In our neverending search to develop new revenue sources while supporting our core business of membership recruitment, referrals and retention objectives, several clubs have discovered a new untapped revenue source: medical exercise services (MES).

While personal training is still ranked as the most profitable club program, MES offers a high-quality fit to a club's programming mix. MES programs provide an incremental boost to personal training revenue for both clubs and the more experienced fitness staff members who are providing these services. Mike Jones, Ph.D., RPT, developed and launched the MES programming concept in 1992 at the American Association of Health, Fitness & Rehab Professionals (AAHFRP) meeting. The American Council on Exercise Clinical Exercise Services Certification Program also reinforced this concept.

Successful MES programs offer a diagnosis for each client, who is determined and quantified by the client's medical practitioner. Under no circumstances does the health club or its staff members provide the diagnosis. The personal trainers who participate in the MES program serve as lifestyle change facilitators and personal coaches. Because of the special skill sets required to provide comprehensive customer service to participants, only those fitness professionals who have completed the program's educational pre-requisites are allowed to provide MES program services. Participating personal trainers adhere to club documentation requirements and HIPAA guidelines that have been established by their MES program administrators. If pain, swelling, numbness/tingling or decreased range of motion are present or develop during the program, the client is sent back to his or her referring medical professional.

The only way that MES programs can succeed is if they are positioned as a programming option that supplements the work of licensed medical practitioners. MES is never positioned to interfere with the scope of practice of licensed medical practitioners.

The International Health, Racquet and Sportsclub Association's January 2004 Trend Report found that during the next decade the country would face a $1.6 trillion increase in health care spending with aging Baby Boomers contributing heavily to the total. At least 50 percent of adults between 50 to 64 years old live with at least one chronic condition. More than 44 percent of U.S. consumers take at least one prescription medication daily and the 50+ age group accounts for nearly three-fourths of spending on prescription drugs. The most commonly prescribed drugs for 40- to 60-year-old adults are for high cholesterol, gastrointestinal disorders, diabetes and hypertension. As more non-club members who actively participate in the U.S. health care system join our clubs seeking solutions, we will need to position our programs and facilities to address their non-traditional needs. As with any other business, we must change, modify and refocus our service delivery system as our customer profile and their associated service needs change.

MES programs, depending on your facilities, can be provided as both land-based and water-based programming options. They are all fee-based and can be structured in 30- or 60-minute sessions, in either a one-on-one or small group format.

The personal trainers who participate in the medical exercise services program should have a combination of the following credentials: an undergraduate college degree, a graduate degree, a certification from at least two nationally recognized certification organizations, completion of the club's special population training curriculum and completion of an additional 30 hours of continuing education training per year.

Genesis Health Clubs in Wichita, KS, is one of the many clubs that has implemented a MES-type program. Rodney Stevens, Genesis owner, established a strategic partnership with the Via Christi Regional Medical System in Wichita. This partnership quantified the two-way flow of post rehabilitative hospital patients to the Genesis MES program and the reciprocal flow of club members to the hospital system.

Our membership profile is evolving daily. In order for our industry to stay ahead of the “service curve,” we need to proactively update our customer relationship management assumptions. This means that we have to revise/update our service provisioning concepts, our fee-based and non-fee-based programming options and our staff training curriculum so that we can support our core business: membership recruitment, membership retention and membership referrals.


Bob Esquerre, MA, MES, NSCA-CPT is a fitness consultant and owner of the Esquerre Fitness Group. He is a Reebok Master Trainer with certifications as a medical exercise specialist from AAHP and personal training from NSCA.