Doctors Need To Become Personal Trainers

I’ve been thinking about this a lot lately.  It’s so hard to find good, reliable fitness advice out there.  A simple Google search will yield about 20% good information and 80% spammers hoping you’ll buy their junk.  It’s easy for the average person to throw up their hands and do nothing.

We need a trusted source to give us information about getting fit.  Yeah sure, I’d like to be considered one of those sources, but what about the medical community? They should be on the front line of the obesity war.  They should trade in the white coats for a pair of sweats.

I frequently get clients in my studio who were told by their doctors to “work out more.”  Great, what exactly does that mean?  For the most part, the people I see don’t really know and they wander into a gym and sign up or they wander into a bookstore and grab a book or DVD and hope for the best.  Doesn’t that seem almost irresponsible of the doctors?

Exercise prescription is the new frontier of medicine. (Okay, it isn’t, but I’m trying like heck to convince people it should be.)  A while back, I posted an open letter to President Obama on how to fix the health care crisis and one of my suggestions was to place personal trainers or exercise physiologists into every general practitioner’s office.  Think about it.  How many patients need fitness advice?  (I’m thinking 95%!)

So here’s what I’m thinking: six of the top ten causes of death in the U.S. are related to obesity.  If a doctor sees a patient with symptoms for any of those six diseases, they write them an exercise prescription and a nutritionist referral.  My very forward, progressive doctor has both of these professionals on staff and the patient immediately gets booked for follow up.

Instead of being handed pills as a pre-diabetic or borderline hypertensive or whatever, the patient first gets an exercise and nutrition prescription.  It is the doctor’s job to scare the bejeezus out of these people.  There needs to be a speech along the lines of “Do this or die!”  Yes, it needs to be that strong.  Fear is a fantastic motivator and a doctor should be able to wield it with aplomb.  He is saving lives after all.

The patient then begins their exercise and weight loss program with the doctor’s close supervision.  Monthly checkups can help the doctor keep tabs on the patient and the prescription can be adjusted (and keep the pressure on the patient) as needed.

What do you think?  I know this strategy would save billions; we’d literally no longer have a Medicaid/Medicare financial problem anymore, and we’d increase life expectancy and help change our culture of obesity over to one of fitness.  Wouldn’t that be amazing?

Thanks,

Lisa

About Lisa Johnson

Lisa Johnson here. I've been a personal trainer since 1997, a Pilates instructor since 1998 and the owner of Modern Pilates since 1999. I'm hoping to give you some good ideas to get or stay in shape with a healthy dose of humor and reality. Thanks for joining me.

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17 Responses to Doctors Need To Become Personal Trainers

  1. Julie August 27, 2010 at 8:42 am #

    COMPLETELY agree. Ironically I have been contemplating Selling” the idea to local pediatric offices here in Atlanta, GA. The challenges I can foresee are – trainers are not “licensed”. I recognize many do not trainers want licenses required but I think it would help us gain credibility and weed out the unqualified trainers.

    Think about it that the lady who does nails or hair, the real estate agent who sells your home, and your vet tech all require licensing but training people to become more fit, increase cardiovascular endurance and stabilize metabolism through exercise hair is and we are not even able to try to obtain a license if we wanted one.

    The second challenge would be a physicians fear of “losing business”. They operate from a reactive (sick) standpoint vs a proactive (wellness) standpoint. To shift that may mean loss of revenue for them up front. Of course we know that in the long run people would FLOCK to these offices for a myriad of reasons (health, rehab, decrease in insurance premiums and so on).

    Anyhow, for what it is worth I love this post and sincerely hope t comes to fruition.

    Julie G.

  2. Lisa Johnson August 27, 2010 at 11:09 am #

    Thanks Julie. I really it hope it comes to fruition too. It seems like such a no-brainer solution and cheaper that medical specialists and a whole bunch of pills.

    If the doctors look at it as a revenue generator, kept in-house and reimbursed by health care they’d be all for it. We just have to show them the numbers … I think it’s an easy sell actually they can mark up the training services quite a bit!

  3. Sven Peter Moritz August 27, 2010 at 2:09 pm #

    You are so right!

    As German MD I have the same studip medical shortcuts to fight! Teaching physiotherapists at the same time I only can say: They know it better, so why don’t let them decide? In Germany they are still “helpers” that have to act according to a medical prescription.

    But its good to know that there is a change in thinking all around the world. So thank you for your blog and stay healthy!

  4. Holly August 27, 2010 at 3:35 pm #

    I absolutely love the idea! My concern is that most people don’t want to change and work at it– so the Dr. would certainly have to buy in. The thing that we find here is that the Dr’s are so busy they don’t have the time to add in the extra visits that would be needed to track and upkeep the “healthy prescription” for the patient. (Too many patients to DR. ratio). We had a case here a couple of years ago, where Dr. refused to take on a new patient because she was overweight and a smoker, I believe had been through other Dr.s and she didn’t want to make the necessary changes to her lifestyle… he didn’t want such a, shall we say, high risk patient. I totally agreed with him, why should he take on another health risk… Maybe more Dr.s should stop treating patients who are choosing not to follow the diet and exercise for better healthy prescription? I could go on with this topic but I will stop there! Glad I found someone else with some similar ideas about this.

  5. Lisa Johnson August 27, 2010 at 7:46 pm #

    Sven and Holly thanks so much for your comments.

