Anthony Carey’s Top 10 List for Getting Medical Referrals

May 10th, 2008

In my book, Relationships and Referrals: A Personal Trainer’s Guide to Doing Business with the Medical Community I write extensively about working with the medical community. I thought I would share my top 10 list of things to keep in mind when seeking to work with the medical community. Each of the top 10 are covered extensively in my book.

10. Be persistent

We’d love to believe that we are the most important person on the mind of your targeted referrals. The reality is that the “sales” cycle for getting medical referrals is often months. Sometimes many, many months. Plant the seeds consistently and when that first referral arrives, you’ll need to shine.

9. Nurture the best and forget the rest.

You will quickly realize that some doctors are advocates of exercise and understand your value. Others just don’t “get it” for a number of reasons. Nurture those that can help you help more people. Even get to know their practice and types of patients so you can have confidence providing reciprocal referrals.

8. Understand your certification doesn’t mean sh*t to a doctor.

Few if any medical doctors will know what the letters after your name mean. That doesn’t mean they are not of value (some of them anyway). Just don’t expect that to open doors for you. Use your education to help validate your work.

7. Don’t market to medical providers the way you would market to clients

Understand that medical professionals refer to whom they know and trust because you will be an extension of their care. They will not refer because of a brochure, web site, business card or ad. These collateral marketing materials are only supplementary to the person or business.

6. Provide them with documentation whether they ask for it or not.

Gather your client’s medical provider’s contact information. Get permission from your client to share your exercise plan with their doctor and send the doctor your assessment and plan. Send an accompanying cover letter and that exercise plan should end up in your client’s file with their provider. Your paperwork will be part your client’s discussion with their doctor at their next visit.

5. Let your reputation precede you.

Use your clients to open doors for you. If you are doing a great job with them, have them make introductions for you to their doctors. Your client should be your biggest advocate with their medical provider which can ultimately lead to more referrals once a relationship is established with that provider.

4. Don’t overstep your professional boundaries.

Most of us are in this business to help people and this may cloud our judgment when a client presents a physical complaint or limitation. Our relationships with our clients are often stronger than the client’s relationship with their doctor. Don’t attempt to diagnosis or “fix” your client because they trust you. Refer them to the appropriate medical provider.

3. Speak the language

Never communicate with a medical professional (oral or written) using terminology that you would use with your clients. An understanding of the terminology is a reflection of your level of expertise as well as being the form of communication they are accustomed to. Medical providers have professional standards they must uphold with their documentation. Providing correspondence to them in this manner also implies that you will comprehend any documentation received from them.

2. Find your niche

Working with medical referrals means working with special populations. Special populations have special needs and special risks. Know a lot about a little versus knowing a little about a lot. Do not attempt to be all things to all people.

1. Know your subject matter.

It’s not a good idea to promote to medical professionals that you do “post rehab” when you don’t know what occurs during rehab. This means from the therapeutic procedures, structures involved and contraindications. Please remember, POST REHAB IS NOT A FORM OF TRAINING. IT IS AN OBJECTIVE.

What does your committment to health look like?

April 4th, 2008

I am constantly reminded of the incredible differences between people’s commitment to their own health and well being. Those reminders are often people that walk through our front door at Function First.

Today I worked with woman who lives in Chicago, is staying in Palm Desert and drove 3 hours for her one hour appointment with me. And she is 72 years old! What an inspiration. She knows what she wants. She knows what her body needs. And nothing is going to detour her from her goals of exceptional health.

Several weeks ago I worked with a woman who was in from the United Kingdom. She has been all over Europe for help and heard about us through her personal trainer in London. And after her appointment she was thrilled beyond words. The travel meant nothing.

When do you reach your threshold? Is that when you will finally be willing to do something proactive? Is it going to take a full-blown crisis before you take the extra steps you know you need to take to prevent that heart attack or herniated disk in your back? I hope not.

After doing this work for more than 17 years, I am still astonished at the person I meet who will spend $40,000 on a car but won’t spend a dime on their health outside of what their insurance will pay for. That same person will take better care of their car then they will their own body.

The health crisis in the US is a societal issue. People placing blame and responsibility outside of themselves (how dare you not tell me how many grams of fat were in those french fries!). Your health insurance is crisis care. Not health care. How many people do you know that go to a medical provider because they feel great and just want to take their health to the next level?

Make yourself a promise and commit to moving beyond the “status quo” of your current health. Your body will thank you and your life will be much richer.

