MedFit Professional Summer 2020

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Online Learning for Fitness and Allied Health Professionals Continuing education in the fitness & wellness industry is critical, and professionals working with clients with medical conditions, chronic diseases and the aging must have a higher level of knowledge and skill. As part of the nonprofit MedFit Education Foundation, MedFit Classroom was created to offer fitness and allied healthcare professionals online education to learn how to effectively and appropriately work with our aging population and those with medical conditions or chronic disease, to help improve quality of life.

Available Now on MedFit Classroom WEEKLY WEBINARS Professional education webinars, presented live on Tuesdays at 10:00am PDT. Watch live or the recording at your convenience. SPECIALTY COURSES Online courses and programs to expand your education and services, and help grow your client base. Courses available now: • Discover Your Life with Breath as Medicine • Five Joints: Exploration of Joints and Their Wholistic Relationship with the Body • Genetic Testing and Personalized Programming for the Fitness Professional • Medical Fitness IMPACT Plan Online Program and Kit • Multiple Sclerosis Fitness Specialist • Profit, Power and Permission: A Course in Escalation for the Personal Trainer Courses coming soon: • Arthritis and Exercise • Medical Fitness Practitioner • Osteoporosis & Exercise Specialist • Parkinson’s Disease Exercise Specialist • Total Joint Care Specialist • Women’s Health, Fitness and Hormone Specialist







Lisa Dougherty |,

By Dan Mikeska


Josh Vogt |





By Andrew Wyant

What is a Medical Fitness Practitioner? Lisa Dougherty

national sales director

Josh Vogt | editor

Erin Eagan | audience development manager

Rachel Spahr | graphic designer



By David Rachal, III



Maurice Williams





By CarolAnn and David Lyons








Kelli Cooke | contributing writers

Andrea Leonard CarolAnn Mark P. Kelly David Lyons Dan Mikeska David Rachal, III Andrew Wyant

featured columnists

Maurice Williams




he advent of COVID has really impacted our industry and caused many of us to come up with creative ways to keep earning a living doing what we love by going online with virtual classes, training and coaching. This has certainly created an awakening on the importance of health and wellness. We are still facing a chronic disease, obesity, opioid and mental health crisis where Medical Fitness Practitioners can step in and serve an endless amount of people who need help in prevention, rehabilitation and managing chronic disease, helping those out of pain — physically and mentally. At our 2nd annual conference at UC Irvine, CA on Feb 6-8, 2020 we had a breakout session on “What is a Medical Fitness Practitioner?” After many go arounds with our Education and Medical Advisory Board we came up with definition and scope of practice that I wanted to share with our readers. A Medical Fitness Practitioner (MFP) is uniquely qualified to work with individuals within the medical-fitness continuum. The MFP has received ongoing education

and training to work with individuals who have been diagnosed with a medical condition including but not limited to: obesity, diabetes, hypertension, neuromuscular disorders, heart disease, lung disease, orthopedic disease, cancer, Alzheimer’s, arthritis, Parkinson’s, multiple sclerosis or mental disorders. These individuals may have been recommended by a licensed healthcare professional (i.e. medical doctor, chiropractic physician or physiotherapist) to participate in a structured physical exercise and/or begin behavioral change, like dietary modification and mental health processes. This includes individuals who have a specific health or fitness goal and have taken it upon their own merit to begin an exercise or behavior change program. The goal of working with an MFP is to responsibly direct the individual in a specific process that leads to improvements in overall health and wellness based on the medical history and goals of that individual. They understand how to make modifications, monitor and create progressive programs. An MFP has been trained to take a thorough history, keep accurate records and work within the scope of their respective training.

Additionally, an MFP has been trained to recognize that when an individual — either one who expresses an interest in, or is currently participating in, physical exercise and/or a behavioral change (e.g. dietary and mental health) program — has the possibility of an undiagnosed condition or exacerbation of a current medical issue, they make the necessary referral to a licensed healthcare provider. The MFP is also able to communicate with and educate the individual about the medical-fitness continuum as it relates to their unique medical circumstances and needs. To ensure coordination of care, the MFP is trained to competently communicate (both written, verbal and/or electronic) with allied health professionals. With this edition’s theme of “Career and Business Development,” we have content specially curated to get you thinking about what is needed to be successful in this space.



DAVID RACHAL III CEO and Chief Medical Fitness Officer, HEALTHEFIT, Richmond, VA

Tell us about you. I was the personal trainer that got the “unappealing” clients to my colleagues. The clients with the orthopedic limitations, chronic diseases and lack of motivation. Yet I managed to take knowledge and skills acquired through an unrelated degree in Therapeutic Recreation and turn it into a niche. Since 2001, no matter how challenging the comorbidities a client may have, I’ve been able to develop lasting and sustainable health solutions. I have given people back their quality of life and renewed outlook on living life to its fullest potential. I’ve always had a gift of turning lemons into lemonade and it didn’t take me long to realize that my gift for problem solving would make a huge impact in a major way. Today I’ve turned my sights on solving one of the biggest problems we have today… the rising costs of America’s healthcare system through the integration of medical fitness. In layperson's terms… what are you doing that’s unique? It’s been said that the medical fitness industry has existed for over 20 years and yet no one has seemed to develop a definitive role with health insurance until my company HEALTHEFIT came into its own. Through two years of hard work, consistency of standard operating procedures and reliable health outcomes, we established the first known medical fitness in-network contract with commercial health insurance. Our care model can reverse chronic disease in less than 12 weeks and we’re



