Eric Durak - The Past, Present, & Future of Medical Fitness

Hey everybody, welcome to the Future of Fitness, a top-rated fitness industry podcast for over three years and running. I am your host, Eric Malzone, and I have the absolute pleasure of talking to entrepreneurs, innovators, and cutting-edge technology experts within the extremely fast-paced industries of fitness, wellness, and health sciences. Please stop by futurefitness.co to subscribe and learn more. There is one thing that fires me up. It's elevating the personal training and coaching industry. For that, the Workout app is an absolute game changer. No more promoting top brands without compensation or dealing with confusing social media links. In just a few clicks, Workout's user-friendly app lets top trainers and coaches curate and share the world's most sought-after fitness brands like HyperIce, Vega, and more. Product lines covering everything from fitness equipment to supplements and apparel. Save time and boost your earnings with generous commissions and bonuses every time your client purchases the products you already endorse. Do not wait. Maximize your income and streamline your business with store by workout. Discover more at workout.com. That's w-r-k-o-ut.com. Just one-o. W-R-K-O-U-T. Go get it. All right. We are live. Eric Durac. Welcome to the future of fitness, my friend.

Good morning, Eric. Eric and Eric. The Eric and Eric show. I appreciate you having me on because uh this is we had to we had to do like a we had to do a another take here from a couple weeks ago. And so I appreciate the the extra opportunity here.

So yeah, absolutely, man. I I appreciate you too because you've always been, you know, when I I first got introduced to the concept or the you know um specific area of medical fitness, you've pretty much been my go-to and I have questions about that stuff and getting clarity on it. And uh so your your wealth of knowledge in the space, you've been committed to it for quite some time now, and I think it's uh you know a topic I haven't really broached on this podcast yet. So this is it's gonna be really good for our listeners to get it. And you are uh now you are coming from beautiful, snowy Santa Barbara, California, which is is quite a funny thing to say. Uh and uh I'm excited to have you on. What is uh Q Q1 2023? What is going on in Santa Barbara right now?

Uh well, you know, the global warming, it's not. It is in the it's been in the 40s and 50s here for weeks. It we had massive rains yesterday. We have we had feet of snow in the San Inez Mountains over the last couple weeks. Um, and of course, you know, we haven't had any floods this year. But you know, you know, six, seven years ago, half a montecito went down to the ocean, and it was it was a terrible, terrible thing for the for the community. And and so everyone sort of holds their collective breaths about you know the weather here because as you know, being a resident in the past, almost every day is sunny and 70.

Yeah.

So when we get and we've had rain here since you know December. I mean, most of the month of January has been wet and cold and rainy and windy and all that stuff. So and nobody complains about the rain, because we all need the rain. Lake Cochuma is like 80% full now, fantastic. Uh everything is green here. You know, you drive up the coast, which I'm sure you've done, and it's just spectacular, you know. And and you know, the you know the adage in California, we have two seasons, green and brown. And and it is it is it is absolutely magnificently green, and it's just such a sight. I was I drove up the coast uh last weekend, and uh just it's it's amazing. So, like I say, but but you know, we could use a little bit warmer weather. I have my I have my my sweater here and all this other kind of stuff. So anyway, it's it is what it is.

The Santa Barbara Patagucci, that's what we call it. There you go. Uh well, enough about the weather, Eric. Let's let's get into medical fitness. And I think specifically, uh, as I was kind of telling you prior to this, I want I want to start by obviously qualifying your background because you've been doing this for a little while. And then I'd like to get into what exactly the definition by your standard of what medical fitness is. So let's start with your background, then we'll get into the rest of it.

