A qualitative interview of health professionals found that while many viewed physical activity promotion as important, many also felt it was outside of their expertise, and less important than other health promoting activities like quitting smoking. Some physicians felt a referral for exercise was as a holistic alternative to medication with possible added social benefits, while others reported concern that it would have limited reach and exacerbate existing health inequalities.
Healthcare professionals noted geographic isolation and uncertainties about patient selection criteria, medico-legal responsibilities, and a lack of feedback about patient progress as barriers to referring them to exercise programs.
A healthcare provider’s own activity level can play a crucial role in whether or not they refer. In the same study, interviewees linked their decisions on whether to recommend physical activity to patients to their own physical activity levels and their subjective assessments of patient motivation. Another review found consistent evidence indicating physically active physicians and other providers are more likely to advise their patients on physical activity and can be powerful physical activity role models.
Physicians are aware of and generally feel positively about health clubs. In the survey of ACSM physicians, the majority reported being familiar with health clubs, viewing them favorably, and seeing them as an appropriate place for their patients. Only 41% reported recommending health clubs to patients, citing expense and convenience as the largest barriers.
Doctors have significant power to influence their patient's behavior, so developing a successful relationship with the medical professionals in your community is key if you want them to refer patients to your club.
Key Practices for Clubs
Many U.S. health clubs have found success implementing a 60-day exercise referral program called P.r.e.p. Originally designed by acac Fitness & Wellness and implemented by clubs across the states, P.r.e.p. leverages a few key components to address barriers and facilitate uptake and referral:
- Moderate cost: The program is only $60 for 60 days—or just $1 a day—making it an affordable option for physician referred members. Throughout the program, participants deal with health and fitness professionals, not sales staff.
- Building confidence and social support: The twice-weekly small group training provides a comprehensive introduction to the club over eight weeks, building confidence and self-efficacy as well as fostering a supportive environment.
- Provider education: Physician Liaisons educate healthcare providers about the program and benefits of the club, and invite them to experience it for themselves before referring. The club also offers healthcare providers an opportunity to go through the program themselves.
- Regular feedback to physicians: The club uses HIPAA compliant software, enabling them to report back to physicians—addressing one of the several barriers noted to their referrals.
Many people physicians refer may be visiting a health club for the first time or the first time in many years. So, offering a dedicated program that provides education and support and builds self-efficacy can help ensure the person feels comfortable and well-adjusted in your club, making them more likely to join at the end of the program or trial period and continue exercising for the longer term.
IHRSA has free resources available to help you create your club's medical wellness program and connect with local health professionals.