With health care costs increasing and obesity and related illnesses on the rise, what are fitness professionals doing to help our nation's health? Likewise, what are health care professionals doing to help their patients? More importantly, how can these two groups of professionals work together to prepare for the obesity epidemic and decrease rising health care costs?
Not a day goes by in which Americans are not made aware of how exercise and nutrition can impact their health, including longevity and quality of life. We've all heard the statistics; two-thirds of Americans are overweight or obese. Obesity-related diseases cause as many as 300,000 preventable deaths per year. According to the National
The Physician's Role
The cure for the present problem seems straightforward: weight-management programs in medical offices, insurance billing codes for clients to see dietitians and health club reimbursements by insurance companies. Sound easy? The problem is that there is no published peer-reviewed data supporting or proving that these types of health interventions are effective in preventing obesity. Additionally, there are structural hurdles that inhibit implementation of these progressive health care reforms. For instance, traditional medical facilities are not equipped to help patients with their fitness needs. Some physicians and nurses do not want to address obesity-related issues because they do not have the training to advise patients about the benefits of physical activity and nutrition. According to an Archives of Internal Medicine survey, only 38% of physicians polled participated in vigorous exercise; half of the surveyed physicians exercise; and the majority of these respondents recognized that they do not exercise enough. Medical school curriculum is inadequate. Nutrition courses are usually optional. Exercise physiology is not offered at most programs. Cathy Farrell, registered dietitian at the East Bank Club in
Health care professionals do not believe that they have the time or the money to hire dietitians or certified personal trainers in their offices. Obese patients are reluctant to go to a health club to seek the help they desperately need. Prevention programs are where the answer lies, but the oversight of these programs is dependent upon the collaboration of fitness professionals, health educators and medical intervention. Barry Broutman, founder of Chicago Personal Training, states, "First and foremost, understanding what patients need is crucial to improving their health. Right now, society usually picks one avenue to go through when it comes to treating health aliments and these patients only get one point of view from that health care professional. There is not enough communication between doctors and trainers."
Complementary and Alternative Medical Centers
Some facilities are beginning to use roundtable discussions to help treat their patients as a mechanism for all the professionals involved to be aware of the treatments their patients are receiving. The Universal Health Institute in Chicago (UHI) does just this. UHI offers a unique combination of traditional and alternative health care options such as chiropractic, kinesiology, holistic medicine, nutrition, rehabilitation, Pilates-based exercise, physical and massage therapy, acupuncture and craniosacral therapy. The options offered are sometimes effective and more affordable than medications or surgery. Further, because each doctor or therapist meets daily with the other members of the practice to discuss their patients' progress, all patients receive personal attention. Dr. Nathan Conroy, a chiropractor at UHI states, "Complementary and Alternative Medicine (CAM) providers continually promote fitness as a solid staple of a healthy body. Many of those involved in fitness professionally visit with
Corporate Wellness Programs
To curb many escalating health care costs, companies are increasingly implementing corporate wellness and fitness programs to improve the health of their employees and to consequently increase the bottom line. In 1999, 86%, (up 25% from 1996), of companies that employ more than 50 employees have some sort of wellness and fitness program. Today, that percentage is up to 93%. The companies that have implemented these programs are reaping the benefits of lowered health care costs, reduced absenteeism, greater productivity and increased employee morale all of which yield a positive return on investments.
Corporate wellness programs vary in scope and cost. Based on its financial status, demographics and employee health risks for disease and lifestyle choices/habits, a company can choose one of many options. Common alternatives include hiring a full-time staff dedicated to employee wellness, offering on-site health screenings and/or hiring a speaker to educate its employees. This is an opportunity that any company cannot afford to overlook, as healthier and happier employees have a positive impact on the company's bottom line.
Numerous studies show that for every dollar spent on a preventative health program, companies can save up to six dollars in insurance costs. Studies done by the
sedentary to physically active;
levels from 240 mg to 190 mg; and
(more than 30 pounds overweight) to a healthy weight.
Based on these results, implementation of wellness programs will result in decreased health care costs and workers' compensation costs.
Providing on-site health screenings is another way to save on medical claims. While companies have found that early detection may cost them approximately $15,000 in surgical costs, the health care costs for acute disease averages $40,000 per incident. Johnson & Johnson found that it spends about $4.5 million every year on health risk appraisals programs, but without them, its medical bills would be at least $13 million higher. This is a savings of about $8.5 million!
Medical-Based Fitness Centers
Medical Fitness Centers (MFC) provide the win-win situation for health care and fitness. They collaborate with physical and massage therapists, cardiac rehab, personal trainers, dietitians medical doctors and create the ultimate medically supervised fitness center. A survey published in April 2004 by the Medical Fitness Association found that there are 715 medical fitness and wellness facilities in the
The Bottom Line
Fitness professionals are continuing to seek respect and acceptance from health care professionals. Although more and more health clubs are crossing over and offering services such as physical therapy, chiropractic, massage therapy and in-house dietetics, the services are not being used to their maximum potential. This is causing a revenue problem for health clubs, so we find ourselves in a no-win situation. Since health clubs are tapping into medical and alternative services, it is the perfect opportunity for fitness professionals to take the initiative and offer their services to surrounding businesses for corporate wellness programs. Additionally, fitness professionals can help the dilemma by collaborating with area hospitals to educate the staff on how to better serve patients through health prevention and rehabilitation programs. The goal is to not put anyone out of business, but we really need to start thinking about how we treat patients for diseases and illnesses. In order for us to help reduce obesity and age-related disorders and health care costs, while enhancing emotional and mental well-being, we all need to work together to invest in preventative medicine.
Look for Jasmine Jafferali's next article on stress management in April.
"The Ultimate 20th Century Cost Benefit Analysis and Report," University of
"Prescribing Exercise: Is Your Physician's Head in the Game?"by Thomas J. Beckman. Archives of Internal Medicine, 2004; 164:2066-2067.