Physician Fitness Referral Alliance.To the Doctor I wish to form an alliance with,Diet and lack of exercise account for more than 400,000 deaths annually. Recent studies have shown that only 30 percent of the population exercises regularly; however, another 30 percent state they would like to exercise. Exercise has been shown to improve medical outcomes in chronic diseases such as diabetes, hypertension, and coronary artery disease. However, few individuals know how to begin a safe, effective exercise program.I can help. My name is Glenn Greer, co-owner of 30 In A Hurry Fitness, a fitness company located in Coral Gables, Fl. I have included a brochure for more information in regards to our concept. My certifications are from the only two accredited credentials in the fitness industry. They are the National Strength and Conditioning Association (NSCA) and the American Council on Exercise (ACE). As a Professional -Certified Trainer with over 13 years of experience, I have a backround in evaluating individuals referred to me by their physicians for design and supervision of the ideal exercise program. My assessments includes: *Exercise history *Postural *Exercise likes and dislikes *Aerobic capacity *Body Composition *Weight analysis with impedance and BMI calculations *Range-of-motion evaluation/ * Blood Pressure/Exercise Heart Rate and Resting Heart Rate. Our clients range from a healthy, athletic high school softball and volleyball player to an eighty one year old with arthritis, total knee replacement and a history of heart attack and stroke. I also train individuals with fibromyalgia, multiple sclerosis, history of seizures, diabetes, hypertension, post cardiac patients, gastric bypass and several with histories of musculoskeletal injuries. In addition to private training, I am also a lecturer and newsletter writer. Once I have evaluated the client, with your specific instructions and guidelines, I will tailor an exercise program usually includes both cardiovascular and resistance training. I monitor the client’s progress and frequently provide you with progress reports and follow-up information. We believe patients need good exercise programs that are developed with fitness and medical professionals to avoid injuries and improve function. Our approach does not seek to “treat” symptoms of any kind. Our training modalities emphasize: *Balance. *Coordination. *Function. *Strength. *Cardio respiratory efficiency (Target Heart Rate Zones).
What patient populations can I refer?Many research studies have proven the efficacy of physical conditioning and fitness programming for the support of medical management for many diseases including:1. Diabetes (Type I & II)2. COPD3. Chronic Muscle Pain4. Depression5. Obesity6. Sarcopenia7. Coronary Artery Disease8. Hypertension9. Osteoporosis10. Neuromuscular disorders11. Postural Imbalances12. Athletic Injury As well, physical reconditioning is appropriate for pre-surgical weight loss and fitness to facilitate recovery and prepare the physiology for the rigors of the surgical intervention. It is also a great tool for post-physical therapy. Orthopedic injuries frequently force active people to become sedentary while recovering. Physical reconditioning is a great way to restore full body function to move them into ADL’s (Activity of Daily Living) quickly, efficiently, and safely. Patients recovering from trauma and injury that results in the loss of strength and flexibility, of both the injured and uninjured areas of the body, can benefit from physical reconditioning. When should I refer a patient to Glenn Greer, 30 in a hurry fitness?Whenever possible! All patients from 13 to over 80 that are not contraindicated from physical activity can be eligible for our program. I provide the following guidelines to assist your decision making: 1.Existing diagnosis if applicable (asymptomatic patients are welcome too.) 2.The patient has reached maximum medical improvement or is considered medically stable, with current drug therapy and surgical intervention (unless pre-surgical conditioning is intended). 3.The patient has completed any acute phase intervention and any physical therapy requirements. 4.No known psychological disorders affecting cognitive learning or any displays of violent tendencies. What kind of reports should I expect?After the initial assessment is completed and the program is developed, you will receive a written narrative and copies of the initial training regime for review. I welcome any input from you at this point. Progress reports will follow at your specified intervals or we will send one every 4 to 6 weeks depending on the length of the training period. Additionally, I take a client subjective report at each three week period of training.
