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Elaine,

My advice is simple. If it is part of your passion, do it. Start

small, share with others if you want (realizing the potential complications of

those interactions), but follow your passions. If you are looking at this as a potential

money-maker, tread cautiously. I think primary care docs are looking for

anything to help boost revenue and so we can be talked into anything. But in my

experience, things which look good on paper don’t pan out unless you are

willing to invest the time and energy necessary to really make it work. If it

is something you love to do, then it will easily be incorporated into your

practice and life, and the extra time necessary to make it work flows naturally.

If it is not something you really like to do, it gets ignored until it becomes

a festering wound and has to finally be dealt with (which is never pretty).

Having a gym you can access to stay in shape is very cool.

Offering that option to patients is also very cool. Dealing with the potential

headaches associated with it (not enough equipment for the demand, not enough demand

for the equipment, hours of operation, upkeep/upgrades, ? showers/towels, cleaning,

etc) is not cool unless you really love it or you can make enough money to hire

someone to do it for you. Running a practice (even a small IMP one) is

overwhelming enough without extra distractions pulling you down. Good luck with

your decision.

From:

[mailto: ] On Behalf Of

Sent: Friday, December 04, 2009 11:53 PM

To:

Subject: Re: Starting a small Gym

I heard on NPR today that part of the health

care bill will give discount ins rates to those who are part of a wellness

program. How do you think that will be defined? There is a Chiropractor who

wants to rent and share this gym w me. The chiroprater has this rehab program

that involves exercise. Thx for letting me know about the defibullator. It not

that important f anyone uses the gym, its just having it. But anyway.

Many my pt are like friends I have known for many yrs. Many live in

smaller apts, walk around my neighborhood, sometimes drop by just to say hi or

drop off some food etc.

The only reason I would go to my doctor to exercise

is if I want to be resuscitated in the event of a cardiac arrest.

Do you plan to have a portable

defibrillator on site?

On Sat, Dec 5, 2009 at 11:41 AM,

wrote:

I already have the spare room. Equipment used commercial reclining bike is

$750. My neighbor just bought one. So I $1000 output in costs. I could also use

the equipment for some exercise when I have some down time. It would be a

definite non covered service.

On Fri, Dec 4, 2009 at 6:05 AM,

Egly

wrote:

Elaine,

I have toyed with the idea of

starting a gym membership practice. Everyone who pays me a retainer for between

$1 and $2 a day would have access to the gym and my services.

I do not know the economics of a

gym, but " Anytime Fittness " comes to mind. If they can make an

income just on gym membership, I think I could make a compelling stand that it

can work.

I think I just need to investigate

the concept and draw up a proforma to decide if I could invest i the idea.

Your idea of starting small is a

good idea. Just make sure you can afford the venture and have a plan for

growth.

To: practiceimprovement1 < >

Sent: Thu, December 3, 2009 9:48:35 PM

Subject: Starting a small Gym

I am thinking of starting a " retainer "

practice. With that, pt would have access to a small gym (non covered service)

in my office. I can get a used commercial grade reclining bike and a

machine for upper body work . They can reserve a spot online. with my retainer

fee, I could afford to hire a receprionist/ MA who can help me out and also

keep eye on pt in gym. Likely my liability insurance will go up. Anyone

doing this?

--

M.D.

www.elainemd. com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

--

M.D.

www.elainemd.com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

M.D.

www.elainemd.com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

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Elaine,I think you are thinking of something like this practice in Sierra Madre (which had told us about at your house):http://www.proactivecarepartners.com/This practice doesn't accept any insurance, however, and it sounds to me like the physical therapist and dietician have other jobs, but are available if this practice needs their services. Not a bad idea if you are just starting out. SetoSouth Pasadena, CAI heard on NPR today that part of the health care bill will give discount ins rates to those who are part of a wellness program. How do you think that will be defined? There is a Chiropractor who wants to rent and share this gym w me. The chiroprater has this rehab program that involves exercise. Thx for letting me know about the defibullator. It not that important f anyone uses the gym, its just having it. But anyway. Many my pt are like friends I have known for many yrs. Many live in smaller apts, walk around my neighborhood, sometimes drop by just to say hi or drop off some food etc. On Fri, Dec 4, 2009 at 4:11 PM, Graham Chiu <compkarorigmail> wrote: The only reason I would go to my doctor to exercise is if I want to be resuscitated in the event of a cardiac arrest.Do you plan to have a portable defibrillator on site?On Sat, Dec 5, 2009 at 11:41 AM, <elaine2mdgmail> wrote:I already have the spare room. Equipment used commercial reclining bike is $750. My neighbor just bought one. So I $1000 output in costs. I could also use the equipment for some exercise when I have some down time. It would be a definite non covered service. On Fri, Dec 4, 2009 at 6:05 AM, Egly <kevin_egly> wrote: Elaine, I have toyed with the idea of starting a gym membership practice. Everyone who pays me a retainer for between $1 and $2 a day would have access to the gym and my services. I do not know the economics of a gym, but "Anytime Fittness" comes to mind. If they can make an income just on gym membership, I think I could make a compelling stand that it can work. I think I just need to investigate the concept and draw up a proforma to decide if I could invest i the idea. Your idea of starting small is a good idea. Just make sure you can afford the venture and have a plan for growth. From: <elaine2mdgmail>To: practiceimprovement1 < >Sent: Thu, December 3, 2009 9:48:35 PMSubject: Starting a small Gym I am thinking of starting a "retainer" practice. With that, pt would have access to a small gym (non covered service) in my office. I can get a used commercial grade reclining bike and a machine for upper body work . They can reserve a spot online. with my retainer fee, I could afford to hire a receprionist/ MA who can help me out and also keep eye on pt in gym. Likely my liability insurance will go up. Anyone doing this?-- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. -- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. -- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

