A Team Approach to Wellness

Lisa Dougherty is the founder of the Medical Fitness Network (MFN). This mostly volunteer‐driven project is supported by more than 100 national businesses. Dougherty's vision is to improve the quality of lives of many millions of people by connecting them with fitness and allied health professionals who have a background in the prevention, treatment and rehabilitation of chronic diseases, medical conditions and disabilities, as well as in the management of women's health issues, including prenatal and postpartum care. The MFN provides resources for more than 30 nonprofit medical and health organizations.

Dougherty has worked in the fitness industry since 1999. She graduated from the University of California, Irvine, fitness instructor program and went on to earn her Personal Trainer and Health Coach certifications through the American Council on Exercise. She has pursued specialized continuing education in working with clients with arthritis, cardiovascular disease/stroke, breast cancer, diabetes, fibromyalgia, knee and hip replacement, multiple sclerosis, osteoporosis and Parkinson's disease, as well as prenatal and postpartum women. PFP (Personal Fitness Professional) magazine named her a Trainer of the Year nominee in 2016 and a finalist for the 2015 Trailblazer Award. She has been featured in the Huffington Post and was acknowledged by the White House as a Champion of Change Finalist for 2016 for her community service project.

ACE: You work with clients who have chronic conditions and/or disabilities in addition to being overweight or obese. What are the main challenges that arise when teaching these clients about fitness and health?

Lisa Dougherty: The main challenges I see when teaching these individuals about fitness and health is having them adhere to a long‐term exercise and wellness program. Compared with the average healthy client or athlete you may work with, this population is starting with a deficit and low self‐esteem. These clients need to know you understand where they are physically and mentally and that you can take them safely to a fitter, healthier lifestyle at a pace that is comfortable for them. They need to be reassured that they can learn new things and achieve their goals!

In addition to evaluating their fitness level and emotional state, I spend the first month teaching them about anatomy and how their muscles function and their bodies move. The gym where I train my clients has a large anatomy chart. I begin the first two sessions there and go back to the chart frequently during the first month. People are amazed to learn about the body, and they find a new appreciation for using it. We become partners in their fitness goals as they understand why I choose a certain exercise or have them do particular things to progress. I find that empowering them with knowledge sets them up for better success in achieving a long‐term exercise and wellness program.

ACE: Do you have any general recommendations or helpful tips for fitness professionals who are interested in working with overweight or obese clients who have chronic conditions or disabilities?

Lisa Dougherty: Program design, periodization and safe progression are important components when working with those who are overweight, obese or have chronic disease/medical conditions. In addition to being an ACE Certified Personal Trainer and Health Coach, I have taken many courses over the past 20 years to help me with these populations. Adding special‐populations course work is the best thing you can do to gain knowledge and to position yourself as an authority in your community.

These clients, once thought of as the exception, are now becoming the norm. Baby boomers (aged 52 and over) make up almost 30% of the U.S. population. As this group ages, we are seeing significant increases in obesity and chronic disease, as well as in the number of individuals with multiple medical conditions. Among the many conditions a boomer client may face are joint replacements (often two or more), arthritis, cardiovascular disease, cancer, diabetes, obesity, osteoporosis, Parkinson's disease and muscle loss.

ACE: What are the most effective ways you have found to collaborate with medical organizations and other healthcare professionals in bringing fitness to your clientele?

Lisa Dougherty: I am very fortunate to have a strong marketing background and to have gone to school at the University of California, Irvine. I was in the securities industry (stocks, bonds) before changing careers in my mid‐30s. This background was very helpful when I was creating a website and marketing materials, and having networking skills was useful as well. I've always favored a team approach and had the mindset that building a healthcare team around an individual increases the chances of a positive outcome and lasting success. Over the past 20 years, I have gathered like‐minded individuals around me—including an orthopedic physician, a sports medicine doctor, a physical therapist, a massage therapist, a Rolfer, a dietitian, a chiropractor and a mental health professional (psychologist)—to work with me and cross‐refer. We collaborate and share our views of a client's path to wellness. It truly is a team approach to someone's health care.

ACE: In your opinion, what are the best approaches for networking with other fitness professionals and businesses to get the word out about creating inclusive fitness opportunities for everyone in the community?

Lisa Dougherty: I find that joining forums on Facebook has been helpful in learning what my colleagues are doing, in asking for advice and in posing questions. Social media is a very powerful tool for spreading the word and getting ideas that you can apply to your own business. I have also searched via the internet for other trainers in my area and introduced myself to them, sometimes even going to where they train to meet them. Everyone I have come across has had great ideas and different perspectives, which I find interesting and helpful.

ACE: From your perspective, how has the medical fitness landscape changed over the past 10 years? Will you share your vision of what you hope to see occur in the medical fitness space in the next few decades?

Lisa Dougherty: I entered the fitness industry more than 20 years ago, inspired by my father, who was a three‐time cancer survivor. Over the past 10 years, the youngest baby boomers have entered their 50s and are facing some serious health challenges. This group is expected to live longer than previous generations and is one of the biggest population segments in our economy.

Baby boomers are looking for fitness professionals who understand who they are, what they are suffering from and how they can restore function and preserve their quality of life. Their goals are different from those of people just looking to boost their fitness levels. This is an important direction for our industry to address because we need to service our aging population. I feel that the expansion of the "medical fitness" field is going to be one of the most important and most positive changes in health care.

What I'd like to see in the next 10 years is an industry standard for certification and credentialing. I'd also like to see current, ongoing, disease‐specific education that will serve our aging population. This will create a new "profession" that health insurance companies can look at as a reimbursable expense, if deemed medically necessary, as they currently do for other allied health professions.