Um well, I did my undergraduate uh uh in phys and sports medicine at Eastern Michigan University, where I competed on their varsity track team. I was Division I decathlon, uh which was a great experience. And my anatomy and physiology professor recommended that I apply for a teaching fellowship at Michigan, which was right down the road. So I did my graduate work uh at University of Michigan, and I studied with Vic Ketch, uh, who is um you know one of the authors of the Ketch and McArdle book textbook. Um I started my career actually in New York City uh at a place called the Sports Training Institute. And I I put my you know a couple thousand hours into personal training that year, but uh uh I had the opportunity to come to Santa Barbara to work for a medical research facility doing clinical exercise programs in diabetes. And that facility was the Samsung Diabetes Research Institute. Um and I got to work with for three or four years some of the top people in the world in diabetes research, metabolic research, cancer research, and pathology. So I did everything from clinical exercise programs for type 1, type 2, obesity, and gestational diabetes, which is GDM is pregnancy. So I had to learn a lot about pregnancy. Um, but I also did body composition studies, I did uh magnetic resonance imaging research. Um, I did laboratory studies. I was part of a group that actually did lab uh blood labs for the first generation of home glucose monitors, which are pretty much standard fare in the industry now. We would test thousands and thousands of samples of these things to get the best device. So, and the blood labs has come back to haunt me here 35 years later. Um, but uh in the 90s, I started one of the nation's first cancer exercise programs at the Santa Barbara Athletic Club. We were awarded the Ursa Institute Award in 1990. Uh I've worked with end-stage renal disease, I've worked with hypertension, I've worked with, as I said, high-risk pregnancies. Uh, I've worked with Guyan Barre syndrome, I have worked with uh probably about 15 or so medical conditions, and then I uh did a stint uh at ISSA uh back in the 90s, and I developed their fitness therapy course. And then just the the ball just kept rolling. You know, I did clinical and then, you know, whatever. And um, and after a stint at the University of California, uh I retired last year after 17 years, and I'm sort of back in the industry as a as a consultant, but in the medical fitness space, uh I have my company, Medical Health and Fitness, here, which is doing primarily work in research. Um I I actually just submitted a paper to the ACSM journal last Friday. Uh and I'm submitting a paper this week to a disability and rehab journal, and I'm submitting another paper, while it's actually is March. I'm submitting one or two papers this month for a strength and conditioning company that I work with uh from Los Angeles, Ultimate Performance. So I'm I'm really working with uh some of the top groups now in the country, and I've got other you know, uh clubs that are very much interested in the whole issue of data analytics. Um I have a partnership with Weld Health, and we developed a software program about a year and a half ago called uh Healthy Stats, which looks at blood labs assessments and day-to-day rehab um programming on a very simple level so people can um uh you know sort of follow and track the success, the outcomes of their of their clients and patients over time. So um I'm trying to sort of play the chessboard here in terms of where I think the industry wants to be. And uh I'm gonna take you back. I don't know how long you've been in the industry, but in the in the early 2000s, uh an economist named Paul Zane Pilzer wrote a book called The Wellness Revolution. And as an economist, he talked about the fact that there's a trillion dollars on the table for companies who want to do work in this wellness space. And he spoke at URSA and he said, you guys know that there's 75 to 80 percent of Americans who aren't members of health clubs. Some of them have medical conditions, but some of them just don't understand the process. And so my goal for the medical fitness aspect, which is really integrating the exercise component to people who have been diagnosed with a medical uh condition, because that's really, you know, we spoke about this before we went on air, is what defines medical fitness. And I would say it's just simply as the application of some type of exercise program or wellness program to a person who's been diagnosed with a with a medical condition. And it doesn't have to be a serious medical condition. Some people can have mild hypertension and they're gonna do fine uh, you know, with with with a with a program. Some people with advanced cancers, they'll they're gonna need a different type of program. So you have to specialize the program based on what the diagnosis is. And the meds and the therapies and the surgeries and all those other kinds of things. And we've I think the industry has done a fantastic job in moving in this direction from, like I say, ISSA started with a medical fitness. Uh there's the medical exercise specialist with ACE. Uh, Andrea Leonard has the cancer exercise specialist, Lisa D'Arty has the MedFit Network, which has CEUs for two dozen medical conditions. So so the industry is expanding in this direction, and I say it's about time.

And when you say this it's expanding in this direction, are you meaning like it's it's going from the medical community into the fitness community as an industry?

Or how how do you think that's an interesting question because because clinical exercise never really started in medicine. The only thing I can turn to from a historical standpoint is in the 70s, uh we started with cardiac rehab. So you had Neil Saul, who just passed away here last year, who was a pioneer, uh, and Dan Lynch, who is still in the profession, and and uh Lauren Brink and all these guys who started in cardiac rehab in the 70s, and they sort of brought it into medical fitness. And so now we've got the Medical Fitness Association, and they pretty much started with cardiac rehab. And um so, but it it's it's not really something that medicine has given to the fitness industry. It's something the fitness industry is just it just sort of it got dumped on our doorstep, Eric. I was I was working at the Santa Barbara Athletic Club, and someone came up to me and said, Do you train people with cancer? And I'm like, well, I've never no. And then I said, All right, well, let me do some research. So I started doing research and I found some work by a woman named Dr. Merrill Winningham, and she did bicycle testing and walking programs for women with breast cancer. And that was kind of about it. And that was in the early 90s, and since then we have had uh there are thousands and thousands of papers, and I'm actually working with a group uh from um uh uh a breast cancer surgeon from Arizona, uh a woman named Dr. Karen Wonders from Maple Tree Cancer Alliance, and some other people from around the country to actually move uh exercise and cancer as part of the standard of care for cancer survivorship. And once that happens, we're now working on the reimbursement component, which I'll get into in a little bit. But like I said, I think that medical fitness got kind of put on our doorstep because people with weight loss programs also had hypertension, people with weight loss programs had diabetes, uh, pregnant women wanted to learn how to do exercise, uh, and then the whole thing with cancer. And cancer is really snowballed, and now you've got Parkinson's. I'm working with a company in um in Syracuse, New York, uh, who has one of the nation's leading Parkinson's therapy programs, and we're gonna expand that nationwide. And I'm working with a company in Pomona, California called the Perfect Step. They do post-rehab programs for people who have spinal cord injuries. We're gonna he's gonna be at URSA, we're gonna have that go nationwide. Our first licensing contract is ready to go. So we're moving things in a direction that I think is going to be very significant. And I think because of the outcomes piece, which is what medical health and fitness does, and then my partner in Florida, Cosmo Wollen, we have the uh uh uh fitness is medicine, and we do the licensing, we do the operations, we do all the management of all of those kinds of programs because people do, you know, they still have to understand. Well, I've got this program, how do I get it from point A to point B? And that's where we come in. And then I also work with a company in Phoenix, Arizona called Life Corps Group, which is working with companies and clubs right now to get health savings accounts dollars, HSA dollars, to pay for or to quote, reimburse the cost of personal training programs. And that's gonna be a very significant aspect of getting clinical programs into health clubs in the next five years is the HSA and then reimbursement components.

