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MFA News: Industry News

Patient Transition through the Physician Referral Process

Tuesday, November 13, 2012   (0 Comments)
Posted by: Stephanie Marquart
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Transitioning patients from acute care into membership is one of the key tasks of a medical fitness center. The most effective way to transition these patients is through a physician referral process. Every medical fitness center should have a physician referral process; whether this means just casually receiving referrals from physicians or having a structured process in place for referred patients.

At the South Jersey Healthcare Fitness Connection the PREP (Physician Referred Exercise Program) has assisted over 1200 patients in five different areas: Lifestyle Management, Diabetes Management, Cancer Survivorship, Heart Health, and Prepare for Surgery (Hip and Knee). The PREP is a physician referral process designed to allow patients to start exercising in a safe and supportive environment with the help of the medical community.

Why should physicians refer to you? As fitness professionals, we should be able to provide high-quality exercise programming – and we should be able to do this better than a physician can! The Exercise is Medicine initiative not only encourages physicians to prescribe exercise, but to send their patients to qualified professionals for exercise prescription. We should be competent selecting exercise variables that are appropriate for low, moderate, and high risk patients. If physicians have a trustworthy place or person to refer their patients for exercise expertise, many are willing and excited to do it.

Promoting physician referrals at your center encourages physicians to use your center as an exercise resource, and this in turn strengthens your continuum of care within your medical community. Establishing programs that can be a part of a patient’s continuum of care is a critical task of a medical fitness center. Nearly every patient who visits their doctor for some kind of chronic condition like obesity, hypertension, hyperlipidemia, or diabetes could benefit from increased activity. These patients need exercise intervention after completing acute care treatment, and your center should be well-positioned to offer this service. The market that could benefit from a physician referral program is not only enormous, but also highly motivated. Exercise greatly improves the quality of life and even the years of life for individuals with chronic diseases and disabilities. We also know that patients who are referred from physicians are more likely to start exercising then those who are not.

There are several things to consider before implementing a physician referral program. A few considerations are your program design, staffing, outreach to physicians, location, tracking, and what will happen to patients when they finish your program.

Program design refers to the length of your program, the cost, how you will receive referrals, the exercise programming, assessment and re-assessment process, and how you will report to the referring physician. Regarding staffing, you need to consider how many full-time equivalents will be necessary to run your program and whether you will pull from your existing staff or hire new fitness professionals or medical staff. Outreach to physicians involves your marketing materials for your program and the person who will act as a physician liaison to reach out to local doctors. In regards to location, will your program take place on your existing fitness floor or in a separate area? Tracking is one of the most important aspects of your referral program. Items that need to be tracked include: number of patients, number of referring physicians, referrals per physician, health histories, risk stratification, exercise programs, and biometric markers. Tracking all of these variables provides you with measurable outcomes to share with your referring physicians. When patients finish your program, will you allow them to re-enroll, will you transfer them to membership at your facility, will you give them a home exercise program, or will you just let them go? All of these details are important to consider before implementing a physician referral program at your center.

At the South Jersey Healthcare Fitness Connection, we use the PREP program to transition our acute care patients into membership. The mission of the PREP program is to provide an entry-way to life-long activity with the help of the medical community. Our mission is similar to the Exercise is Medicine Initiative, and we share the same goals. The purpose is to introduce exercise as a tool to prevent disease and as a co-treatment for controlled disease. PREP is a 60-day program that is a self-pay cost of $60. It includes a full membership at our facility and 2 supervised group sessions per week. PREP members also receive a one-on-one intake which includes a health history review, biometric measurements, and an equipment orientation. Halfway through the program, PREP members receive a one-on-one midpoint evaluation and at the end a final evaluation. Reports are sent after each one-on-one appointment to the patient’s referring physician. Our participants also have the opportunity to receive nutrition counseling with a registered dietician within our center. The main focus of our program is creating well-educated members who understand the basics of cardiovascular, strength training, and flexibility exercise.

The PREP program receives most of its referrals from primary care physicians, but we also partner with acute care departments in order to provide a safe exercise program post-rehab. The departments that we partner with include cardiac rehab, physical therapy, bariatric surgery, oncology, and mental health. After completing treatment, patients can be referred into PREP for disease co-treatment or prevention of reoccurrence. PREP provides a natural transition for these patients to learn the proper exercise routine for their medical conditions with the hope that they will continue with a long-term membership at our facility, which about 40% do.

A well designed physician referral program can offer your medical fitness facility an excellent opportunity for transitioning patients from acute care into membership. Whether you are hospital-based or independent, creating relationships with physicians in your community is essential to developing a referral program. Once a referral stream is established, you will be creating new members that are well-educated and committed for a lifetime.

Brittany Raup
South Jersey Healthcare Fitness Connection
PREP Program Coordinator

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