currently working on reducing that time with the inclusion of genomics and epigenomics. Why is your work important now? What are you working to change? We have proven that our medical fitness practitioners can work side by side with physicians as partners in healthcare. This collaboration provides patient-centered physicians an opportunity to disrupt traditional healthcare with a more competitive, patient-friendly experience. With our new value-based models we have the ability to go beyond surface relationships to build a deeper mutual commitment that supports shared growth objectives. Through this medical fitness collaboration, supporting health insurance carriers can take a leading-edge position and compete more effectively to protect and grow market share. This provides greater incentive for medical fitness service reimbursement and increased career and financial stability for our medical fitness providers working to make a significant impact on their community. Why are you so passionate about this? HEALTHEFIT was born out of frustration. Frustration of an industry without any career path and almost no stability. I’ve watched hundreds of fitness professionals leave the industry because they could not generate enough personal training sales at a commercial gym to earn an income slightly above the poverty line. Frustration out of watching fitness professionals with bachelor degrees compete for jobs with

individuals with only a personal trainer certification. Not to mention that credible fitness professionals often compete with mobile apps, Instagram models and quick-fix gadgets. It’s my mission to make sure that there is a standard in the medical fitness industry that does not bend to the fads of an untamed and unregulated fitness industry. I cringe every time I accept an exercise science/physiology intern and discover that their current plan post-graduation is to work for a gym. The day of not having a career option is coming to an abrupt end with the expansion of HEALTHEFIT. Why excites you about the MedFit Project-MedFit Network & MedFit Education Foundation? The MedFit Project represents leadership and growth for an industry still in its infancy stages. This organization will do what no other network or certifying body has managed to do in over 20 years — bring like-minded individuals and companies together to achieve a common goal of healthcare inclusion. The MedFit Network is a crucial platform that allows the most prolific minds in the medical fitness space to have a voice and be heard. Often overshadowed by the fitness industry’s glitz and glam, these best-kept secrets are gaining visibility and influence in their respective communities and becoming greater assets to patients and healthcare. It is imperative that this project continue to thrive as its members represent the best solution available to an ailing healthcare system.


Maurice Williams



t is safe to assume that not everyone a fitness professional works with is injury- or disease-free. As a fitness professional, it is your responsibility to ensure that you provide your clientele with safe and effective programming. The question you have to ask yourself is: are you truly qualified and up to date on the latest information to work with your current (and future) clientele? A second question to ask is: are you marketing yourself to those who need you most in this healthcare crisis? If you're honest, you should at least say that perhaps you are not. Well, this is where the MedFit Network (MFN) can help! The MFN is both a professional membership organization for fitness and allied healthcare professionals and a free online resource directory for the community to locate professionals with a background in prevention, treatment and rehabilitation in working with those with chronic disease or medical conditions. As a fitness professional, here are three reasons why you should join the MedFit Network. Reason #1: Raising the Fitness Professional Standards by Becoming a Medical Fitness Practitioner MFN is dedicated to making sure fitness professionals are highly educated and prepared to work with any medical issue. The name given for this person is a Medical Fitness Practitioner



(MFP). The MFP helps make the transition from medical management and/or physical therapy to a regular physical activity program following a surgery, an injury, a medical diagnosis or exacerbation of a pre-existing condition. They also possess the training and skills to work with medical conditions like obesity, diabetes, hypertension, neuromuscular disorders and heart disease. So, a medical fitness practitioner is not just a personal trainer but includes wellness- and health-related disciplines such as chiropractors, massage therapists, physical therapists, nutritionists, etc. Reason #2: Continuing Education The MedFit Education Foundation (MFEF) is the nonprofit partner of the MedFit Network dedicated to elevating the quality and amount of available education for the medical fitness professional and the entire fitness and wellness community. For example, there is a Multiple Sclerosis Fitness Specialist and A Women's Health, Fitness and Hormone Specialist course that are both one-of-a-kind. Continuing education is required for all their specialty courses. This is typically not the case. It is usually continuing education only for your certification. All of their continuing education courses are approved by a medical advisory board of some of the brightest professionals in the nation. MFEF also has weekly educational webinars that are included with your membership. These webinars are pre-

sented weekly (50 in total) by industry experts on such topics as medical fitness and active aging. The MFN is an organization filled with people from all walks of the wellness professional spectrum. For example, they have MDs, PTs, chiropractors, dieticians, fitness and massage therapists to name a few. As a result, opportunities to network are endless. Because of this, current members have developed their own educational courses and even started their own blogs. Also, members have been able to designate their facility as medical fitness facilities by working with a member who specializes in helping people achieve this status. The MedFit Network is a unique organization dedicated to improving the standards of the fitness and allied healthcare professional. The ability for the diseased community to go to a directory of qualified medical fitness professionals is something unheard of anywhere else. The three reasons given are just the tip of the iceberg as to why you should be a part of this movement, the MFN! Maurice Williams offers a rare combination of advanced academic training, personal experience as a competitive athlete, entrepreneur skills and 22 years of experience in personal fitness and training. He has a BS in Exercise/Sport Science from Elon College (Now Elon University) and an MS in Clinical Exercise Physiology from Ohio University.


The Difference Between Health Coaches and Functional Health Coaches


ealth coaches of all kinds are united by one common goal, to better the lives of their clients through health-building principles. They are passionate about seeing their clients

succeed and restoring health and ultimately achieve optimal wellness. You can often find a health coach reading up on the latest dietary theories or learning about new ways to expand their business so they can help more people. However, when clients aren’t seeing results after carefully laid out lifestyle changes, clients and health coaches become frustrated. But what if there was a way to improve this process and improve client satisfaction? There is a particular type of health coach that stands out from the rest. Functional Health Coaches exceed the limitations of regular health coaching and are trained to uncover issues that lie deep within the body so that their clients can achieve their ultimate health goals. What are some limitations of an average Health Coach?  You can only work on generalized wellness with clients.  You cannot help clients with deeper health issues.  You want to provide clients with results to build your business, but find you face far more clients who need help beyond what you can provide.  Your clients expect results. If you are working with them on a six to 12-month program and they don’t see results, motivation can be lost.  Recruiting clients may become difficult. Training through Functional Diagnostic Nutrition to become a Functional Health Coach can help you get the answers you need to help your clients get to the root of their health problems and with complaints that cannot be resolved through diet alone. As a Certified Functional Diagnostic Nutrition® Health Coach you will be able to help people on a deeper level and get real results. ®

