(Photo by Brian Baiamonte: Al Moreau III, physical therapist and partner, Moreau Physical Therapy)
Denham Springs resident Kenneth Hawkins is no stranger to physical therapy. His body took a beating during his decades of working as a mechanic, and the physical punishment led to a string of surgeries ranging from bicep and rotator cuff repairs to a disc fusion and two knee replacements.
A few years ago, after his second knee surgery, his primary care physician delivered more bad news: Hawkins showed early signs of Type 2 diabetes. “That was a stopping point right there,” Hawkins, now 64, recalls.
He had known other people who had not only suffered with diabetes but even endured amputations as a result of the disease. “I decided nobody was going to cut my toes off,” he says.
Hawkins already knew the value of physical therapy through treatment he had received at Peak Performance Physical Therapy and Fitness following a couple of his surgeries. Now, armed with the knowledge that exercise can play a crucial role in managing diabetes, he set new health goals and made the transition from physical therapy patient at Peak Performance to membership in the company’s adjacent Spectrum Fitness Center.
These days Hawkins is a fixture at the “gym,” where he works out using a stationary bicycle, stair climber, elliptical trainer and an array of free weights. He has modified his diet to reduce carbohydrates and boost his protein intake. In the past two years he has lost 40 pounds, cut his need for prescription medications and sharply lowered his risk of diabetes.
“I feel great,” he says.
His health transformation has made Hawkins something of a poster child for “medical fitness,” a concept garnering increased attention from the medical profession and prompting physical therapy clinic owners to add traditional health club services to their offerings.
At least a few clinics in the local area have joined many across the country that are partnering with or acquiring health clubs in order to extend the benefits patients receive from short-term physical therapy. The clinics hope to tap into the growing popular interest in physical fitness.
Moreau Physical Therapy in Baton Rouge, for instance, which offers services in eight private practice locations and six contract facilities, has in the past decade put health clubs into its mix by acquiring Spectrum Fitness Centers in Zachary and Central.
“We have incorporated fitness and wellness into our business model because our strategy is prevention and not just treating the injury or dysfunction,” says Al Moreau III, a physical therapist and partner in the company.
Moreau says that because physical therapists are highly trained, with an increasing number obtaining doctoral degrees in their specialty area, they are well suited to guide clients into safe and beneficial exercise programs.
“We are experts in musculoskeletal care and have a ton of knowledge that can help clients stay well and, hopefully, avoid expensive medical care,” he says.
For example, he points to a patient experiencing lower back pain because of osteoarthritis or degenerative disc disease. Doctor-prescribed physical therapy can effectively treat the pain, but it’s a short-term solution.
“If patients don’t continue along with a program that can maintain the results of the therapy, then three or four months down the road, if they have become inactive again, they’re going to fall right back into the cycle of pain, increased medications and potentially surgery,” Moreau says.
AN EARLY EXPERIMENT
The therapists at Peak Performance have been preaching a similar message to patients—and doctors—for years.
The company, which has seven locations around Baton Rouge, was an early convert to the medical fitness movement. Peak Performance in 1999 began testing the concept by leasing space in a Spectrum Fitness Center and creating a mini-physical therapy clinic in the club. As therapy patients received their prescribed treatments, they often would begin using the club’s equipment as they progressed.
Peak Performance eventually bought that Spectrum center and three more around the area. Today, each of those locations has a separate entrance for physical therapy and fitness center clients, but Peak Performance makes the most of cross promotion, according to co-owner Chris Purvis.
He says therapists who work intensively with patients on physical rehabilitation are ideally suited to guide them in gaining strength through regular exercise to prevent future injury and a recurring need for therapy.
“As exercise specialists, we’re in a really good spot to say, for instance, that your knee pain should not necessarily stop you from exercising, and that if you lose 25 or 30 pounds your pain may go away,” Purvis says.
As much as the Peak Performance therapists address their message to clients, they try to drill their point home even harder to physicians.
The company developed a service it is promoting to doctors that offers introductory supervision to individuals who are not deemed to need physical therapy but could benefit from a regular exercise program. “It’s a cross between personal training and therapy,” Purvis says. “It’s a good base program to get people jump-started into exercising.”
Ideally, Purvis says, doctors will gain enough confidence in the company’s fitness services that they will recommend the program to appropriate patients. And as doctors see patients improving from the exercise, the idea may also gain traction with health care administrators and insurers.
Purvis, who has spoken to the annual conventions of the International Health, Racquet and Sportsclub Association, says many of the organization’s 30,000 members are interested in finding innovative ways to partner with health care providers.
Meanwhile, the Virginia-based Medical Fitness Association, a national organization of health and medical care providers of which Purvis is also a member, is working to develop a continuum of care between therapy and fitness and has created a certification process to strengthen the linkage.
Certified medically integrated fitness centers, according to the association, “feature the professional expertise and programming necessary to safely and effectively assist people, regardless of their current health status,” to maintain an active lifestyle that minimizes the risk of illness and promotes wellness.
Purvis says two Peak Performance health clubs are on track to become certified as medical fitness facilities.
As they tout the benefits to patients of linking physical therapy and long-term fitness, local clinic owners say the impact on their own bottom line does not escape them. While physical therapy remains their bread and butter, revenue from other sources is welcome, says Moreau, at Moreau Physical Therapy.
Physical therapists, like many other health care providers, face reduced reimbursements for their services in the current health care environment as third-party payers tighten up on coverage, he says.
“Any cash-based program, whether it’s fitness and wellness or adding nutritional services, can definitely help offset the declining reimbursements,” Moreau says.