A new prescription for additional services

Regular exercise can lower people's risk for a number of diseases. It can also help people rebound from illness or injury. Yet many health clubs find it difficult to convince doctors to refer their patients to them. Why? The reasons can range from overworked docs who don't have the time to handle a referral program to a gut feeling that health clubs don't have qualified personnel on board.

What can you do to change all that? It may be a challenge, but it's one a club can meet, provided it lays some basic groundwork. Here's what experts advise:

- Build credibility. "First and foremost, you have to be a respected credible provider and be recognized for that in your community," says Mary Jayne Johnson, Ph.D., regional health and fitness director for The Wellbridge Company, in Albuquerque, N.M. "You can't go in to a doctor's office and say, `Well, if you refer your patients to me, we'll hire somebody.' The first thing a doctor is going to say is, `How are my patients going to benefit by going to your facility?' A physician lays his own credibility on the line when he refers someone to your club."

How do you build credibility? Establish a track record. Hire de-greed and certified people who can deal with their patients' issues. "That is a commitment because you're going to have pay these people more," says Dr. Johnson.

- Hold an open house for physicians. That's what Wuesthoff Fitness Plus, in Rockledge, Fla., does. This allows doctors to meet the staff, learn about their credentials, and "see that the facility is clean, the staff professional," says director Bob Michaels.

- Offer doctors a membership at a discounted rate. Or give doctors a free trial membership for a month. "Have them come in and experience the club," says Michaels. And don't overlook discounts for the doctor's office staff.

- Gain visibility. Many clubs put an ad in the paper and wait for people to come in the door, notes Dr. Johnson. "You need to be out in the community developing the trust of the patient as well as the physician," she stresses. Talk to local civic groups, she advises. Give complimentary lectures on wellness. Be a part of community events, by offering free blood pressure screenings or body fat readings. "Let your neighbors know what you stand for," says Dr. Johnson.

If a person doesn't want to enter your facility or is intimidated by you, he isn't going to come, even if his doctor refers him. On the other hand, "a patient may say to his doctor, `I was at my rotary club meeting and someone from the health club was there and told me I could drop my blood pressure by 20 points if I started an exercise program. Is that true?' Sometimes the patient can drive that referral," says Dr. Johnson.

- Make it clear that you have the programs in place. "Physicians have to know what you have available that would help their patients," says Dr. Johnson. Do you have a program for diabetics? For smokers? Do you offer classes in easing and preventing low back pain? Do you offer a weight-management program?

- Develop relationships with your members' physicians. The American Col-lege of Sports Medicine says that people over 45 need a physician's clearance prior to starting an exercise program.

After a new member fills out a Physical Activity Readiness Question-naire (PAR-Q), Wellbridge asks those who have risk factors for heart disease for the OK to contact their physician. "We choose not to say, `Get your doctor's clearance and come back,'" says Dr. Johnson. "We take it upon ourselves to fax the physician's office and ask for clearance. That gets our name out to the physician, and the doctor knows we're actively participating in that person's health care."

- Develop a prescription pad for doctors to make it easier for them to refer patients. "Physicians are busy," says Michaels. Giving them a prescription pad on which they can check off a particular program - such as weight loss, smoking cessation or blood pressure - makes it easier for them to make referrals. All they have to say to the patient is, "Go to this fitness center and they'll help you out with this program," according to Michaels.

- Track outcome and forward the results to the physician. "We record everything a patient does," says Michaels, "and send periodic reports to the doctor." You can work out the timetable with the physician. But a one- to two-page report is helpful. And it should track the patient's progress, chronicling such benchmarks as blood pressure, body fat, weight, frequency, intensity and duration of exercise. "Once a doctor trusts you and sees the results and sees that his patients are happy, that gives him another avenue to use to help his patients," says Michaels.

And make sure the patient chimes in. "If we have someone who is doing well, we'll ask him or her to relay their feelings to the doctor," says Michaels. "What we say is one thing. What the patient says is quite another. If a doctor believes the patient is feeling good and improving, that is what is going to build the trust."