How becoming a Functional Health Coach can change the game:  Using functional lab testing to uncover the root of a client’s health issues can allow you to give clients the answers they’ve so desper-

 You can confidently assist your clients in a way that will give them the results that they have been longing for.  Happy clients will refer others because they got results and believe in your work, and your health coaching business will naturally thrive! Becoming a Functional Health Coach through FDN® can help you to take your health coaching business to a whole new level. FDN® gives you the functional lab training, data-driven protocols, tools and leadership you need so you can confidently solve your client’s health issues and grow your career as a Functional Health Coach. And, it will feel great seeing your client’s health and quality of life improve significantly. Do you want to separate yourself from the pack, enhance your practice and be able to help your clients see better results? Visit or call 858-842-3266 ext. 1.

ately been searching for.  Training as a Functional Health Coach will empower you to feel like you know enough to truly help your clients.  Knowing the root causes associated with health issues allows you to focus on the body imbalances that need to be addressed.  Using the D.R.E.S.S. protocol from FDN® allows you to help clients uncover hidden stressors and unhealthy habits in their daily lives.


By Dan Mikeska


Scope of practice, prevention and interprofessional collaboration


hysical activity is any bodily movement produced by voluntarily contracting skeletal muscle that results in energy expenditure above a basal level. Physical activity has been demonstrated to positively affect over 30 chronic conditions and is considered the best deterrent of chronic disease in primary and secondary prevention. The main goal of a Medical Fitness Practitioner (MFP) in the healthcare continuum is to prevent the onset of chronic disease and bridge the gap between clinical intervention and conventional fitness programs. This is achieved by developing exercise programs for those who have, or are at risk for chronic disease or dysfunction, have health conditions that may be mitigated or managed by exercise and activity, are newly diagnosed with disease and



need exercise guidance, or have completed a medically supervised rehabilitation program and need to continue to progress. A fitness professional versed in medical fitness protocols, such as an MFP, can work with those who are at risk for chronic disease. Scope of Practice Scope of practice refers to boundaries set by knowledge, skills and abilities (KSAs), as well as education, experience and demonstrated competency, such as a program of study, or an exam to measure proficiency. A basic personal training certification suggests the holder can develop exercise programs for apparently heathy clients. Unfortunately, considering the overweight and obesity rate is near 70%, and 50%-60% of the adult U.S. population has at least one chronic disease,

adhering to scope of practice becomes increasingly important, yet at the same time many fitness professionals may be providing services outside their scope of practice, and beyond their level of certification. By accepting a client, the trainer is proposing a safe workout will be developed and implemented, and the client will not be at risk of injury. If advice is given that is not within the trainer’s scope of practice, the trainer and the facility may be subjected to a lawsuit. An MFP who integrates medical fitness into practice has the KSAs, based on education, experience and demonstrated competency to conduct pre-participation interviews, perform fitness assessments and to design and implement health and fitness programs for disease management to avoid future injury and to improve activities of daily living. Unlike

an MFP, unless otherwise educated, a fitness trainer who promotes medical fitness is not a licensed healthcare provider and does not possess the KSAs to diagnose an unknown condition, suggest supplements, design meal plans, physically touch a client or provide behavioral counseling. Prevention In the United States, medical care tends to focus on treatment rather than prevention. Whereas treatment is given for a diagnosed disease or injury, the goal of prevention is to avoid, improve or slow down the progression of a probable or possible disease or injury. Prevention can be categorized as primary, secondary or tertiary. The goal of primary prevention is to foster a life of wellness and therefore avoid or reduce the chance of disease or dysfunction. Primary prevention includes immunizations, targeted types of exercise, balanced nutrition and wellness and education programs. Secondary prevention is managing a symptomatic disease in the hopes of slowing down or reversing the progression. Examples include treatment for hypertension, asthma and some cancer treatments. Tertiary prevention involves the management and treatment of symptomatic disease with the goal of slowing progression and severity, as well as reducing disease related complications. Tertiary prevention includes treatment for late stage cancer, coronary heart disease and some types of rehabilitation to include orthopedic, cardiac and pulmonary. Physical activity has been demonstrated to effectively treat over 30 chronic conditions, mostly in primary prevention but also in secondary and tertiary, making it the number one intervention against chronic disease. Interprofessional Collaboration Due to the growing incidence of obesity and chronic disease, leveraging the skills of various providers who can collaborate to deliver the best possible care, based on clinical needs, is necessary to manage the complex health care demands of a population with an increasing incidence of comorbidities. Due to a worldwide shortage of health workers, in 2010, the World Health Organization (WHO) recognized interprofessional collaboration as means to mitigate the global clinician shortage, strengthen health systems and improve outcomes. Interprofessional collaboration refers to health care teams, made

up of trained professionals with various backgrounds, who work alongside patients and their families to provide high-quality care, based on the needs of the patient. Consequently, as medical providers begin to recognize the need to prescribe evidence-based exercise as an intervention in the management of chronic disease, MFPs, who are on the front line of health care, are trained and educated to be part of a clinical team that complements and leverages the strengths of each team member to improve population health. As health-science and technology advance, it is imperative for fitness professionals who work with clients who have one or more chronic disease to remain up-to-date on emerging fitness protocols. An MFP is required to participate in continuing education in areas including cardiopulmonary disease, metabolic disorders and orthopedic dysfunction. Although the scope of practice of many allied healthcare fields overlap, the role of the MFP is to work with the client's team of other healthcare providers, while staying within the scope of practice, based on KSAs. Regardless of the collaborative health team, the client’s physician is always the center, and as such should be provided regular updates as to the client’s progress. An MFP is uniquely qualified to work with individuals within the healthcare continuum. Some KSAs associated with MFPs are:  Knowledge of basic chronic disease pathophysiology  The use and side effects of common medications taken by someone suffering from a chronic disease  The knowledge to perform and analyze