Yeah, and I want to circle back on that because that's that's tremendously huge for the industry, right? Um perhaps we can do this, Eric. If you want to give me an example like how medical fitness may be different than what we know is traditional fitness, right? Like I have I've numerous times I've worked with people who um in my coaching life, maybe obese that goes along with you know, pre-diabetic or diabetic or um and you just have to be very careful as a fitness professional. You you're you're very limited in in what you can do because maybe we just like honestly, I didn't really have the knowledge set and experience to handle it. So I was just, you know, hey, we're just gonna put you on a rower for like five minutes and then see how you feel, right? That was kind of the limitation. So maybe, you know, give us a specific. Let's start with like Parkinson's, right?

Like how how is a uh Well, let me let me actually start from the meta from metabolic and then I'll go into neurology. So, metabolically speaking, when I worked with diabetics, I was, I'm gonna use the word a trailblazer because exercise is blood sugar dependent. When a person comes into an exercise program and their blood sugar is, they test their, you know, with the finger stick, and it's 93. Well, a good trainer who knows their who knows their uh aspects will say, okay, you're gonna do a light program, we're gonna give you like a half a protein bar, we're gonna get some calories in you so your blood sugars don't crash halfway between the program. But if a person comes in, let's say they're training for a 10K or a half marathon, and their blood sugar they come in is about 183, you have a lot more leeway for intensity and duration because it's blood sugar dependent. And that blood sugar will probably get down to about 115 to 125 at the end of their session. And the more fit they get, the more consistent their blood sugars will go from high to low and stabilize. Because as you get more fit, you get more gluconeogenesis, the liver will start to produce, the body will start to regulate itself a little bit better because it's fit. Okay? Same thing with um uh like hypertension. You're gonna take a blood sugar before or a blood pressure beforehand. If the blood pressure is high, maybe they're gonna do a meditation session for 15 minutes, you'll do another blood pressure, and then they'll get on aerobics or whatever. But if a person's blood pressure is normal, they can do the weights, they can do a combination of things, and then you'll do a blood pressure afterwards. So I think with fitness, medically fitness, medically based fitness programs, you're gonna actually do some sort of a medical um intervention like a blood sugar test, um, a blood pressure test, um, like for cancer patients, you do a quality of life, how are you feeling today? You'll do a pain management test, you'll do a range of motion test, et cetera, et cetera. For a person maybe with back, they've had a back injury, can they do side bends, front to back, twisting, whatever? And then you can jump into the program. So there's a there's a there's a level of assessment and outcomes that you're wanting to do with that. And I think that's where I have sort of cut my teeth in the industry because I started doing outcomes in the 80s with my diabetes program. And then from day one at the athletic club, I started doing assessment tools and follow-ups with every patient who went through the program. And then 10 years later, even when I wasn't at the club, I did a follow-up survey with about 69 or 70 patients to see how well exercise helped them over the course of their survivorship. It did very well, by the way, too.

So awesome. Awesome. I mean, the first thing when I'm hearing you explain this, the first bell that goes off is like scope of practice, scope of practice, right? Like uh as a fitness professional, you're always gonna be very careful, you know, with scope of practice. So, how do we handle um, you know, as is it the higher level of education? Is it working alongside a licensed medical professional to work those angles and make sure that scope of practice is honored? Like, how do you how do you work within that?

