Something has to change. We see study after study saying we are losing the battle with lifestyle-caused chronic diseases in the United States. More gyms and boutique classes with new technology and better equipment are clearly only part of the answer. To serve a true total population, we have to offer more in the way of medically directed exercise, nutrition and mental health services. The reality is that the very segment of the population needing the most help is still largely underserved. Those suffering from chronic conditions and past injuries often don’t feel safe going to a standard gym. And they are probably right to feel this way. When they do join, it is often a short-lived experience without any real and lasting change.
Although several health clubs are linked to physical therapy clinics, few have a fully integrated model necessary to deliver the best outcomes. Patients and members benefit from being together in the same safe and effective gym environment where physical therapists, athletic trainers, nutritionists, mental health specialists, personal trainers and health coaches work together to serve the whole person. The majority of physical therapy services can be performed on tables and equipment outside of private treatment rooms and right in the main gym. This puts physical therapists and athletic trainers out on the floor where they can spot possible issues, such as the way a member and/or former patient is exercising. Likewise, coaches can spend time getting to know patients while encouraging them to continue as a member once their clinical visits are complete. Becoming a member in a health club such as this will go a long way in keeping former patients safe and healthy.
Ultimately, this is all about achieving desired outcomes by increasing quality of care while decreasing medical costs. As people continue to pursue pills and other options for perceived quick fixes, we know that getting and staying healthy is hard work, plain and simple. We also know that deep-rooted behaviors must change in individuals struggling with a lifetime of poor decisions and habits. At times the individual is self-motivated, especially after a sentinel event, but more often than not, behavior change requires great effort while working with a team of professionals and support from loved ones. A well-trained and effective coach provides the care coordination needed for such a team.
When it comes to driving behavior change, several proven methodologies exist. Motivational interviewing and Prochaska’s Stages of Change along with newer methods in areas such as gamification provide valuable theory-based approaches. However, turning these theories into actions requires skilled coaching since every individual is different. Getting to the root of one’s barriers and building pathways around or through them requires the help of a team of professionals led by the coach. Although the coach should have a good understanding of the tools (nutrition, exercise, mental health, etc.), it is most important for the coach to be skilled in driving engagement and behavior change in their members. The coach can get support from the team when putting together customized programs. Their main objective is to make sure the member follows the program, gets measured on a regular basis and ultimately achieves established goals. Accountability with regard to outcomes rests equally with the coach and the member.
The Medicare Access and CHIP Reauthorization Act (MACRA) was passed with bipartisan support in 2015. The main objective of this legislation is to fundamentally change the way we evaluate and pay for healthcare. Quality and value of care will ultimately be reimbursed more than quantity of care. Providers need the support of safe and effective integrated gyms to achieve the measured outcomes required in value-based medicine. Gyms providing this level of care will benefit from the trend in new risk-based payment models, and, more importantly, they will truly change lives for the better.
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David Barlow is a partner in RehabGYM. RehabGYM membership programs and classes are designed for the total population. Staff welcome and value the fit and healthy as much as those who are struggling with injuries or chronic health concerns. For the fit members, the main goal is to enable and maintain peak performance through safe and effective methods of exercise, diet and good mental health. For those with past or present injuries, staff members design programs that get individuals back into doing what they love while decreasing the possibility of re-injury through increasing centeredness, functional movement and strength. Members who are faced with chronic conditions are coached through every step of their journey to better health. Nutrition, mental health and safe/effective exercise are a part of every program design. Barlow can be reached at [email protected].