Perhaps what is most frustrating about the rising number of people with diabetes, heart disease and obesity is the fact that in many cases exercise and diet can prevent these conditions. And prevention is more cost-effective than treatment, which is why partnerships between fitness facilities and hospitals are growing.

While the reasons for developing these partnerships are obvious, making them happen is not as simple as it sounds. “Medical practitioners find themselves in the awkward and frustrating position of knowing the medicinal value of exercise and trying to ‘sell’ reluctant patients on exercise because insurance won’t cover it,” explains Gregory Mack, owner of Physicians Fitness, which places personal fitness trainers within medical settings in Columbus, Ohio.

“Because of liability, physicians are apprehensive to refer patients to a wellness center if it doesn’t have a good reputation,” says Michael Jenniex, MS, fitness director of the Wellness Center of Cape Coral and Fort Myers in Florida, which is affiliated with a local hospital. Debi Pillarella, MEd, program manager at Community Hospital Fitness Pointe in Munster, Indiana, stresses the importance of clearly defining the fitness facility’s role, since some medical professionals may feel threatened by the prospect of partnering with fitness practitioners. “Not all of it is an uphill battle, though,” says Pillarella.

The fitness and medical communities can partner up in numerous ways. At Physicians Fitness, Mack places personal trainers in the offices of local chiropractors and physical therapists. This setup allows the medical practitioners to monitor their clients’ exercise programs and be “on-call” for medical questions. In a different model, the Wellness Center of Cape Coral and Fort Myers is owned by Lee Memorial Health System and was established to fulfill the hospital’s mission of providing preventive treatments for the community. The Community Hospital Fitness Pointe was also established by its parent hospital in order to provide wellness and medical services for the community. Finally, Omni 41 Health & Fitness Connection in Schererville, Indiana, was a successful commercial fitness facility for 24 years before a local hospital bought it. The hospital administrators considered building a wellness facility but decided it made more sense to purchase an already successful facility and add the wellness and medical components.

Getting Started. “Develop a relationship [with medical providers] first,” stresses Jenniex, who suggests offering hospital employees a membership discount and doing health fairs to start. Jenniex also suggests learning your community hospital’s mission statement. “Most community-based hospitals have in their mission statement [the commitment] to offer preventive medicine to the community. Use the mission statement as a way to approach the hospital,” says Jenniex. Mack recommends asking your clients for the names of their physicians, then contacting the physicians by phone or letter to let them know you are developing exercise programs for their patients.

Pillarella suggests that club managers create an advisory board of local medical professionals. You can ask the board to speak at health and wellness fairs at your facility and also to review your monthly newsletter, which can go out to local medical facilities, doctors’ offices and members.

Once you’ve established and nurtured relationships with a core group of medical professionals, branching out will be easier. Sharon Sporman, executive director at Omni 41, points out that lots of different niches need to be served. “Before [hospital or medical professionals] will outsource a service to you, you need to offer something they aren’t doing already or something you could do better and more cost-effectively,” says Jenniex.

“Start small and have a concrete business plan,” says Pillarella. She suggests focusing on one or two at-risk populations or medical conditions. Mack advises, “Be prepared to answer tough questions like, ‘What makes you [or your facility] skilled enough to work with orthopedics?’”

Business Benefits. According to Pillarella, almost half the members at Community Hospital Fitness Pointe are referred to the facility because of a medical issue. Clients referred to a fitness facility for a specific medical condition usually pay out-of-pocket, and their insurance company may or may not reimburse them. After their program is done, they often join the facility. “In the first three years [after the hospital bought Omni 41], membership grew from 8,500 to 9,400 members,” says Sporman. As a wellness center, the facility became an even more valuable resource for the community, explains the general manager, Marci Crozier.

Business Risks. When you’re dealing with an at-risk population, liability may be higher than when you’re working with healthy clients, and staff need to be trained to respond to emergencies, notes Jenniex. Since Pillarella’s staff members are hospital employees, they go through the hospital’s standard training programs. Fitness personnel are also trained to operate automated external defibrillators (AEDs). (For a related article on AEDs, see page 28.)

Staff Qualifications. Again, because the population may be at risk, physicians—and their patients—do look for fitness professionals who have the experience, education and appropriate certifications to work with particular populations. The initial health assessment for new members needs to be more stringent at wellness facilities than at fitness clubs, explains Pillarella. Mack hires personal trainers who already have clinical experience and then has them complete an intensive in-house training program. At Omni 41, a registered nurse is on staff.