Figure 1 Association of various health care providers and interprofessional collaboration.

basic assessments related to movement and anthropometry  The knowledge to design a safe and effective workout based on information received via assessment results, and the clinical recommendations from other healthcare providers  FITT protocols, exercise progressions and regressions  The implications of exercise and activity for individuals with chronic disease  Contraindications of chronic disease, and signs and symptoms of distress related to chronic disease  Knowledge of signs and symptoms that require expertise outside of the scope of practice for medical exercise  The ability to recognize a medical emergency  Current CPR and adult AED are required

Dan Mikeska has a doctorate degree in Health Science and a master’s degree in Human Movement, as well as certifications from NASM, ACE, the Cancer Exercise Training Institute and the Exercise Is Medicine credential from ACSM. He currently owns NOVA Medical Exercise and Medical Exercise Academy and is adjunct faculty for A.T. Still University’s Master of Kinesiology program. Dan’s mission is to improve population health and to increase the quality of life by connecting education, medicine and fitness. He can be reached at or


By Andrew Wyant

CLOSING THE TRUST GAP Are personal training certifications failing medical fitness?


or over 30 years, the alphabet soup of letter-bearing personal training certification companies like ACE, NASM, NSCA and ISSA have focused on providing education leading to a fitness certification. While the companies have differing audiences and missions, collectively they have failed to truly make the connection between the fitness industry and the healthcare industry. Personal trainers tend to be health advocates (and sometimes zealots) who show up as the face of the fitness industry. They tend to actually live and practice the life they espouse. Most leave the industry quickly, but even as they leave personal training and continue throughout their careers they tend to retain their core values around fitness. Listen to almost any group of personal trainers and you’ll hear them speak passionately about the value of fitness and the ability



to help control or eliminate diseases like type 2 diabetes, heart diseases and some forms of cancer. For their more affluent customers, personal trainers are frontline soldiers in a battle for healthier living. So, how is it that well-intentioned organizations that believe that healthier living improves lives and who have over 350,000 personal trainers working in America alone have been unable to connect those trainers to the next higher level of their mission? What has gone so wrong that the average consumer would more likely connect a personal trainer to an Instagram or social media influencer than to their healthcare provider? In a recent ISSA survey, personal training buyers were asked what education or qualifications were required to become a personal trainer. Nearly 80% of those surveyed did not know. Fortunately, nearly everyone surveyed believed that some form of education or cer-

tification was required. Perhaps consumers would have the same answer if the question was asked regarding nursing or other healthcare positions other than that of a doctor. In this situation and those like it in America, we are accustomed to trusting the person in the job has the knowledge, skills and abilities to do the job. We may not know how or why, but we have given them the magic ingredient — trust. In our society, we fundamentally trust that by achieving the title of doctor, the holder will do no harm and will have the secret to curing what ails us. Do we trust that our personal trainer will do no harm and will have the secret to help us achieve our fitness goals? Not so much. In the same ISSA survey, buyers of personal training were asked if personal trainers could help clients lose weight and 90% answered yes. When asked if personal trainers could help cure type 2 diabetes only 10% answered yes. There was an 80% difference when asked the same question in the context of personal training goals versus medical goals! It would seem logical that if the same question was asked in the context of knee pain or joint pain and heart disease or blood pressure the results would be the same. We trust that personal trainers understand how to improve our fitness, but we don't connect our fitness to our healthcare. This is a trust gap. This trust gap is the most fundamental issue preventing all of the subsequent steps which need to happen in order for medical fitness to

thrive. There can be no insurance reimbursement or physician prescription of exercise as medicine as long as we don’t first believe our health is in our control and that fitness professionals can help their clients achieve results. Today, even physicians who believe in exercise as medicine are reluctant to refer clients. Despite some of the most forward-looking physicians and groups bringing exercise and personal training into their medical practice, compliance remains spotty and reimbursement varies widely. A recent study provided insights around prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculoskeletal

disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. But, how much of this is studied by medical students and applied by physicians? Why does the majority of our society doubt fitness? Is it because we don’t trust fitness professionals? If so, what is the fitness certification world to do? If we are to close this trust gap, the industry needs to achieve three milestones: personal trainers need to have a common standard of professional knowledge and skill, required continuing education and training must be in place and we need to have standards of care for fitness programming. This requires that the industry through leadership such as IHRSA combined with

companies like ISSA, NASM, ACSM, ACE and others eliminate the need for individual exams and certifications and move to a common standard of excellence for all. In the absence of the fitness industry creating an environment where all parties can trust their personal trainer to provide safe and effective training programs, none of us can expect medical schools to teach fitness or doctors to prescribe exercise or insurance companies to reimburse for exercise. COVID-19 has finally created a broad national awareness of the incredible risks of obesity and underlying medical conditions which largely could be controlled through diet and exercise. Now is the time to take action and help a new generation live healthier lives.

Andrew Wyant serves as the President of the ISSA after having helped successfully build and grow a series of businesses in a wide variety of industries. Since becoming ISSA’s leader in 2018, the ISSA has grown by over 400% and has become the No. 1 rated and reviewed personal training company in the world. Andrew is passionate about the potential personal trainers have to help improve our world by reducing the rates of preventable diseases. He has been deeply involved in the health and fitness industry since 2011.

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Founder & Owner, Metabolic Solutions, LLC; Director of the Association of Functional Diagnostic Nutrition Practitioners (AFDNP) Overland Park, KS

Strength and Conditioning Specialist, Corrective Exercise Specialist & Certified Massage Therapist at Sports Conditioning And Rehabilitation (SCAR) Orange, CA

Since being diagnosed with an aggressive form of rheumatoid arthritis my goal is to teach others suffering from arthritis and other autoimmune diseases the physical and mental benefits of exercise to improve the quality of their lives. I have developed various FUNctional Fitness programs for people with autoimmune disease, as well as a facial fitness program to improve facial muscles and fight disease. These programs will not only make you stronger, but also increase self-confidence and improve overall wellbeing.