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Thanks . i think I will check this out to see if this will work for me.

 

Elaine, I think you are thinking of something like this practice in Sierra Madre (which had told us about at your house):

http://www.proactivecarepartners.com/

This practice doesn't accept any insurance, however, and it sounds to me like the physical therapist and dietician have other jobs, but are available if this practice needs their services. Not a bad idea if you are just starting out.

Seto

South Pasadena, CA

I heard on NPR today that part of the health care bill will give discount ins rates to those who are part of a wellness program. How do you think that will be defined? There is a Chiropractor who wants to rent and share this gym w me. The chiroprater has this rehab program that involves exercise. Thx for letting me know about the defibullator. It not that important f anyone uses the gym, its just having it. But anyway. Many my pt are like friends I have known for many yrs. Many live in smaller apts, walk around my neighborhood, sometimes drop by just to say hi or drop off some food etc. 

On Fri, Dec 4, 2009 at 4:11 PM, Graham Chiu  wrote:

 

The only reason I would go to my doctor to exercise is if I want to be resuscitated in the event of a cardiac arrest.

Do you plan to have a portable defibrillator on site?

On Sat, Dec 5, 2009 at 11:41 AM,   wrote:

I already have the spare room. Equipment used commercial reclining bike is $750. My neighbor just bought one. So I $1000 output in costs. I could also use the equipment for some exercise when I have some down time. It would be a definite non covered service. 

On Fri, Dec 4, 2009 at 6:05 AM, Egly  wrote:

 

Elaine,

 

I have toyed with the idea of starting a gym membership practice. Everyone who pays me a retainer for between $1 and $2 a day would have access to the gym and my services. 

 

I do not know the economics of a gym, but " Anytime Fittness " comes to mind.  If they can make an income just on gym membership, I think I could make a compelling stand that it can work.

 

I think I just need to investigate the concept and draw up a proforma to decide if I could invest i the idea.

 

Your idea of starting small is a good idea. Just make sure you can afford the venture and have a plan for growth.

 

From:  To: practiceimprovement1 < >

Sent: Thu, December 3, 2009 9:48:35 PMSubject:  Starting a small Gym

 

I am thinking of starting a " retainer " practice. With that, pt would have access to a small gym (non covered service) in my office. I can get a used commercial grade reclining bike and a machine for upper body work . They can reserve a spot online. with my retainer fee, I could afford to hire a receprionist/ MA who can help me out and also keep eye on pt in gym. Likely my liability insurance will go up. Anyone doing this?

--  M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. 

If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. 

--  M.D.www.elainemd.com

Office: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. 

If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. 

-- Graham Chiuhttp://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--  M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. 

If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. 

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

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Elaine,

I wanted to share a potential resource with you. There is a doc

in SIMPD, Knope, in Tucson that has an extensive gym for his pts as an

option in his practice. You might reach out to him and see what he has to

say. Looks like his website is www.conciergemedicinemd.com

From:

[mailto: ] On Behalf Of Dr.

Brady

Sent: Saturday, December 05, 2009 2:55 AM

To:

Subject: RE: Starting a small Gym

Elaine,

My advice is simple. If it is part of

your passion, do it. Start small, share with others if you want (realizing the

potential complications of those interactions), but follow your passions. If

you are looking at this as a potential money-maker, tread cautiously. I think

primary care docs are looking for anything to help boost revenue and so we can

be talked into anything. But in my experience, things which look good on paper

don’t pan out unless you are willing to invest the time and energy necessary to

really make it work. If it is something you love to do, then it will easily be

incorporated into your practice and life, and the extra time necessary to make

it work flows naturally. If it is not something you really like to do, it gets

ignored until it becomes a festering wound and has to finally be dealt with

(which is never pretty).

Having a gym you can access to stay in

shape is very cool. Offering that option to patients is also very cool. Dealing

with the potential headaches associated with it (not enough equipment for the

demand, not enough demand for the equipment, hours of operation,

upkeep/upgrades, ? showers/towels, cleaning, etc) is not cool unless you really

love it or you can make enough money to hire someone to do it for you. Running

a practice (even a small IMP one) is overwhelming enough without extra

distractions pulling you down. Good luck with your decision.

