My mother's doctor bugged her for years to exercise. I remember she complained one time that her doctor thought exercise would cure everything. Well, a few years ago, my mother found out that she had pre-diabetes. The doctor told her again that she should exercise. Guess what? This time she followed his advice. She began walking every day and watching what she ate. Since then, she's lost 20 pounds and has controlled her diabetes to the point that she is not insulin dependent.

Unfortunately, not enough doctors tell their patients that they need to exercise or risk facing serious medical conditions. However, things may be changing. A few recent reports found that more doctors are writing prescriptions for exercise. And their patients — more often than not — are heeding their doctors' advice.

But patients need more than a prescription. They often need an exercise plan. A survey in the May issue of Diabetes Care found that diabetes patients who received an exercise plan from their doctors were three times more likely to exercise on a regular basis than those who were simply told to exercise. However, the study also noted that doctors often don't have the time to work on an exercise plan with patients.

That's where a qualified personal trainer could — and should — step in. Unfortunately, not enough doctors take personal trainers seriously. IHRSA and many certifying agencies are working to improve the credibility of personal trainers and the service they provide to members, decrease liability issues for club owners, weed out unscrupulous certifying agencies, and help move the insurance industry to reimburse members for personal training. Unfortunately, dissension exists about the best way to do this. IHRSA and some certifying agencies are advocating a third-party accreditation of certifying agencies' exams. Other groups contend that a certifying agency's curriculum should also be accredited. Still others are advocating the National Board of Fitness Examiners, which is developing a board exam for personal trainers that it says will give personal trainers more credibility with doctors.

Time will tell which of these options you as club owners, general managers and personal training directors will embrace. But time is running out. Despite 72 percent of Americans being overweight and health club memberships rising by 25 million in the past five years, the 2005 Yankelovich Preventative Healthcare Study found that only 30 percent of the population was trying to lose weight and exercise ranked 17^th in the respondents' list of ways to maintain health. Twenty-eight percent of the obese respondents in this survey said that insurance not covering exercise programs was one reason they did not exercise.

Getting insurance companies to see the benefits of reimbursement for personal training would go a long way in getting some Americans to exercise. Insurance billing codes may soon be in place for personal training (see story on page 13), but their existence won't automatically equate to their use. First, the industry must convince doctors that personal trainers have obtained the professional status to be recommended to patients. Then, insurance companies must be convinced that personal trainers are professionals whose services are helping to decrease their reimbursements for medical procedures. The more insurance companies that decide to reimburse for that training, the more likely that Americans will begin to exercise before a medical condition such as diabetes makes it mandatory. How we as an industry become a respected part of the allied health field is up to you.

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