With all the uncertainty regarding the sustainability and future of the healthcare system, physicians and private medical practices, fitness professionals are beginning to see a unique opportunity. The obesity epidemic and the incidence of chronic disease and injury have forced the need for a preventable, medically integrated and outcome-based model of medical fitness. Most medical professionals and healthcare administrators understand the impact healthy eating and exercise can have in the management and prevention of chronic disease, but the integration of these two professions have largely remained segregated up to this point. The goal is to combine the science of medicine with the physiology and endocrinology of the body to develop a healthcare model that creates permanent changes, heals degenerative conditions and restores health and vitality to patients.

If you're considering opening your own medical fitness facility, be sure to review the checklist of considerations below:

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Consider real-estate needs


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Suggested locations: small office inside of an existing clinic; physical therapy space during off-hours; rent a separate space; parks; recreation centers or contract with local fitness clubs that allow independent contractors.

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Size/space needs: start small and grow as volume dictates. When offering more than 1-to-1 training, the larger the space requirements.

2. Plan the business and systems

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Consider the various types of medical practices. Medical fitness centers may operate within hospitals, family practice, sports medicine and orthopedics, OBGYN, pain management, physical therapy, aesthetics, functional medicine, chiropractic andmore.

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Determine how the model will benefit each department when integrating a clinic.

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Determine how departments will communicate and operate effectively with each other.

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Understand billable tests and services: including biometric labs, metabolic testing,digital pulse analysis, Vo2 Max, bio impedance analysis, heart rate variability, food sensitivities, allergies, nutrient testing, hormone testing, genetic testing, EKG, stress testing.

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Explore cross-promotion and referral programs.

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Create a system of how to use a client's health history and exercise screening to determine if a patient starts with medical testing before beginning training program.

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Create different progressive exercise systems used to best serve sedentary, high-risk and/or injured patients.

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Determine how patients will start and where and when they transition; for example, can a patient progress from medically supervised, to 1-to-1, to group and then to bootcamp?

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Explore corporate wellness opportunities.

3. Set goals and benchmarks

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Clearly define investment, operating costs, revenue projections and break evenbenchmarks.

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Forecast based on market research and similar models.

4. Define your legal and accounting structures

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Appropriate business entity (sole proprietor, partnership, LLC, corporation)

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Create compliance systems including human resources, HIPAA, corporate, OSHA, bloodborne pathogens and workers compensation.

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Obtainprofessional and liability insurance.

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Understand Stark/Anti-Kickback laws

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Determine if you are going to accept insurance, cash or use a hybrid model. When operating as medically supervised,patients can use health savings accounts and flex dollars with letter of medically necessity.

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Setup your accounting, billing and payroll systems

5. Purchase equipment

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Compare cost savings with used versus new equipment.

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Consider equipment designed for obese and high-risk patients.

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Investin insurance-billed or cash-based medical diagnostic tools.

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Develop an integrated infrastructure: choose the appropriate software that offers cross-department communication, point of sale, scheduling system and outcome tracking.

6. Develop your medical fitness operating systems

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Clarify your services, for example, personal training, semi-private training, boot camps,working with a dietitian, cooking classes, eating out with a fitness professional, grocery tours, behavioral sessions and other unique offerings.

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Solidify your systems including: intake process, pricing structures, client progress tracking, retention systems, lead-generation, conversion and referral systems.

7. Design your marketing strategies and components including:

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Social media

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Email management system

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Free marketing mediums vs. paid advertising options

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Direct-response marketing

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Online and offline marketing

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Lowbarrier offers


While it is difficult to predict the future of our healthcare system, current evidence and trends support that this integration lends to enormous opportunity for the pioneers and early adopters. There are thousands of practices looking for new cash-based revenue streams and to improve patient outcomes. Our culture and future societal needs have been brewing the perfect storm. The compelling argument for adding medical fitness may be the best answer for the immediate future.


J.R.Burgess is the CFO/VP of Rejuv Medical and President of MedFit. Partnering withDr. Joel Baumgartner MD, they developed a successful medical practice thatintegrates medical fitness. The mission is to help change the future ofhealthcare using exercise and nutrition as medicine and are sharing their modelto the world through licensee and franchise opportunities.
www.rejuvmedical.com, www.mymedfit.com

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