I am a Functional Medicine Expert and Holistic Health Practitioner, specializing in treating complex chronic illness; I’ve increasingly become known as one of the world’s leading experts on Metabolic Dysfunction and Mold Illness. I primarily educate doctors and practitioners on cutting-edge strategies for functional lab interpretation, holistic healing program design, therapeutic protocol construction, psycho-emotional coaching strategies and everything in between.

For the past 16 plus years, I've strived to create the best exercise programs for my clients not to mention the company that I work for. Within these years, the industry has seen many changes in a positive direction leading to a newfound scope of respectability that this profession hasn't seen in the past. I'm honored and excited to be a part of that change and continue to move the needle forward as far as I possibly can!




CHRISTINE CONTI Founder, Conti Fitness & Wellness LLC; Creator, Let’s FACE It Together™ New York, NY








Owner, UFIT (Unique Fitness and Independence Training) Dublin, OH

Founder & CEO, Nova Medical Exercise and Medical Exercise Academy Herndon, VA

Owner, FitZone Bakersfield & FitZone Ventura Bakersfield, CA

Many people with autism, Down syndrome, Prader Willi, CP, obesity and a myriad of other neurological, physical and developmental delays do not have qualified professionals to help them access a lifestyle of health and fitness as they age. After spending 25 years in education as an Adapted Physical Education, I decided to open UFIT. I provide individualized programming for individuals with disabilities, including a unique visual system to build independence. Helping people who are differently-abled achieve their potential is the goal of UFIT.

NOVA Medical Exercise was built on helping clients overcome their chronic disease by networking with referring clinicians and providing individualized workouts based on the client’s abilities and goals. Throughout my career, I’ve been continuously learning, including advanced degrees and multiple certifications, and have now developed programs to pass on that knowledge to clients and other trainers. Medical Exercise Academy was created to educate fitness and health professionals who want to make medical exercise a part of their business.

I began my fitness career working at a gym owned by physical therapists. We’ve always worked together with therapy to enhance our member’s experience, but last year we integrated our spaces and collaborate using fitness, wellness, rehab, recovery, nutrition, lifestyle and more. We offer Rock Steady Boxing for Parkinson's patients and run a non-profit called Move to Improve, offering services for those with chronic conditions. My passion is working with these individuals and seeing the difference we can make in their lives.


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TIME TO MAKE HOUSE CALLS? As more healthcare companies see the benefits, it presents a huge opportunity for qualified medical fitness practitioners



tudies have shown that the number of physicians making house calls is increasing. One of the reasons house calls might be back on the rise is because U.S.'s senior population is growing at a rapid pace. Years ago, most physicians would make house calls for their patients. They would come directly to their patients’ homes to provide them with care. But over the course of the last 50 years, the development of hospitals has brought about a decline in house calls. The number of house call physicians could potentially spike in the years to come due to a variety of factors. Let’s look at why medical fitness practitioners might want to start making house calls, too.

The Aging Population in the United States Is Growing Quickly People who are 65 years old and above

providers that make house calls may be the only ones equipped to provide it.

are going to make up 20% of the U.S. population by the time 2030 rolls around. About a decade after that, this population is expected to double and consist of more than 70 million people. This means there will be more seniors living throughout the U.S. than ever before. Many individuals will be able to make their way to physicians’ offices to get treatment, but many others will be homebound or confined to assisted living facilities. As a result, there will be a need for mobile healthcare providers that provide medical care at a patient’s home. In anticipating about two-thirds of this aging population to address chronic conditions, they’ll need access to medical attention early and often. Mobile healthcare

Transportation and Mobility Issues Can Prevent Patients from Making Appointments There are all sorts of chronic conditions that people are afflicted with these days. Some of these conditions include:  Metabolic diseases  Cancer  Cardiovascular disease  Pulmonary disease  And more Some people afflicted with these chronic conditions can make their way to and from a medical facility for the treatment they need without help. However, many have limited mobility and need transport to and from a facility or a physician or other healthcare

providers who can come to them. Without home healthcare, the chronic conditions afflicting individuals can deteriorate and force extended and expensive hospital admissions down the line. Insurance Companies Are Offering Better Reimbursement for House Calls While there haven’t been many house call physicians working in recent years, the recent COVID-19 pandemic has demonstrated the need for not only telemedicine, but also resurgence of house calls. Healthcare has embraced the value as they’re able to operate with lower overhead costs and are approving medical treatment for patients who request house calls. Medicare, for some reason, seems to have indicated an inclination to approve more patients who request house calls. As more healthcare companies see the benefits of house calls, it could present a huge opportunity for qualified medical fitness practitioners.

* Free mobile app for professionals to record, stream and monitize their classes. Available on iOS and Android devices.

People Embrace the Convenience and Safety That Comes Along with House Calls With the current COVID-19 pandemic in full effect, we live in a time when convenience and safety are two huge factors driving decisions. Society has become so accustomed to instant information, feedback, entertainment and more, that we’ve grown impatient with waiting — for new movies, a meal and especially for health check-ups and medical appointments. While we want instant access to doctors and other healthcare providers, we also want more time with them to have in-depth conversations that address all of our health and wellness concerns.

Even for middle-aged patients who are relatively healthy and proactively managing chronic conditions, a house call from a medical fitness practitioner is convenient. Especially when they have a little one not feeling well, the last thing they can do is leave their home to drive — or take public transit — to an appointment. They want to keep their child tucked under a blanket on their couch and engage in their medical fitness therapy appointment with you. As more and more healthcare providers provide house calls for those in need, you can expect to see more people — young and old — open to this model of care.

