics. Vital Health Stat. 2010;10(249).
3. Centers for Disease Control and Prevention. U.S. obesity
trends. 2010; http://www.cdc.gov/obesity/data/trends.html.
4. Blair SN. Physical inactivity: the biggest public health
problem of the 21st century. Br J Sports
5. The Presidents Council on Physical Fitness and Sport.
Physical Activity Facts. http://www.fitness.gov/resources_factsheet.htm.
Key Words or Phrases
Medical fitness centers
Accountable care organizations
Peggy McDonagh Bravo, RN, BSN, MA,
Vice President Operations, Power Wellness, MFA Member
Wesley R. Waggener, PhD,
CSCS, Medical Integration Director, Power Wellness
Power Wellness Management, LLC
W Army Trail Road, Suite 124
Addison, IL 60101