Yeah, well, I'm you're talking to a guy that was involved with uh licensure work back in the late 1980s, and now I'm I'm actually proud of the fact that our our profession is not licensed because I think licensure as a state government mandate has a lot of limitations. But I like the scope of practice in that um, you know, when I started working with cancer patients, there was no scope of practice. Now we have in a we have a body of knowledge in exercise and cancer that is absolutely phenomenal, and that body of knowledge which is which is um which has developed the scope of professional practice for cancer, and you can read, you know, many, many different articles and et cetera. And Andrea Leonard and her cancer exercise specialist has all of that. She's defined scope of practice. Dr. Wonders has defined scope of practice uh in the industry. And a lot of it is just being careful. And, you know, like I say, if you have a hypertension person and you're not doing blood pressure monitoring, you're you you better be because you're out of your scope of practice. If you have a patient that you're working with that you don't have a relationship with their doctor, you you should probably get one because that means you may be doing something out of your scope of practice and you might not even know it. But because clinical exercise has been around for such a long time, and we have programs for many, many different types of medical conditions, uh, I think that we are moving in the right direction because uh you had mentioned advanced degrees. Most of the certification groups now that want you to be a clinical exercise or a medical exercise person say you should have at least a bachelor's degree in exercise science or or health sciences, which which makes good sense. Lisa Doherty's group is like that. You need to have the college education, and then you need to have some training. My clients in Los Angeles, the perfect step, the spinal cord group, um, if you want to be trained as a perfect step uh rehabilitation specialist, you need to have almost uh a thousand hours of training. It's it's way beyond the scope of what most other personal training and higher level certifications are. You have to do literally clinical rotations at their at their location. And uh they're a fantastic facility. Um I am absolutely beyond grateful to be working with them because of the level of professionalism that they have. And I believe they're setting the standard for the industry as we continue to move up the ladder. You don't have to be a doctor. And and the issue with physical therapy is uh I've always said if if the if the exercise profession stays more metabolic, because most people most people in the United States have metabolic issues. And now we have behavioral issues. You know, post-COVID, we're seeing, I think it's a 600% rise in behavioral issues, uh, you know, depression, anxiety disorder, ADHD, um, you know, uh threatening to commit suicide. All these kinds of things have really elevated. And I think and and and um Kevin Steele, Dr. Kevin Steele, just posted last week on LinkedIn a great study that again shows the benefits of exercise above and beyond medications for for depression. Uh and again, it's we've known it for a while, but we just need to keep hitting on it. Exercise is the the pill that if if you know, I could say you've heard this probably in your career that if exercise were a pill, blah, blah, blah. So anyway.

Yeah, yeah. And I I'm in favor, I like the thousands of hours in the you know, the the higher level of education that goes into being, you know, an exercise professional within the sphere of health, right? I think it's really important. I mean, I've had this conversation so many times with other people in the industry. It's like, you know, we're we're really not like no one no one thinks of a personal trainer and be like, oh, that's that's a career that demands respect, right? It just doesn't it just doesn't happen that often if we're honest, right? But I think the big part is is like, you know, why aren't we working with medical professionals more often? Why aren't we seeing as part of the health continuum? And a lot of it is like we just don't have the Level of education or accreditation that that allows. And I know we don't want we also it's a fine balance, right? Because we don't want overregulation either.