David Rachal, III is our 2019 MedFit Pro of the Year. His lifetime commitment to engage, educate and empower individuals to achieve optimal health has led to the success of hundreds of private clients benefiting from his use of exercise as medicine. His vast subject matter expertise in healthcare and fitness has allowed him to serve as a sought-out fitness presenter/speaker to developing programs that are used to educate and train military personnel at Quantico and the U.S. Air Force Academy.

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By CarolAnn and David Lyons

EXPAND YOUR CAREER Become a Multiple Sclerosis Fitness Specialist


he health/fitness industry is constantly evolving with new scientific research and education released on a regular basis. Currently, the medical fitness track is on the precipice of explosion and expansion. Therefore, obtaining your personal training or group exercise instructor certification is only the beginning for launching your professional health and fitness career. One area of health/fitness specialization that is gaining attention is with the



multiple sclerosis (MS) community. There is a huge need and demand for qualified health/ fitness professionals to provide proper programming for those with MS. The National MS Society states that the MS population is more than double what was previously recorded with over one million people diagnosed in the United States alone. Health/fitness professionals can effectively work with those who have MS, providing them with a better quality of life, hope for the future and continued improve-

ment. Education and specialization on the part of the professional is key to the success of the professional and the client through proper exercise programs, nutritional guidance and mindset training specifically for those with MS. What Is Multiple Sclerosis? Multiple sclerosis (MS) is considered to be an immune-mediated disease in which the body's immune system attacks the central nervous system (CNS). With MS affecting almost three million people worldwide, MS is usually diagnosed between the ages of 20-40. But because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, the prevalence of MS in the U.S. can only be estimated. Symptoms of MS can be divided into two categories, common symptoms and less common symptoms. Some common symptoms include fatigue, walking (gait) difficulties, numbness or tingling, spasticity, muscle weakness and depression. Other less common symptoms include speech problems, swallowing problems, tremors, seizures, breathing problems, respiration problems and hearing loss. The cause of MS is unknown; however, scientists

believe MS is triggered by a combination of factors including inflammation, bacteria, viruses, geographical location and genetics. Nailing down your area of expertise and specializing in the area of MS and Health/ Fitness will not only expand your career but could also become a lucrative part of your income. Here are a few benefits of obtaining a specialty certification and continuing education in the area of MS and Fitness. Career Expansion By specializing in MS and Fitness, you’re diversifying your career, becoming more valuable to your current clients and future clients. You are also increasing your value to your future employers or business opportunities. Many health/fitness professionals with only basic foundational certifications are struggling to make actual REAL steady income. By specializing in MS and Fitness, you can turn what now may only be a parttime job into a legitimate full-time career. Specializing in MS and Fitness allows you to target a specific audience and create a revenue stream that will continue to flow through word of mouth within the MS community. The MS fitness community is growing rapidly, especially in the MS Fitness Challenge Charity which is now in 25 countries and Facebook groups like the MS Fitness Challenge GYM. With 7,000+ members with MS and who are interested in a lifestyle of fitness, this is your target audience who are looking to work with an MS-specialized trainer. Brand Marketability As more people with degrees and/or health science backgrounds enter into the field, the fitness industry expects more from its professionals than ever before. In addition, it is more imperative that you differentiate yourself from the rest of the health/fitness experts. It is not enough to just be a “personal trainer.” Being a health/fitness expert is about creating your brand. Specializing in your career is developing your brand and how you are going to be found and known to your potential client base. Not only are MSers looking for the expert who is going to help them with their specific need, but also MS organizations and companies are looking for that specific expert to educate and work with their constituents. You are more likely to secure that job or grow your business because you have established your brand and have gone the extra mile to expand your knowledge base.

Referral Systems and Collaborations Establishing your brand as the go-to expert in MS and Fitness will be the catalyst for building relationships with other professionals in your area. Creating a referral system with other allied health professionals like MDs, chiropractors and physical therapists takes a tremendous amount of trust on their part. They are not going to refer their clients to just anyone. They want to ensure that they are referring to trusted health/fitness professionals with expertise and expanded knowledge in the area of MS. This is a great referral stream that will be beneficial in growing your MS and Fitness business. In addition, once that symbiotic relationship has matured, you and your allied health professionals can work on mutual health/fitness projects together, doubling your efforts to grow each other’s businesses. Maintaining Relevancy Gone are the days when all you need is your personal training certification to start physically training clients. Initially, there were primarily only two main organizations that were known to provide comprehensive education and testing to achieve a certification. Now, there are hundreds of health/fitness certifying bodies and continuing education organi-

zations. The industry is constantly changing and evolving and it is imperative that you as the health/fitness professional stay relevant and current, otherwise the industry will pass you by. Continuing education provides you the tools necessary to stay relevant in the MS and Fitness world. In addition, your clients use you as a litmus test, and they trust you to either confirm or explain what they read on the Internet. Because you have the latest education and research information, your clients will come to you with questions regarding the latest MS information. Continuing education can be achieved through attending industry conferences, reading published peer-reviewed literature, reading industry publications, taking online courses and attending webinars. Bridge the Gap Fitness professionals can effectively work with those who have MS, providing them with a better quality of life through proper movement and nutrition, but you need to specialize. You as the MS health and fitness coach can provide a positive experience to facilitate an effective path to better health and wellness. For more information on how you can become a MS Fitness Specialist, visit

CarolAnn (M.S., CPT, CN) is a 30+year fitness industry veteran holding positions such as program director, studio owner, educator, presenter and author. She develops health/fitness curriculum for organizations such as FiTOUR, Hydracize, MedFit Network and PT Global. Along with producing and starring in several fitness videos, she is an expert contributor for publications such as Livestrong, Personal Fitness Professional (PFP), MedFit Professional, and New Tampa Style Magazine. She serves on the Education Advisory Board for MedFit Education Foundation. She is now spreading the gospel of health and fitness targeting churches with Chiseled Faith®. She has been selected to be a 2019-2021 National Fitness Hall of Fame Fitness Superstar. You can find her work at www.CarolAnn.Fitness and