From:

[mailto: ]

On Behalf Of

Sent: Friday, December 04, 2009 11:53 PM

To:

Subject: Re: Starting a small Gym

I heard on NPR today that part of the health care bill will give discount

ins rates to those who are part of a wellness program. How do you think

that will be defined? There is a Chiropractor who wants to rent and share this

gym w me. The chiroprater has this rehab program that involves exercise. Thx

for letting me know about the defibullator. It not that important f anyone uses

the gym, its just having it. But anyway. Many my pt are like friends I

have known for many yrs. Many live in smaller apts, walk around my

neighborhood, sometimes drop by just to say hi or drop off some food etc.

On

Fri, Dec 4, 2009 at 4:11 PM, Graham Chiu wrote:

The only reason I would go to my doctor to exercise

is if I want to be resuscitated in the event of a cardiac arrest.

Do you plan to have a portable defibrillator on site?

On Sat, Dec 5, 2009 at 11:41 AM,

wrote:

I already have the spare room. Equipment used commercial reclining bike is

$750. My neighbor just bought one. So I $1000 output in costs. I could also use

the equipment for some exercise when I have some down time. It would be a

definite non covered service.

On Fri, Dec 4, 2009 at 6:05 AM, Egly

wrote:

Elaine,

I have toyed with the idea of starting a gym membership

practice. Everyone who pays me a retainer for between $1 and $2 a day would

have access to the gym and my services.

I do not know the economics of a gym, but " Anytime

Fittness " comes to mind. If they can make an income just on gym

membership, I think I could make a compelling stand that it can work.

I think I just need to investigate the concept and draw up a

proforma to decide if I could invest i the idea.

Your idea of starting small is a good idea. Just make sure

you can afford the venture and have a plan for growth.

To: practiceimprovement1 < >

Sent: Thu, December 3, 2009 9:48:35 PM

Subject: Starting a small Gym

I am thinking of starting a " retainer "

practice. With that, pt would have access to a small gym (non covered service)

in my office. I can get a used commercial grade reclining bike and a

machine for upper body work . They can reserve a spot online. with my retainer

fee, I could afford to hire a receprionist/ MA who can help me out and also

keep eye on pt in gym. Likely my liability insurance will go up. Anyone

doing this?

--

M.D.

www.elainemd. com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

--

M.D.

www.elainemd.com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

M.D.

www.elainemd.com

Office:

Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

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Have seen gym equipment used for several tribal sites that had diabetes programs

and grant monies.. of course there was no charge for these.

One site had all of the equipment but no one could use it because they couldn't

monitor the users and since it was associated with the clinic they had no AED or

staff on hand in case of emergency.

One tribe hired an exercise physiologist to be there while the " gym " was open

and everyone had their own program designed for them.

I would definitely talk with an attorney to see what type of liability insurance

would be needed for this type of service.

We had much more success with a simple walking program at lunch time.. lots of

fun!

Freida Eng MD

Seattle

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remember, we live in society that people sue you because you sell them hot coffe.adolfo

To: Sent: Sat, December 5, 2009 3:13:18 PMSubject: Re: Starting a small Gym

Have seen gym equipment used for several tribal sites that had diabetes programs and grant monies.. of course there was no charge for these.One site had all of the equipment but no one could use it because they couldn't monitor the users and since it was associated with the clinic they had no AED or staff on hand in case of emergency.One tribe hired an exercise physiologist to be there while the "gym" was open and everyone had their own program designed for them.I would definitely talk with an attorney to see what type of liability insurance would be needed for this type of service. We had much more success with a simple walking program at lunch time.. lots of fun!Freida Eng MDSeattle

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This is truly excellent advice. I should print it on a 3X5 card to look at least weekly!My advice is simple. If it is part of your passion, do it. Start small, share with others if you want (realizing the potential complications of those interactions), but follow your passions. If you are looking at this as a potential money-maker, tread cautiously. I think primary care docs are looking for anything to help boost revenue and so we can be talked into anything. But in my experience, things which look good on paper don’t pan out unless you are willing to invest the time and energy necessary to really make it work. If it is something you love to do, then it will easily be incorporated into your practice and life, and the extra time necessary to make it work flows naturally. If it is not something you really like to do, it gets ignored until it becomes a festering wound and has to finally be dealt with (which is never pretty).

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I remembered my favorite book ( the Alchemist, from o Cohelo) when I read

Dr. Brady's advise.When he mentioned to follow your pasion its like saying

follow your personal legend as it was mentioned on the book.

>

> > My advice is simple. If it is part of your passion, do it. Start

> > small, share with others if you want (realizing the potential

> > complications of those interactions), but follow your passions. If

> > you are looking at this as a potential money-maker, tread

> > cautiously. I think primary care docs are looking for anything to

> > help boost revenue and so we can be talked into anything. But in my

> > experience, things which look good on paper don't pan out unless you

> > are willing to invest the time and energy necessary to really make

> > it work. If it is something you love to do, then it will easily be

> > incorporated into your practice and life, and the extra time

> > necessary to make it work flows naturally. If it is not something

> > you really like to do, it gets ignored until it becomes a festering

> > wound and has to finally be dealt with (which is never pretty).

> >

> >

>

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