(Editors' Note: This article was part of Club Industry's April 2019 "Wellness Integration in 2019" report. You can download the full free report here. In addition, the Club Industry Show will include a Healthcare & Fitness Integration Summit bringing together physicians and health club operators. Register for the show here.)
As one of the owners of Fitness Connection, Jeff Skeen saw the growing competitive pressures of the fitness industry and those of the medical community where healthcare costs were continuing to increase. Professionals in the fitness industry too often focused on physical beauty while professionals in the medical community too often focused on managing chronic conditions, he said.
To him, the disconnect between the two groups was an opportunity. To grab that opportunity, he left his CEO role at Fitness Connection in 2017 to start a new career and new company, Results Redefined, McLean, Virginia. The fitness and healthcare consulting company works directly with primary care physicians, insurance companies and fitness professionals to create healthy solutions personalized to an individual’s needs. The goal of the company is to be the bridge between health clubs and primary care physician offices in part through one of its healthcare investments, ReShapeMD clinics, which are medical clinics that provide services that the company’s primary care physician partners do not provide.
In July 2018 ReShapeMD opened a pilot medical clinic inside one of Body Renew’s two locations in Winchester, Virginia. (Skeen is in negotiations with other chains to open more ReShapeMD locations.)
The care offered at the clinic, which has a separate entrance from the gym, is the same as that offered in a doctor’s office, according to Dr. Vaishali Geib, partner and chief medical officer at ReShapeMD. Anyone can use the clinic, even if they are not a member of the health club.
“This is a comprehensive clinic where we are focusing on prevention, identifying patients that potentially could have problems,” she said.
The medical staff at the clinic includes physicians, physician assistants, nurses and nurse practitioners, numbering at least 12 people depending on the patient flow, according to Skeen. Services offered at the clinic include wellness exams, physicals, sports physicals, acute minor illness care, hormone replacement and nutrition services. They also offer obesity services that include medically supervised nutrition counseling, health coaching, pre-diabetes or diabetes counseling (in consultation with their primary care physician) and even setting up fitness programs through the club.
Through ReShapeLabs, Body Renew also sells blood panel tests either in upgraded memberships or as stand-alone tests, Skeen said. Up to 90 percent of people who have had a blood test analyzed by ReShape Labs find that they have a health issue, such as diabetes, heart disease, high cholesterol, high blood pressure or low testosterone. The majority of the clients did not know they had these conditions.
Bringing a medical clinic into a fitness center allows for wellness discussions between a physician and patient that don’t often happen at a traditional doctor’s office because most primary care physicians are focused on “sick care,” meaning discussions about how to cure patients of existing illnesses, Geib said.
“Traditionally, fitness has been in its own little corridor by itself separate from the medical construct,” Geib said. “What we are saying is that it needs to be integrated and part of the full picture of health and wellness that goes as a continuum from well and preventative care all the way to sick care.”
Traditional primary care physicians have limited time to talk through options for patients with a medical condition, but the physicians and providers at ReShapeMD have the time to go a step further and work with patients on options other than medication, such as diet and exercise, for conditions such as high blood pressure or options to minimize the medication needed, Geib said.
In the first six months that ReShapeMD was open at Body Renew, nearly 67 percent of those who used the clinic bought club memberships and personal training, Skeen said. Not only has the partnership led to more revenue from memberships but also more revenue from personal training.
The partnership doesn’t just feed patients into the health club; it also helps to alleviate some of the pressures on physicians, pressures that are causing a growing number of primary care physicians to move away from independent practice and become employees of hospital systems or insurance companies, Geib said. In 2016, just 47.1 percent of doctors were independent, according to an American Medical Association study, the first time the number had dropped below 50 percent. Movement away from independent practices stem from the ability of larger practices to negotiate better rates with insurance companies and the ability to keep up with the financial pressures of new technology platforms.
One of the biggest pressures on physicians is the pressure on their time, Geib said.
“In our current insurance model, I don’t think anyone would argue that doctors are time stressed,” she said, noting that many patients would say they don’t get enough time with their doctor during their appointments.
Lack of time and the need to address traditional medical problems are the main reasons primary care doctors don’t have wellness discussions with their patients, she added.
“Physicians were incentivized and paid for sick care,” she said. “But you weren’t really incentivized and paid for preventive care, and I don’t mean preventive care like physicals. I mean these long discussions about diet and nutrition and exercise.”
Primary care physicians also face a challenge that health clubs face: competition. With the growth of urgent care clinics and minute clinics, patients don’t always turn to their primary care doctor for every ailment. And although some people might see that as a positive development because it frees primary care doctors to deal with more serious ailments, that is not necessarily the case, Geib said.
“Maybe it’s not the best thing for the patient because there’s no continuity of care,” she said. “If you have a kid that is going in for a sports physical, you want to make sure that if the urgent care finds something, that their pediatrician knows about it. Or in children, you have growth charts. You have to track that. Now if a pediatrician doesn’t do the physical, how are they going to track if there is a problem?”
It Takes Effort
Investing in this type of a partnership takes work. ReShapeMD is a medical practice, which means it must carry its own malpractice insurance and must follow all regulations required of medical practices, including HIPAA regulations, Geib said. The entrance is separate from the gym entrance and must remain locked when the business is closed.
“It takes commitment to do this and do this right,” Geib said.
But so far, the work is paying off for Body Renew. Owner Jeremy Wright is projecting a profit of about $400,000 for 12 months from the ReShapeMD and ReShapeLabs partnership. To read more specifics about what Body Renew is doing, download the free "Wellness Integration in 2019" report.