Oh, I I and I I you know 20 years ago, Peter Davis said that he felt, uh and I've actually quoted him in a few publications, um, that the that that the health and fitness industry does a very good job of self-regulating and we should keep it that way. And I'm I'm gonna make a point here without I don't want to get political, but I've worked in medicine. I've worked in I've worked in a cardiology department, I've worked it with renal disease patients clinically, uh, and I've worked in in a physical therapy center, and I've worked in a medical research center. And what I saw with COVID over the last two years, three, three years, has almost destroyed my faith in medicine in the United States. So my thing is yes, you still want to work with doctors. A lot of doctors still want to do great by the, especially oncologists. They want to do well by the oncology world has embraced exercise like nobody's business. But but I look at the the the the entirety of medicine in the U.S. and they got some fixing to do. Okay? So when I look at professionalism in personal training, I say to myself, you know, David Lyons is the multiple sclerosis guy. David and I presented at a conference in Las Vegas in December called Health 2.0, which is a healthcare executive level conference, and we got fitness guys speaking at this, and he was actually on a panel called Fitness and Healthcare. Fantastic. So we're making great strides in a direction because he was so popular. He David, David, I don't know if you know David Lyons, but he he had uh uh a multiple sclerosis as a as a bodybuilder. So we had to completely redo his whole body over years, and now in his probably late 40s, um, he's he's he's pretty much found the right type of exercise program to keep his uh MS at bay. And we have a lot of other people that are trying to do that. How can exercise mitigate these symptoms for a lifetime? How can exercise mitigate type 2 diabetes? If you lose enough weight, your blood sugars will regulate, your your metabolic profile will regulate. Um and it's with cancer, it's a little bit different because we're looking at health care costs and we're looking at survivorship. And when I did my 10-year follow-up, I found that uh I don't think that any cancer patients passed away in one group. I split it down the middle, those who continued to exercise and those who stopped. The people who stopped exercise, I think they had about three or four out of thirty people who had passed away. And again, there's a lot of mitigating factors there, but I felt very strong that the people who exercise over time just have an edge in terms of the health of their body. And that's that's the only thing that I see is that if just to be regular, uh, you know, I've been exercising now, Eric, for 50 years. And I I would be considered part of that special population category. You know, I'm over 60, I've got musculoskeletal things that have creeped up on me. I have to be very careful about range of motion, about you know, the amount of weight that I lift, you know, the et cetera, et cetera. And so I'm my own, you know, mitigator here, but but you know, I actually am working with a new generation of a few trainers locally here, talking with them about how to train someone like me, someone who's fit, someone who works out every day, but I got this, I got this, I had this surgery, uh, you know, whatever. So, and that's what they're gonna find. And I think that if trainers ask the right questions, keep learning uh about stuff, there's so much, there's so much information out there now. Uh there's, you know, it's it's you almost get inundated with it. I I get a post from a doctor almost every other day with a new exercise study from somewhere around the world, and that's just cancer. You know, there's you know, you you you pick pick something that you want to work with. Uh, you had mentioned um uh uh uh uh Parkinson's disease. So I'm working with a gentleman named Carl Sterling uh in uh in uh Syracuse, New York, and Carl has a neurological Parkinson's training institute, and he's wanting to branch out nationally. He's doing amazing work. He has great clinical outcomes, and he has a whole contingency of doctors in his community that refer to him. He's got too many patients. You know, he's got he had to hire somebody here in January because he's got too many patients. We all should have that problem, right? You know what I mean? But I think that the business is there, and I really think that with COVID, if you look at the URSA data, you know, they said that uh uh statistically that health clubs are about the safest places to be. Infection rate is essentially zero. People in my gym clean. I I said you can eat breakfast off the floor in my gym. It's so clean in there now, and that's that's a good thing. Um so you know, it's just it it's it's we're moving in a direction. People like Carl, people like David Lyons, people like Lisa Daugherty, uh, you know, et cetera, that they've they've created a niche for themselves. I mean, there's a guy that spoke at her conference a couple years ago, Lisa's, who spoke who spoke on uh exercise and autism. Now, outside of my exercise world, I I am a researcher in autism and vaccines. I have been for 30 years. And I am fascinated with the fact that you could actually use uh fitness protocols to mitigate some of the symptoms of autism. So interesting.

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Well, my goal for you know, I've been very lucky. I retired from the University of California last year, and I started this company, and I've already got two massive clients. I mean, Ultimate Performance is, I think, the world's leading uh high-intensity strength training center. They have they have places all over the world, and I'm I'm right now working with their Los Angeles groups, and and they have 10, they have I'm working with almost 100,000 lines of data right now just for two clubs. I mean, this is something that could, I mean, if I just stayed with them, that could be, that could be my life's work. But the grand vision here is if you look at where the industry in general needs to go, um, is is is the health club industry an essential business? Well, according to the CDC, it's not because they they closed, you know, maybe they should start selling liquor because liquor stores in California stayed open. You know, you see, you see the irony here, but but I see that with medical fitness, and I'm a huge proponent of essential business, I I I I have written, I have a whole series of articles on why exercise and health clubs are essential businesses. And um, my gist on that is if you incorporate some level of medical fitness programming in your club and you do things like blood labs and outcomes, you become a therapy center. So why would you close your doors? Because you are providing an essential uh uh uh program for these people. And I do believe that the CDC and the World Health Organization will try to close health clubs again. They will try to whatever, you know, whatever new avian flu or whatever it's gonna be, uh and and I am completely against it, but I want health clubs to be um really solid. So so having a medical fitness program of any kind, and and you know what I'm gonna say? Weight loss. What was the big thing with COVID? If you're overweight and have diabetes, your odds of having severe COVID are seven to eight, ten times of that with people who have a normal body weight. So if health clubs got into the weight loss business like ultimate performance, okay, they used to be in the high intensity strength for athlete business, and they found that two-thirds of their customers who came in there wanted weight loss. So they're doing an amazing job right now in using high-intensity interval training for weight loss. How do I know? Because I'm doing all their data. You know what I mean? I know exactly where they are in terms of statistically significant changes over time in body fat percentages. Unbelievable. So that's that aspect. Keep your doors open. All right. Um, number one. Number two is that it allows trainers to actually learn new skills, all right? How to how to use outcomes software, how to how to interpret blood labs, how to do all those kind of things that are now a part of uh the clinical exercise experience. And by the way, I have a I have a contract with LabCorps nationally, uh, and we actually, through their online portal request a test, any consumer can get blood labs. So they actually leave the HIPAA realm, you know, and and they can do it on their own. So if the client chooses to talk with their trainer about their cholesterol levels, that's between them. That's not some doctor saying, I can't give that to you because it's it's against HIPAA policies. So there's there's a number of things that are sort of shifting. The shan, the sand is really shifting, Eric, in in medicine and health promotion and public health in the United States. Um, you know, here we had to stand six feet apart and wear a mask during COVID, but the entire town of Palestine, Ohio was, you know, told to go back home with one of the worst toxic clouds in the history of this country hovering over their city. So I see the ironies and the inconsistencies with public health. I want the industry to be prepared, and I want to give them as much information and data as I can in order for them to make great decisions to keep their doors open for the next 20 years and expand and grow. I believe health, I believe health clubs are going to be part of our new sort of self-care system.