David Lyons (BS, CPT) has spent most of his life in the gym either training as a boxer/martial artist or bodybuilder. He owned fitness centers across the US in the late 80s/early 90s; consulted in sales/marketing/management for gyms such as Golds’ Gym, Powerhouse Gym, Anytime Fitness and others; created and manufactured his own line of supplements; trained athletes and celebrities; and, after being diagnosed with multiple sclerosis in 2006, founded The MS Bodybuilding Challenge and co-founded the MS Fitness Challenge nonprofit charity with wife, Kendra R.N. (www. He is the author of the #1 selling book Everyday Health and Fitness with MS and columnist for the largest online wellness magazine, David is also the Senior Fitness Director for MS Workouts, overseeing all trainer programs.




Facing the increasing challenge of competing with underqualified trainers


s a personal trainer, you may find it increasingly difficult to compete in an industry that has no licensure and very little in the way of requirements. As an industry, we let anyone willing to take a two-, four-, six- or eight-hour online course become a personal trainer. This may explain the lack of expertise that is witnessed in so many trainers at gyms across the country. You may find yourself watching them from the sidelines, cringing as you notice the client performing deadlifts with an arched-back; squats with their knees caving in; or any other combination or poor supervision, direction and form. It’s unfortunate, but the average person has no idea what to look for in a trainer. They don’t know the questions to ask, the accredited certifications and whether or not that trainer is able to work with any pre-existing conditions that they may have. As gyms

hire underqualified trainers, underselling those of you who are worth your fee, clients continue to get injured. The client goes to a physical or occupational therapist and tells them they’ve been working with a trainer at X gym. The therapist rolls their eyes, having heard the story time and time again, discrediting personal trainers and the fitness industry as a whole. If you have put your time in — getting your degree, obtaining every accredited certification you could get your hands on and starting at the bottom of the food chain, scraping your way to the top, you may be feeling frustrated and perhaps a little defeated. Data from the U.S. Census Bureau shows that there are 76.4 million baby boomers. There were actually a total of 76 million births in the United States from 1946 to 1964, the 19 years usually called the "baby boom." Based on these staggering numbers, many nationally certifying bodies are realizing the need for medical fitness professionals. They are looking to change the industry, set standards for our fitness professionals, and require advanced education in order to work with any special population. In the next few years, we are going to see the pendulum swing in the fitness industry. There is a movement towards medical fitness and you can get in at the ground level, setting yourself apart from the low-level trainers. You will be able to create a niche market that will open doors in the medical community, increase referrals and increase revenue. Perhaps you or someone you love has been touched by cancer; there were an estimated 18 million cancer cases around the world in 2018!  One-quarter of new cancer cases are diagnosed in people aged 65 to 74  Median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer and 66 years for prostate cancer In 2018, there were approximately 43.8 million cancer survivors diagnosed within the previous five years. By 2040, the global burden is expected to grow to 27.5 million new cancer cases. During the COVID-19 pandemic we

are seeing that cancer patients, as well as others with compromised immune systems, are more alone and isolated than ever. This provides an unprecedented opportunity for you to provide a necessary and life-changing service to those in treatment or recovering from cancer. The Cancer Exercise Training Institute offers an online university fast-track program that also includes business coaching and training to take your business online. In five weeks, you can sit for the exam and, with at least an 80% passing grade, become a Cancer Exercise Specialist.

way they never imagined was possible, it is truly the most meaningful and rewarding part of your career. As we change the standards in the fitness industry, specialized training will be a requirement and you will be one step ahead of the game. By setting up meetings with nurses, doctors, patient navigators and support groups, you exponentially increase your potential client base. The unqualified trainer will not even be able to get in the door. The medical community will not accept a trainer without appropriate credentials. As a highly credentialed trainer, you can establish yourself as a blog writer, magazine contributor and speaker. Opportunities may range from speaking to a support group at a local hospital to becoming a keynote speaker at a huge event. You can even conduct local or destination retreats for specific groups (i.e.; breast cancer, diabetes, juvenile diabetes, active aging etc.). The doors will also open up to you at medical fitness facilities and possibly hospitals that are looking for highly credentialed medical fitness professionals. There are certainly other ways that you can make your mark and create unique marketing opportunities, but many of those will come and go with various trends and fads in fitness. Sadly, we live in a country that believes that “bigger is better” and wants “more for their money.” This has led to an epidemic of cancer, heart disease and diabetes, among other things. People will continue to age and whether it’s through the natural aging process or poor self-care, this is a market that is here to stay.

As we change the standards in the fitness industry,

specialized training will be a requirement and you will be

one step ahead of the game. To some of you, working with what would appear to be an aging or sick population may not be of interest. You need to decide if you want to be like every other trainer, creating beach bodies and six-packs, or if you want to really make a difference in someone’s quality of life, and your success as a trainer. Think outside the box. Beyond the baby boomers, we have athletes and adolescents who have diabetes, who suffer with obesity, have asthma, cancer and so much more. This is a relatively untapped market. For those of you who are up for a challenge, willing to step outside of your comfort zone and explore a new and exciting avenue in fitness, this offers a tremendous opportunity. There will always be those who want to lose weight, get toned, get ripped and improve sports performance, but after a while you can do that in your sleep. When you have clients that can’t get out of bed, can’t get up and down from a chair or can’t even perform self-care, and you are able to help them to take control of their life and their body in a

Andrea Leonard is President & Founder of The Cancer Exercise Training Institute.


