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Bridging the gap between clinicians and fitness professionals: a challenge to implementing exercise as medicine
  1. Rachele Pojednic1,2,
  2. Amy Bantham3,4,
  3. Fred Arnstein2,
  4. Mary A Kennedy2,5,
  5. Edward Phillips2
  1. 1 Simmons University, Department of Nutrition, Boston, Massachusetts, USA
  2. 2 Institute of Lifestyle Medicine, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 International Health, Racquet & Sportsclub Association Foundation, Boston, Massachusetts, USA
  4. 4 Harvard T.H. Chan School of Public Health, Boston, MA, United States
  5. 5 Exercise Medicine Research Institute, Edith Cowan University , Perth, Western Australia, Australia
  1. Correspondence to Dr Rachele Pojednic, pojednic{at}


Objective Health clubs (HC) and personal trainers (PT) are traditional outlets for the promotion of physical activity (PA) and exercise programming. As physicians are increasingly being called on to write exercise prescriptions for their patients, this study sought to investigate the level of integration between the healthcare and fitness systems.

Design An internet study was designed with five domains to understand physicians’: (1) overall perception of HC, (2) appropriateness and recommendation of HC and PT to their patients, (3) attitude regarding specific aspects of HC, (4) support of patient participation in HC sponsored exercise and (5) elements of HC that physicians would like to know for referral.

Methods An electronic survey was sent to members of two mailing lists of primary care and sports medicine specialty physicians during 2011–2012.

Results On a Likert scale of 1–10 412 physicians reported being familiar with HC (8.9±2.1), indicated a favourable view of HC (7.9±2.2), and believe HC to be an appropriate venue for their patients (7.5±2.3). However, physicians only recommend HC to 41%±28% of their patients and PT for only 21%±21.6% of patients. Physicians ranked expense and convenience as the most problematic elements of HC (8.1±2.1 and 6.3±2.5, respectively). 72% of physicians indicated cost as most concerning when recommending a specific HC.

Conclusion HC and PT are a significant implementation system for the promotion of physical activity, yet physicians are concerned with several elements of HC and are not adequately relying on this partnership to promote physical activity to their patients.

  • physical activity
  • exercise
  • physicians
  • prescription
  • health club

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors RP was responsible for data interpretation and manuscript preparation. MAK was responsible for planning and conducting the study. FA was responsible for planning and data analysis. AB and EP were responsible for planning and conduct of the study and manuscript preparation.

  • Funding This study was funded by International Health, Racquet, and Sportsclub Association.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Spaulding Rehabilitation Hospital Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data will be made available upon request.

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