I love it. I love it. You know, for other people, we talked about this uh on the podcast. One of the things that always seems to come up is, you know, if you want to bridge a gap between medical profession, healthcare, and you know, the exercise professionals in the fitness industry, um, there's gotta be like a common language, right? There's gotta be a connection between the two where information flows back and forth. There's feedback loops and things like that. And uh a lot of times, like, you know, fitness professionals or exercise professionals, I would say don't really speak the language. So, you know, how do you how do you see the professions communicating together? What is that link between them as far as data and communication?

Well, I I do think that the health outcomes are are the most important things because I used to sit, I I I I've applied for a couple big NIH grants and whatever, and we're trying to talk to them about exercise. And I had a doctor stop me once. He goes, you know what? That's that's your business. That's what you do. I'm doing all this, I got to do this or whatever. And I said, Okay, that's interesting. So, but if you can say, I want to take it back to the hypertension person, because I did a series of blood pressures on clients, and I put them all into a spreadsheet and I and I emailed them to a doctor who did not understand that just by doing the exercise, this person had reduced their medication, lost a few pounds, but their blood pressures consistently, consistently went down well below uh you know hypertension levels. And so that's the that's the information they want to see. And it doesn't, you know uh for diet for diabetes, it's A1C in blood sugars. For blood pressure, it's just taking blood pressures on a regular basis. For people who have orthopedic limitations, uh, you know, McKenzie pain rating scale, one to ten. So they went from a 6.5 down to a three, uh, you know, how simple can you get? We we did an insert for somebody, and this is what their pain was. And and this person now, instead of exercising for two minutes, is now exercising every day for 15 minutes on the aerobic machine. All those types of things the doctors love. They love to see the data, they love to see the numbers, they love to see the outcomes. So if trainers can sort of get a little well-versed in that, which is what the the Welled Health Healthy Stats Software does, it's a very simple program to use. Um, there's no reason why they can't draw more patients in because they now have the ability to communicate their health outcomes to the very doctors who referred them in the first place.

So if I'm, Eric, if I'm a fitness professional, a gym owner, um, or just maybe someone entrepreneurial entrepreneurial attitude within the industry. And I'm thinking, okay, this is I want to start getting in here. Like what tools do I need? Like what, you know, as far as education, what are the basic fundamental tools? It sounds like a blood, a blood pressure cuff and maybe just you know some CGM possibilities. Like, what do I need to start venturing into this space?

Well, I mean, I mean, I'm still old school. I I still use a goniometer, I still use body composition. As a matter of fact, Ultimate Performance still uses skin folds for all of their patients. They have a specific reason for that, but but they still use skin fold calipers. But but their people are very highly trained in how to use them. They do things like, I don't know if you've ever heard of a malar skin fold measurement. It's actually a cheek measurement, and they use it for all of their patients. And I actually spent time with Joe Halstead, who's one of their business guys, last week, really talking about a paper we're putting together that we will be submitting on the use of malar skin fold measurements and how it correlates to overall body fat loss. So there's there's this gold mine of data in everything, but having some measurement tools, blood pressure, uh, you know, blood sugar, at least knowing what blood sugar is, um, uh, you know, tape measure, skin folds, body weight, all those kind of things. Uh, we have all of that stuff. Now you can step on a Tanita scale and you can get everything. And one of the big measurements these days is heart rate variability. There are some tools that you can now use to get heart rate variability. It's a huge component of medical fitness. It's a huge component. So I'm thinking like the fitness industry is moving in this direction, which is really great. And I hope they understand that these are very important but simple tools that you can use. So having a little, you know, little FitKit bag there with your medical stuff, uh, having the outcomes tools, you can write it out, you can do it on a software program. And then one of the things I've always been in favor of is just doing regular communication to the industry and to your medical groups, either um either doing uh little podcast or little things that you can, you know, of videos that you can post, or just going out in the community and just doing, you know, lectures, football lectures, stretching lectures, et cetera, et cetera.

So uh can you expand on HRV? I'm I'm a huge fan of heart rate variability for the technology and the opportunities that I think it presents. I still think it's not quite uh understood as well as it could be by the industry. So give us, you know, how how is that uploaded?