WHAT DOES THE Emerging opportunities for trainers and coaches in medically oriented wellness BY MARK P. KELLY



our years ago, almost to the day, I made a keynote presentation at the California Clubs of Distinction annual meeting in Palm Springs. It was not long after the Affordable Care Act, also known as Obamacare, was approved and launched. I decided to make this presentation because the landscape for medical health was at an all-time high, and the certification organizations knew this as they were all scrambling for their market share of this emerging opportunity. I was making presentations in health aging and how to train elderly people in 2014, joined with and became a master trainer for an emerging group at the time and got certified in functional aging. I had met with this energetic woman in Orange County who was starting a network for medical fitness — any guesses? Yes, Lisa Dougherty was super



passionate about it and was busy enlisting all kinds of groups to collaborate with her. After working for the American Council on Exercise and knowing their interest in this market sector, I too saw an interesting niche in the fitness and health market that was not getting filled. The gap between an allied health care professional’s treatment and true functional health for any individual, but especially an aging one. Phil Kaplan has written and spoken quite a bit on this and labelled it as the “new blue ocean.” As he mentions, it is not a small niche, but a huge market opportunity, and it is driven by people valuing their health and quality of life. Market Changes: What does the future hold? Fast forward four years in what will go down in history as the COVID-19 year for the U.S. “We are all in this together” but six feet apart

and in our own homes! There is a lot talk out there about what the future holds. Our country has not seen this level of unemployment and losses of income since the Great Depression. Our government is bailing out people and companies to the tune of trillions of dollars. Large companies such as 24-Hour Fitness is considering bankruptcy and has closed all 448 of their gyms. The social isolation has changed the landscape toward medical fitness even further! The other trend it is causing is online services to be popular. The stay-at-home quarantines we all are supposed to obey has meant a huge upsurge for education and training done online or virtually, respectively. In an interview with Chris Rondeau, the CEO for Planet Fitness, he was mentioning how their facilities were always practicing good cleaning practices but felt the “personal

Figure 1: Factors in the Medical Fitness Perfect Storm

cleaning etiquette” will now likely change amongst members. Thank goodness! No one wants to be on a piece of equipment where another’s sweat was left. This factor and the personal space will likely be in the forefront as the fitness clubs are part of the Phase 1 of the U.S. government’s reintegration policy. He also mentioned how the public understands

tive” or paying a fee for a service, to a “value incentive” or paying for outcomes. So several questions the public is asking; 1. Are the big box gyms doomed? No but they may need to serve the two ends of the spectrum, with clubs like Equinox serving the high-end client and clubs like Planet Fitness serving low end clients.

2. Are group classes going to go away? Not likely, but the need to have six feet of spac-

What is next? It is believed that the fitness marketplace will change over the next decade, and that the pandemic has sped this change along. 24-Hour Fitness was going through financial problems prior to the COVID-19 shutdowns. The evolution of “gyms” becoming “health care” facilities is happening. You should position yourself to either deliver a variety of wellness services or have a network of people you work with who can deliver these services. I believe the future health center will be a place offering several services and most will be proactive in nature. You will need to join organizations that

ing and therefore smaller classes are likely to change the way group classes are run, and that is “when” they come back. 3. Will online or virtual training increase? No doubt they will. This trend was already going strong with Peleton (stationary bikes) and other fitness devices having the virtual coach. 4. Will wellness and health coaching services increase? Also, no doubt. People, like me,

expose you to people who desire these services, like the MedFit Network. Be sure to take advantage of this “downtime” to “gear up” with education and new business plans that include specialties in disease conditions like osteoporosis, Alzheimer’s disease and obesity. Others like women’s health or cancer or multiple sclerosis are available through the MedFit Education Foundation (MFEF) as well.

Bridging the gap between rehab and fitness is a process that is long overdue and much needed. that fitness is good for the immune system, and the lower price point of the Planet Fitness facilities are something the public will need to consider with the losses of income. He also mentioned how the company’s app and virtually lead fitness is exploding. He called it the digital content consumption and said it is at an all-time high for the company. So what factors were part of my “perfect storm” as I labelled it? The Affordable Care Act, the baby boomers becoming seniors, people living longer, medical costs going out of control, ROI on preventative services being realized and new opportunities for corporate wellness as well. Now we have a new perspective on staying healthy during pandemics, keeping ourselves and our families away from large crowds, and watching our budget. There has been a shift in society for quite some time now from a “volume incen-

have been not been in a standard gym for almost two months and are realizing the importance of their mental and physical health over just looking fit and trim.

Dr. Mark Kelly is a board member of the MedFit Education Foundation and will be launching certificate programs in Osteoporosis, Alzheimer’s Disease and Obesity for the MFEF soon.


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Chronic diseases and the health risk behaviors that cause them account for most healthcare costs.

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50% of the U.S. population is now over age 50. 80 million baby boomers make up 30% of the nation’s population and 3/4 of its wealth. As this group ages, there is a significant increase in obesity, chronic disease and individuals with multiple medical conditions. These individuals, once thought of as the exception, are now becoming the norm. They are seeking fitness and allied health professionals who understand who they are and can help them maximize and preserve their quality of life. There is a huge opportunity for fitness and allied health professionals to serve as pivotal players in our nation’s healthcare system.

What is the MedFit Network (MFN)? MFN is a professional membership organization for fitness, allied health and medical professionals, helping them elevate their career, recognition and profitability. The MFN also maintains a national directory of its members; this directory is available to the community for free, to search for professionals in their area who can help improve or preserve their quality of life.

Free Educational Webinars Weekly live professional webinars, led by industry experts and educators. ($400+ value) Subscription to MedFit TV Access to a library of 70+ hard hitting webinars and conference recordings on MedFit TV. ($99 value) Exclusive Savings Member discounts on certifications, continuing education, products and services. Examples include: Altra Running offers 50% off their award winning footwear; MedFit Classroom offers 20-50% off online courses. Medical Fitness Tour Members get a discount for the Medical Fitness Tour educational conference, as well as early registration. Marketing Opportunities As a member, you’ll get opportunities to market yourself or business via our social media, websites and more.

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