    Holly you have a very good point, exercise adoption based on medical advice is high. But retention of the new habits is low. Six months out most people are no longer working out despite the fact that it’s literally life or death. The call of the couch potato is too darned strong. But with a monthly check up for a period of time, say a year, then we could get higher levels of retention.

    It’s definitely one of the issues that has to be addressed. Such a great discussion! Thanks everyone for adding to it.

    L–

  6. Phil Earnhardt August 28, 2010 at 12:32 am #

    Hi, Lisa. No disagreement that exercise should be part of our medical prescriptions.

    Tom Myers, author of the outstanding text “Anatomy Trains”, wrote an intriguing essay “Spatial Medicine” ( http://www.anatomytrains.com/explore/spatialmedicine/expanded ) several years ago. It draws an interesting relationship between what doctors normally do (prescription medicine) and the fraction of our total health that covers. In the process, Myers provides a great working definition for body/mind exercise.

    What’s great about Pilates is that it pairs strength-building work with mindful movement. People work out hard with Pilates, but they are remarkably injury-free. We’re generally ignorant why body/mind work helps us become pain-free. Spatial medicine is the secret sauce.

  7. meg ford August 28, 2010 at 12:47 am #

    Just thought it would make you happy to know that my Dr. did exactly what you suggested they do.(prescribe exercise and put me in touch with a nutritionist. He also requested occasional update reports.) This was about a year ago, I am going to print this out for him. Thanks for the article!

  8. Jeremy Speed August 28, 2010 at 3:45 am #

    In the UK physicians are able to refer patients for exercise at local leisure centres where exercise specialists give advice and support on exercise. The problem we have is that behaviour change is hard prescribing the right physical activity from a physiological stand point is easy (build up to expending 1000 kcals per week in moderate physical activity, thats 5 x 30 mins per week). The hard part is finding a regime that people can stick with ie changing behaviour so that physical activity is part of your everyday life (forever) and that is very hard. 7 years at medical school doesn’t make you better at supporting behaviour change (in fact it probably makes you worse!!). Your point about having a behaviour change specialist in GP practices is sound but they don’t need to be an exercise physiologist they need skills to help behaviour change. Pushing gyms and other formal exercise may not be what a person needs so really a referral to people who believe “gyms are great” is not the answer. The evidence base on what works in getting people active is weak.

  9. Lisa Johnson August 28, 2010 at 10:09 am #

    Jeremy,

    There is some great research in the US about activity retention. There are 5 steps to starting and ingraining an exercise plan. #5 is maintenance and it is definitely the hardest. I’m in agreement that this is the toughest thing for everyone. (Even Pilates instructors and fitness bloggers!) Some of it is wrapped up in our society. With the recession those of us with jobs are working harder to keep them. We’re so tired that we turn on the TV when we get home instead of going for a quick run, etc. The health club definitely doesn’t have to be the answer for everyone. Someone staring down diabetes can start with a simple walk around the block and work up from there.

    Thanks so much for your comments, it’s a good discussion.

    L–

  10. Lisa Johnson August 28, 2010 at 10:10 am #

    Phil, great point and as a Pilates instructor and studio owner I, of course, completely agree with you! :-)

  11. Janice - The Fitness Cheerleader August 28, 2010 at 9:46 pm #

    I agree with your first commentor – personal trainers often have taken an online course, so even their exercise physiology knowledge is limited. Although this won’t help the current generations at risk, but why don’t we make exercise physiology, nutrition and sport/exercise psychology mandatory in highschool? We should all be accountable for ourselves, and not relying on someone else’s “expertise” to keep us fit & healthy.

  12. Lisa Johnson August 28, 2010 at 10:55 pm #

    Janice, I agree, I could kiss you for that comment. It should absolutely be integrated into the school system. Ironically, in my high school it was. It was called “Health education” and it was mandatory.

  13. Phil Earnhardt August 30, 2010 at 11:07 am #

    Janice: I recently looked at all the anatomy and physiology texts used at a major (and very good) university. Every one of these books used a “levers and hinges” model to describe our musculoskeletal structure. Not a single one of them noted that this is only a first approximation of how our posture and movement actually work, and none of them suggest any alternative models. “Levers and hinges” is wholly insufficient to describe concepts like prestress or the flowing movement of exercises like Yoga, Pilates, and T’ai Chi.

    We’re generally aware of the concept of an aerobic threshold, but we’re barely cognizant of a tensional threshold and how it should inform our training.

    I’m not disagreeing with your basic premise that more education is needed. I’m just saying that even more education is needed.

  14. nick October 16, 2011 at 12:31 am #

    Yes Lisa!! Wouldn’t that make the most sense to prevent the diseases before they happend? Doctors do have the biggest influence of exercise adherance to any workout regimine. I wish more Doctors were advocates for exercise prescriptions and/or refferal to professionals that prescribe exercise programs. Thanks for the post!

  15. Lisa Johnson October 16, 2011 at 1:43 pm #

    Thanks Nick, obviously I agree … next time you see your doctor, let him know! Maybe we can start in a grassroots way. L–

  16. emi January 16, 2013 at 9:19 pm #

    Yess! I want to be a Dr./ personal trainer when I graduate highschool. Total support!

  17. Beverly July 12, 2014 at 3:32 am #

    I agree 100%!!! I agree so much that I am a physician and I have gone back to get a personal training certificate!

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