What club owner wouldn't invest in a program that brings in 350 to 375 physician-referred participants each month, 43 percent of whom translate into members? It's a program that has served ACAC Fitness & Wellness Centers well. The chain of six regional health clubs based in Charlottesville, VA, has offered its Physician Referred Exercise Program (PREP) since 2004. During that time, the program has brought in more than$14 million in membership dues, ancillary sales and other upgrades.

PREP is a low-cost program that helps patients take small steps toward creating a regular exercise habit. Physicians write a fitness prescription to refer patients to the PREP program. Participants pay $60 for a 60-day introduction to exercise at ACAC, which is “significantly lower than our market rate,” says Phil Wendel, owner of ACAC clubs.

In July 2010 alone, the PREP program brought in 350 participants for the company. Since its start, PREP has gained referrals from nearly 1,600 doctors. Plus, 43 percent of PREP participants purchase an annual membership once the initial program is complete. Conversions from the PREP program account for 20 percent to 25 percent of new membership sales at the ACAC facilities, Wendel says.

“We feel it's a membership economic engine of our club growth,” says Wendel. “If people enroll in PREP, at the end of the 60-day period, we want them to purchase a full membership.”

The average PREP program conversion member stays at the club for more than two years, he says.

Once enrolled, PREP patients attend two 30-minute small group training sessions per week. They are supervised by medical fitness professionals, including a registered nurse, exercise physiologists and degreed, certified medical fitness staff. The staff tracks their vital signs at each visit and reports participants' progress to the referring physicians at regular intervals. Participants have unlimited access to the club during their 60-day memberships.

“There's one nurse on staff at each club,” says Wendel. “We need someone who is qualified to meet the needs of people not accustomed to exercise. A lot of club owners, when I give presentations about this, are scared by it and think they can't afford a nurse, but it could be an LPN. It just has to be someone who understands the health benefits of exercise as well as prescriptions.”

This medically supervised exercise program is key to earning the trust of medical professionals who refer their patients, Wendel says. In addition, the PREP program delivers measurable results after the first 60 days by incorporating exercise prescriptions, personalized attention from staff and accountability from peers in the small group training sessions.

“You're not going to gain the confidence of physicians unless they feel very strongly that their patient will have good results with you,” Wendel says. “Don't take physician referrals unless you have the infrastructure in place to be sure individuals have success in the first 60 days at your club.”

To get a foot in the door with local medical professionals, ACAC started a medical advisory board about five years ago composed of several doctors who already were members of the club.

“We would take them to dinner two or three times a year and pick their brains,” Wendel says of the advisory board. “They were members already and already committed to the club. The medical board helped us refine it, but at the end of the day, we do the heavy lifting work.”

In addition, the club markets the PREP program through TV, radio and print ads, informational brochures, health fairs, physician office calls and other medical outreach events. Physicians recognize the need for exercise as part of the solution for the nation's obesity epidemic, Wendel says.

“I think most doctors recognize that four out of five people that sit across from them in the exam room are inactive,” he says. “And more often today, they recognize that what we do for a living is part of a good health continuum.”