What is the difference between sending a patient to a physical therapist or to a fitness professional?This is an important question. The modern physical therapist is dealing with high treatment volumes and very focused on the specific pathology and subsequent functional restoration.Although some physical therapist are well qualified to evaluate and initiate personal health fitness programs, very few have the time to address the intricacies of the long-term implementation of an exercise plan. Also involved are the lifestyle modification, constant nurturing, one-on-one attention, and dietary coaching that an individual needs to learn and ultimately integrate into their daily life. These issues combined with the hourly expense of most physical therapy services frequently make even short term programs financially prohibitive. Individuals recovering from surgery, acute trauma and significant functional limitations need the expertise, detailed skills and experience of great physical therapists thus making the best use of time and skill consideration. I ensure you that the scope of practice issues are respected and coordination of expertise is facilitated. I provide the following information for your consideration: Patient populations that can be readily referred without physical therapist involvement: 1.Stable Metabolic Disease – Diabetes, Hypertension, Obesity, Osteoporosis, Coronary Artery Disease (low risk post event and moderate risk pre-event), Hyperlipidemia, COPD, Stroke, Cancer (in remission). 2.Hypo-Kinetic Dysfunction – Postural and alignment problems (increased lordosis and kyphosis without pain), muscular imbalances, general loss of muscle tone. 3.Mental Health Conditions – Depression, Anxiety. 4.Sport Specific Training/Athletic Conditioning. 5.Pre-surgical for fat/weight reduction and muscle toning to facilitate recovery. 6.The average asymptomatic sedentary patient with no symptoms but stratified high risk due to genetics, family history, environmental exposure, lifestyle. Conditions under which a physical therapist must be involved at the physical fitness and conditioning assessment or referral to physical therapy. 1.Subjective report of pain above level of 4 on a 0 to 10 scale. 2.Inflammation response levels of III and IV. 3.Joints categorized at a level of 1 (ankylosed) or 6 (unstable). 4.Conditions that are exacerbated by activity even with modifications to movement patterns. 5.Conditions that result in paresthesia or parlysis of extremities. 6.Post surgical. 7.Pain reported while sleeping or at night. 8.Presence of open wounds or broken bones. I am trained to recognize scope of practice limitations and will inform you if I feel that the patient’s situation is beyond my skill scope. What is included in the initial assessment?Anthropomorphic Measurements – somatotyping, body composition, body mass indexing, girth measurements. Submaximal Cardiovascular Screening – resting heart rate, submaximal step test, heart rate recovery, Karvonen formula, pereceived exertion, talk test. Postural Evaluation – frontal and sagittal plane views, anterior and posterior views, leg length, body weight distribution.Balance and Coordination Screening – single leg balance, hop and multiplane challenges. Flexibility – all major joint and muscle range of motion analysis. Muscle Strength and Muscular Endurance Tests – multi and single joint loading approximating a 10 or 15 repetition maximum or to temporary muscle fatigue, in timed intervals, using perceived exertion scales. All assessments are adapted from the American College of Sports Medicine (ACSM) and the National Strength and Conditioning Association (NSCA). I provide all medical providers with complimentary assessments to introduce them to my program. Please provide a convenient date and time and a phone number to reach you. What happens when I refer a patient?Initially I will schedule a complimentary consultation that will last 30-600 minutes. This process ascertains the following:a.Brief history. b.Patient’s goals. c.Appropriateness of our services, d.Determination of financial arrangements. If both the client and trainer agree on a working relationship, I will proceed to a formal health history questionnaire and schedule the initial assessment. How do I refer?You may use your own prescription pad; or we can provide you with a referral form to fax directly to me.Please call or email me and request a referral form. If using your own prescription pad, we encourage you to fax it to us with the patient’s phone number so that we may provide a professional follow-up. Example prescription: Diabetes, Hypertension Exercise Program Evaluation and Physical Reconditioning No Contraindications Will insurance pay?Third party reimbursement is unpredictable and very difficult. I am not a licensed medical provider as defined by insurance company standards. Therefore, I establish a comfortable private plan with the patient (my client) and support the client’s efforts to obtain reimbursement. We have often found that a strong referral from a physician with an appropriate diagnosis has assisted clients in attaining reimbursement as payers begin to realize that our services are appropriate and cost effective.It is our hope to establish a network with Professionals such as yourself to help the participants improve and function better. All of the challenges faced by physicians who find it difficult to convince patients to exercise can easily be resolved by developing relationships with qualified fitness professionals. We would love to have you as guests and visit our fitness facility so you know you are referring your patients to a Professional Establishment with exceptional customer service. Possibly we can come with some ideas to help create a Network between us both. Click here to read an article on bringing medical and fitness communities together.
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