You can only tread water for so long until you begin to sink……

The Core-Tex is a hit!

March 11th, 2008

I just recently attended the IHRSA convention here in San Diego.  IHRSA is the largest fitness equipment trade show/convention in North America.  This show was the first time that I publicly demonstrated the invention that my good friend Olden Carr and I developed.

The Core-Tex was an amazing hit.  I couldn’t believe the response we got. Olden and I had been working on this project for many years never really giving it the effort it deserved.  We recently picked up the pace and had a pre-production prototype ready for this show.  And was it worth it!

We should have units available for retail in mid May.  Watch for the Core-Tex to be rated as one of the most innovative products for 2008.

If you want to see a couple of video clips of me using it, you can find them here on the Function First web site.

Anthony Carey interviewed by Rick Kaselj of Healing Through Movement

February 18th, 2008

I had the privilege of being interviewed by Rick Kaselj of Healing Through Movement in Vancouver, B.C. Rick will sponsoring my final public presentation of the Foundations for Function: Movement By Design course.

Rick did a great job of having me describe the course as well as our processes with clients at Function First.

You can listen to the interview here:

Check with your doctor before exercising? For what?

February 8th, 2008

It is the ultimate cover your a** statement placed on any piece of exercise equipment, exercise video, exercise book, exercise facility, etc. It comes in many variations, but the message is the same: You could die or get seriously hurt if you engage in this exercise related activity.

How’s that for encouraging our obese, lower back pain crippled society to exercise? I can’t think of a better way to scare off those who need exercise the most.

We’ve all seen a variation of this warning a million times. And anyone with a mild interest in exercise has probably become oblivious to it because they’ve seen it so many times.

This warning obviously is important to a very small percentage of the population. And even those in that small percentage should not be discouraged from starting a gentle exercise program (such as walking) before seeing their doctor.

But here is the biggest surprise of all: Your doctor is not going to tell you how to exercise because your doctor does not know anything about exercise prescription. As brilliant as he or she might be, the extent of their exercise knowledge is likely limited to their own personal experience (and for some, it’s not even that).

Even if the doctor is physically fit, there is little correlation between what he does to stay in shape and what his patient needs to do. Instead, what the physician should be doing is referring patients with risk factors to a degreed and certified exercise professional that has experience working with that type of client.

Too many physicians are not even recommending exercise in the first place. This begs the question, “Why not?!” Under what rock must a physician be living to not know about the countless studies that support the benefits of exercise on lifestyle related diseases and disabilities?

A survey, “Fitness American Style II” commissioned by IHRSA (International Health, Racquet and Sportsclub Association) found that 70% of Americans say they had an annual physical last year. But only 28% said their doctor suggested exercising regularly to improve their overall health, and only 41% said their doctor asked if they exercised regularly.

The American College of Sports Medicine has initiated a program in partnership with the American Medical Association that is “Calling on physicians to assess and review every patient’s physical activity program at every visit”.

It’s great to see this happening. But once the physician assesses the patient’s physical activity and finds out they are not doing enough-then what? This is where I believe the medical field over estimates the influence they have over their patients. Because most doctors believe that if they just tell their patients to exercise the patient will immediately follow that advice.

The reality is that these patients have never exercised or have not exercised for an extended period of time for their own reasons (whatever they may be). We refer to these as “barriers to exercise”. With all due respect to the doctors, they do not wield the same influence that their house-call making predecessors did. Patients now literally have to be scared to death before they see the consequences of their lifestyles.

One of the best ways to overcome barriers to exercise is for the doctor to provide the patient with clear directions for the next step. Since the doctor is not an exercise expert, those directions should involve a direct referral to a qualified exercise specialist.

Here is where the “check with your doctor part” becomes most valuable. The doctor’s referral should include what the patient should NOT do, also referred to as “contraindications”. This saves the doctor time and the potential embarrassment of not knowing what to tell the patient to do.

For example, the patient 6 months out from a hip replacement will have specific ranges of motion to avoid. This is great information for the doctor to include and for the exercise professional to be aware of.

Another example is the hypertensive patient on beta blockers who should not exceed 60% of their maximum heart rate. The exercise specialist can safely work within these parameters

That is step 1. The doctor documents this in the patients file and can follow up with them on their next visit.