Okay, so uh that was a big question. Here's here's an EKG strip right here. So if an EKG strip, you have a certain what we call a P to P interval or a QRS interval to a QRS interval. So it it comes in a in a specific pipe, a spike at a specific distance, and it should be regular. And if it's not in a regular, let's I'm gonna say if you have a 60 beats per minute heart rate, it should, it should click every second. But if it's off by a little bit, you've got some problems with the electrical conductivity of the heart. And I think that the people who are in the worst shape have the worst electrical conductivity. And the reason I believe this is that as an athlete, I'm sure you know this too, the harder you push the heart, the more it has to actually work correctly. Otherwise, it has a heart attack. So so athletes who train the heart and it has to pump at a certain volume and a certain speed with exercise, it gets used to that thing. And you obviously know that endurance athletes have bigger chambers, and strength athletes have have uh a thicker myocardia. So you actually elicit changes in the heart and you actually create collateral uh circulation within the cardiac arteries. So the the heart rate variability allows people to sort of say this person's in, I think they're in more regular, their physiology is more regular. If their heart rate variability is consistent, their physiology is a little bit more regular because they're not having skip beats, they're not having um you know problems with, you know, well, I'm too fatigued, I've got to start, I've got to stop exercise now. So and and that's how I've sort of, and I'm not a an expert in heart rate variability, but I know a couple companies that are doing it. And I think that that's sort of the next leap here in in in cardiac rehab. And anybody can do it because you can do it now by standing on a machine like a Tanita or some of these other ones that have that capability of doing that.

So awesome, awesome. And you know, I would point people to uh HRV, gosh, I it's been such a Jason Moore at Sprint, Don Moxley at Mode Method, um recently had um Kristen Holmes from from Moore uh sorry, from Woop. And then there's just so many people, you know, that people want to go back and listen to the interviews and get educated on that particular thing. I'm just a big fan of it. Uh one of the things I want to make sure we save a little bit of time for because you know starting to butt up a little bit, but HSAs and insurance companies, reimbursements.

Where's that going? All right, so I'm gonna give you a little background on that, uh, on that. In in 19, in the early 90s, I was getting reimbursed for some of my diabetes uh exercise programs. We would actually submit to Medicare. So I learned how to figure out, I learned how to do a HIC, you know, the uh HIC 1500 forums. I had to learn how to do all the paperwork and submit back in the paper days on a regular basis. And in 1994, I wrote a book called The Ins and Outs of Medical Insurance Billing, which I still give to people because I think it's an important document because it talks about all of the CPT coding, all of the ICD diagnostic coding in terms of who you're working with and how you can actually sort of apply that. And um most people don't do reimbursement dollars, but I think the big title wave here, Eric, in the industry is going to be the use of health savings account, HSA. I have an HSA debit card, I use it for my rehab every week uh here locally. And you can apply that anywhere. You can apply that to a health club. It's it's you know, it's it's essentially money that's given to an employee that they can spend per year on certain types of services. And and in a lot of companies, if you don't use that, those dollars, you have to start over again the next January. So it behooves you to use those dollars. So, and you'd be surprised how many companies don't even know that they have HSA programs. So, my business partner in Arizona, uh Jason Paul from Life Corps Group, uh, is the guy who's spearheading this. And we're actually in communication right now with two health club chains to actually start using HSA dollars for some specific medical-based fitness programs. I think I think that this is gonna be the big thing. Uh and in two years, Jason will be transitioning his company to a nationwide health plan. So he's gonna be finally, finally, in our lifetime, we're gonna see a wellness health plan that will actually pay for a specific portion of they'll have catastrophic, they'll have you know medical, but they will also use it for. percentage of their health uh the health dollars that will go to personal training, massage therapy, reiki work, chiropractic adjustments in the club, uh, nutrition uh consults, et cetera, on a regular basis. And I think that, you know, A, it's about damn time. And B, I think that it's really going to excite people because you're gonna see healthcare cost savings, you're gonna see more participation, because now that people understand, well, I'm not paying for it out of pocket, but I'm sort of paying for it out of my HSA, so I have to be responsible to go. You know it's it's great.

Yeah, and I agree. I mean we're looking for it and I feel like you know the it's uh there's a long way to go to get actual insurance reimbursement, but the HSA seems like a nice bridge it is a bridge that you you have hit the nail on the head.