Step 2 is when contact has been made with the qualified fitness specialist. Now that professional is in a position to use their expertise. Their expertise is not just about designing a safe exercise program. It also involves many of the skills necessary to help this person overcome many of the past barriers to exercise. Then it is the exercise specialist responsibility to communicate their assessment, objectives and plan to the physician.

During your next doctor’s visit, let them know your current exercise status. If they don’t ask, tell them anyway. Ask them for contraindications. And then ask them for a referral to an exercise specialist. If they look like a deer in the headlights with this question, tell them you know this group called Function First…..

Exercise specialist can find lots of great tools for working with doctors in my book, Relationships and Referrals: A Personal Trainer’s Guide to Doing Business with the Medical Community. Relationships and Referrals cover

Corrective Exercise is Functional

January 26th, 2008

I’ve just submitted a HUGE article to PTontheNet.com titled “Corrective Exercise is Functional”. It was so big they have decided to divide it into 3 articles.

I’m really excited about this article and the justification I make for the need and role of corrective exercise in the total continuum of training….even for uninjured athletes.

The first part of the series should be online February 1st.

The article is certainly going to ruffle a few feathers. And this is a good thing.

We should all be open to challenging the thoughts and convictions of one another for the purpose of expanding our own knowledge.

If you’re not a member of PTonthenet.com, remember you can get a discount by going to the Function First sign up page:

http://www.ptonthenet.com/bam.aspx?P=79525

Stay tuned…..

Free Lecture!

January 9th, 2008

From foot pain to migraines: Exercise is medicine!

When: Saturday January 19th

Time: 9:00 a.m-11:30 a.m.

Where: Function First 2700 Adams Ave., #205, San Diego, CA

***Seating is limited for this event. RSVP is kindly required***

RSVP by emailing Melinda at mlacey@functionfirst.com

or call: 619.285.9218

 

Join us for an amazing morning that will inspire you with strategies for achieving your health related goals and educate you on the role corrective exercise plays in long term good health and athletic performance.

Migraine sufferers will get to hear about some of the best strategies for controlling and preventing migraines. Adrienne Navarra will discuss the role of postural correction to combat migraines along with an overview of some of the other leading interventions.

Athletes to computer users will hear Anthony Carey debunk the myth of overuse injuries and the contemporary methods of treating them. Have all your questions answered and come away with a new found hope for resolving your physical challenges.

RSVP by emailing Melinda at mlacey@functionfirst.com

Study: Employer Advice and Devices Don’t Prevent Worker Back Pain

January 4th, 2008

Here is a link to an article in the periodical, Occupational Hazards. It summarizes a study that looked at 18,000 employees from 11 different studies.

Click here for the article

The following is from the last section of the article and is right in line with the Function First Approach:

“This study confirms that much of what is happening at the workplace is well-intentioned but probably pointless,” said Christopher Maher, associate professor of physiotherapy at the University of Sydney in Australia, who was not involved with the study.

According to Maher, regulatory agencies as well as employers make the mistake of concentrating on equipment and policies that don’t work such as back belts, lifting devices and workplace re-design and fail to focus on the “only known effective intervention,” which is exercise.

“We also know that exercise has health benefits beyond prevention of back pain, so you are getting two health benefits (or more) for the price of one,” Maher added.

Change the face of exercise for the seniors, the suffering and the sedentary

January 2nd, 2008

Are you thinking of starting an exercise program for the New Year? Do you think not exercising is bad for your health? In some cases, exercise can do more damage to your health than not exercising at all. High-risk individuals – seniors, the obese and chronic pain sufferers – are gambling with their health by simply walking into a fitness facility and beginning a training program without proper assessment, guidance and training.

Special needs clients require special programs. Highly individualized programs designed by professionals with specialized, advanced training. Unfortunately, most consumers don’t know the difference between a personal trainer with an Internet certification and one with advanced degrees and multiple nationally recognized certifications. And here is where the danger lies for the seniors, sedentary and suffering. Internet certifications and weekend workshops that turn accountants into personal trainers could kill this high-risk group. As more and more individuals with special needs seek the help of fitness professionals, they should literally be scared for their life.

A “One size fits all” approach shouldn’t apply to anyone looking for an exercise program, especially not those in high-risk categories. They require more comprehensive assessments, more individualized program design and a professional with an extensive knowledge of specific risk factors and limitations associated with their condition. Only then can this population progress safely and effectively.

Big fitness chains and franchises often don’t have fitness professionals with the necessary training to adequately train someone outside the prescribed “norm.” Instead, those with specialized training are more likely to be found in smaller, private studios better equipped to supervise clients and closely monitor workouts without losing clients in a sea of club members.