HSA will be a bridge between um the the current system which really you know people say well they get mad because they say something well it doesn't pay for wellness I say it's not designed to pay for wellness. Look at the current procedural coding it's for exercise for a body part it's for you know group exercise which you know have has been used for for group fitness but it's mostly for people who are undergoing acute care in in it's in and remember there are doctors codes for doctors. And so we're trying to sort of transpose this music here to have it work in an industry that's that that is not based in ICD9 diagnostics and you know this you know they have their own little their own silo. We're in a different silo we're just trying to make the music work for our our group of people and you're absolutely right I love what you said the HSA dollars is going to be the bridge because it's money that's already there. Yeah it's just sitting in a checking account basically sitting in an account mine's mine's sitting in my my debit card and I know how much money's in there and I I am just ecstatic you know out all the years I put in the university this is one benefit that I have that they put in every year for me that that yes I can use for an automobile accident I could use for stitches or broken bones but I can also uh use it for like I say I'm I'm doing a a a cash-based um therapy program here in town that uses both therapy and precision wellness and I in in in the one minute we have left I also believe that precision wellness uh uh nano V and compression sleeves and cryotherapy and PEMF and hyperbaric oxygen that is also going to be the future of medical fitness because they are a huge bridge that'll be another uh that'll be another uh uh uh uh interview that we do because I am so high on precision wellness right now I think it's absolutely in an integral part of of the the the system that needs to be done. Awesome.

Uh one last question for you Eric maybe you can move that microphone uh a little bit closer to your mouth because I'm starting to lose a little bit of your volume. But the um what do you need right now? Like if people are listening they want to reach out to you they want to collaborate or you want to collaborate who who would you like to hear from out there?

You mean like names?

Or yeah name sure or just the type of people.

I'm actually I'm actually wanting to work with the top health club chains in the United States. I'm uh I I know I I I I I know people who know folks from Lifetime Fitness I'm hoping to be doing some work with goals I'm hoping to meet with people like Bill McBride at Ursa in a couple weeks and really talk about hey the HSA dollars the blood labs the outcomes data all of those things are part of the puzzle that you guys need to get more types of people who normally wouldn't exercise in a health club and this is exactly what Paul Zane Pilzer said 30 years ago at URSA. I do believe that we are at that critical mass right now Malcolm you know Gladwell says we're at the tipping point. We are at a tipping point from post-COVID how the industry's going to grow how the industry sees itself I know that Liz Clark from Ursa wants to go work with the government and get the FIT Act and all these things. I'm not a fan of that any government that would allow people to go back into their homes in Palatine Ohio when there is clearly clear and present danger is not a government that I would feel cozy uh you know warm and fuzzy to cozy up with to say well let's let's get money for the industry. The money's already there Aaron and the there will be more money and there there's 75% of Americans don't exercise in health clubs. That's our future.

Awesome awesome Eric if people want to reach out to you if you want them to go specifically somewhere online what uh what say you where would you like them to go?

Well medhealthfit.com is my website and by gosh two weeks ago I just I just gave it a facelift so there's all kinds of stuff in there for for people to look at in terms of the medical fitness in terms of videos in terms of uh you know new ventures that I have with companies which I'm so excited about uh I'm starting out a a relationship with a company locally here SOS Nutrients which is which is food product it's it's a powder food for smoothies it's the highest sourced uh natural ingredients I think in the history of the uh of the profession and so I'm I'm I'm I'm getting relationships with those people and I'm I it's every day I get up and it's like oh my God look at all this cool stuff I get to do. So being retired is not that bad Eric sometimes I can only imagine.

Yeah someday well uh Eric thank you so much for for joining me like I said I I always uh appreciate our conversations I always learn a little bit about what's going on in medical fitness and ultimately you know it's it's been said so many times on this show and amongst board rooms and many things that really getting intertwined into the healthcare system and being at the forefront of that really is the holy grail of our industry. So you're out there figuring it out you know there's no road there yet but you're out there figuring it out.

Well there's a there's a dirt road I'm I'm here to pave the road i I'm here to get a really nice smooth paving because like I say from blood labs to HSA dollars to healthcare outcomes to data and research to the the the education process it's all there it's just people need to sort of the road needs to be smoothed out and I believe that that's the path that I have I'm happy to pick up the torch for the industry. I love the fact that I'm doing this now I've been given a second chance I'm like Jimmy Connors at the 1991 open. I got this second chance and I want to go to the finals man. You know what I mean? So anyway and I appreciate you having me on it's it's you know it's it's great to talk with you. I will see you in San Diego this month, right?

Most likely.

Most likely I hope so um yeah yeah I love I love it.

Yeah we'll uh we'll be on soon I'm sure I'll have you on again and ladies and gentlemen Eric DeRoc. Thank you sir hey wait don't leave yet this is your host Eric Malzone and I hope you enjoyed this episode of Future of Minute. If you did I'm gonna ask you to do three simple things it takes under five minutes and it goes such a long way we really appreciate it. Number one, please subscribe to our show wherever you listen to it iTunes Spotify Castbox whatever it may be number two please leave us a favorable review. Number three share put it on social media talk about it to your friends send it in a text message whatever it may be please share this episode because we put a lot of work into it we want to make sure that as many people are getting value out of it as possible. Lastly if you'd like to learn more or get in touch with me simply go to the futureoffitness.co you can subscribe to our newsletter there or you can simply get in touch with me as I love to hear from our listeners. So thank you so much. This is Eric Malzone and this is the Future of Fitness have a great day