Need some ideas on the best questions to ask a potential trainer? You can download a PDF that I’ve prepared that will assist you in making the right choice.

Top 10 Questions for a Potential Personal Trainer

Best of luck for a happy, healthy and prosperous 2008!

The hip bone’s connected to the back bone

December 10th, 2007

The following is an article Zac Marshall, one of our Corrective Exercise Specialist wrote for out newsletter. It got such great feedback from our subscribers, I thought I would post it for anyone else to read.

We regularly send out very informative articles for the general population as well as health professionals. Be sure to subscribe to our newsletters if you have not already.

“The Hip Bone’s Connected to the . . . Back Bone”

By Zac Marshall

We’ve all heard that well-known children’s song about bones: “The foot bone’s connected to the . . . leg bone” and so on. Little do we realize, , the wisdom of this song as it relates to our health. Over the last few decades, one of the most significant principles health and fitness professionals have come to discover about the body is, as this song states, the connectivity of the musculoskeletal system. If we humble ourselves and learn from this simple children’s song, the key to much of our pain and physical limitation may become clearer.

Let’s apply the “Bone’s Song” to the number one reason people visit the doctor behind the common cold: lower back pain. As the “Bone’s Song” develops a key line appears: “The hip bone’s connected to the . . . back bone.” Contrary to this line, when most people think about back pain, there is s common misconception: they only look at the back. The wisdom of the “Bone’s Song” tells us that to understand the back, we must first understand the hip, the back’s closest ally.

Traditionally, the hips have often been an ignored piece of the low back pain puzzle. After all, if the hips aren’t hurting, they’re not a part of the problem . . . right? Wrong.. To better understand the low back pain mystery, it is essential that we look to unveil all the possible culprits behind the symptoms. The possible culprits to low back pain are many, including the feet and ankles; the knee, the upper back, the shoulders, and even the neck. But what we can be certain that if the hips aren’t working, the back is hurting.

There are several reasons why the hips are so commonly connected to low back pain. For one, the hips and the low back are direct neighbors. Thus, when the hip misbehaves, the low back is one of the first areas affected. To make matters worse, the hips have a tremendous amount of responsibility in aiding general musculoskeletal function. Due to their large muscles the hips are appropriately referred to as the “cannon” of the body. The problem with this is, if the hip “cannon” is not contributing properly or adequately to body movement, the low back is left highly vulnerable to undesirable stress and strain.

The low back is left especially vulnerable when the hip experiences one of two problems. The first problem the hip may experience is not providing enough motion (inflexibility). The second problem is not providing enough strength. When either (or both) of these problems are present, the low back often takes a hit.

Let’s focus our attention on what can happen to the low back if the hips experience the first problem: inflexibility. In order for the body to move and function in space the way it was designed to do, the body requires hip flexibility in three dimensional space (front to back, side to side and inward and outward rotation). When the hip experiences limited motion in any one of these three dimensions, it’s neighbor, the low back, is commonly called in to make up for the hip’s limitations. When the low back is asked to make up motion for the hip’s limitation, excessive flexibility occurs in the low back. This excessive flexibility is typically coupled with excessive joint wear and eventually pain.

One common example of the low back achieving excessive flexibility (and pain) due to the hip’s inflexibility is the activity of walking. During walking, the hip muscles must lengthen in order for one leg to extend behind the other. If the hip muscles cannot lengthen sufficiently, the body still knows it needs to move one leg backward. In order to do this, the body will often resort to having the low back increase it’s movement (by arching) in order to aide the leg in moving backward. If this compensation occurs often enough, low back pain is likely to develop.

Another common example of the low back suffering as a result of limited hip motion is in swinging activities. During swinging, the body needs to “wind” up in order to reverse directions and accomplish the swing. The winding that is required is an accumulation of motion at all the major joints of the body, including the hip. If the hip is not able to wind up adequately due to inflexibility, once again the low back will often make up for the difference. In this case the low back will either attempt to rotate more than it is designed to or it will once again excessively arch in order to achieve the movement. Just as in the walking example, if this compensation is repeated often enough the tissues of the low back become irritated and cause pain.

It’s amazing to realize how much understanding we can gain when we take our eyes off the symptom and look elsewhere for the cause of pain. This process is as simple as repeating the words to a simple yet profound song: “The hip bones connected to the . . . back bone.”