Serving the New Health Club Consumer
Establishing a Competitive Advantage by Adding
Complementary and Alternative Medical Services to Your
Facility Offerings
By Donald DeMars
In the 1950's the adult consumer's involvement in health club
activities was epitomized by the Muscle Beach or Charles Atlas "all
or nothing" phenomena. In the 1960's, with its focus on youth, came
the emergence of the President's Council on Physical Fitness and
Sports and the influence of Jack LaLane. The "self actualization"
seventies saw the post-war baby boomers entering the workforce,
and both Richard Simmons and aerobic exercise came into
prominence. In the 1980's both corporate fitness programs and
medically-based fitness/wellness centers emerged, and exercise
science validated the efficacy of anaerobic and aerobic exercise
for both sexes. In the last decade of the 1990's, fitness became
synonymous with wellness as only one important aspect of being
healthy. It was identified as essential for youth, middle age and
seniors, and it could be achieved through walking, spinning and
rock climbing, and by focusing on nutrition, smoking cessation,
cholesterol levels, etc.

There is no question that this evolution of the health club business
has been driven by the most egocentric generation in American
history. Born between 1946 and 1964, the 76 million Americans
who comprise the baby-boomer generation have changed every
industry they've encountered. In their early years, new elementary
and secondary schools had to be built to accommodate them. In
college, boomers redefined the pursuit of higher education. In the
workforce, they gave birth to headhunters and personalized
business services. In the same way that their wishes and demands
have transformed the retail, housing and financial services
industries, these consumers are increasingly taking things into their
own hands as they age and face quality of life issues through their
awareness of their own mortality. For healthcare and for the health
club industry, meeting the needs of this new groundswell of
consumerism is "an imperative for survival".

Fueled by the abundance of health information available through
the Internet, increasing regulatory changes in healthcare driven by
the balanced budget amendment, the rising popularity of
nontraditional care, and frustration over how consumers and their
families feel they have been mistreated by the system, a revolution
is underway not only in health care but in the health club or fitness
industry as well. Those businesses who adjust and provide new
products and services to this consumer will survive, and those who
don't, probably will not.

One very evident characteristic of the changes taking place is the
fact that the average age of health club consumers has risen
dramatically over the past two decades. Although different types of
clubs cater to different age groups by the very nature of their
programming and their environments, even national health club
chains, such as Bally, that have traditionally served a younger, more
price sensitive consumer have been forced to alter their approach
to remain competitive.

One of the advantages that larger club facilities have is that they
have a greater capacity to adjust to consumer demands because
of their size and scale. By adding medical programs to their
normally recreational/social approach, they have more potential to
reach the aging market. Why? Smaller facilities have fewer spaces,
and these spaces are usually dedicated to principally active,
physical fitness programs, such as weight training, aerobics,
spinning, etc. Larger facilities usually have more passive program
areas, such as educational classrooms, spa treatment
components, rehabilitation areas, and social gathering spaces.

Nevertheless, in my opinion, as a health club/fitness center/spa
designer who has worked within this industry for over twenty-five
years, all facilities can reach aging consumers if they keep the
following things in focus:

All facilities should have a balance between active and passive
spaces. Exercise, sports, and adrenalin drive active spaces. These
spaces are louder; they pump us up; they provide the conditioning
effect. Passive spaces are quieter; they slow us down; they quiet
our stresses; they balance us; they center us; they heal us.

Young consumers are attracted to primarily active programs,
whereas aging consumers are attracted to quality passive

Aging consumers experience their first serious illness in their
forties or early fifties as the prevalence of chronic illness rises.
Arthritis, high blood pressure, hearing problems, diabetes, and
heart disease are among the most common ailments. As these
chronic conditions emerge, people spend more on healthcare
products and services. Baby boomers are avid consumers of
"quick fix" and "magical cures". Clubs that offer credible programs
to reach these will have a decided advantage.

In a competitive arena, branding, or being known by a particular
program strength, is a strong advantage in reaching particular

Developing medical alliances to accomplish these goals and
advertising effectively will automatically bring added credibility to
your facility for aging consumers.

Adding such expanded wellness services to your membership fees
and dues revenue base builds ancillary income, and this leads to
greater overall financial stability.
It is a surprising fact that eighty percent of all patient visits to
primary care physicians are linked to stress-related causes.
Stress, in fact, is known to affect the six leading causes of death in
the United States. It affects cancer, lung ailments, accidental
injuries, cirrhosis of the liver, suicide and, above all, heart failure,
the leading cause of death in the United States. The core of stress
management programs is teaching people to relax. Relaxation is
achieved through quiet, singular focus, a lack of interruption,
solitude, low lighting, and a passive unawareness of the rest of the

The health club industry has traditionally served this consumer need
through clean and vibrant spa facilities and programs. This has
included self-serve spa components, such as sauna, steam,
whirlpool, and cold plunge. In addition, spa treatment facilities have
included rooms for hydrotherapy, massage, and other relaxation

With the fitness industry's expanded awareness of their role in
potentially treating many chronic ailments that surface as
consumers age and the consumer's need to have these problems
solved, health clubs and fitness centers can adopt new service
strategies revolving around complementary and alternative
medicine. These can largely be accommodated in existing health
club spaces.

The terms "complementary and alternative medicine", "integrative
medicine", "holistic medicine" and other variations are hard to
define with precision because popular culture uses them
synonymously and interchangeably. This conceptual fuzziness
complicates communication between parties seeking to share
information, observations, and ideas about health and healing
practices that exist outside the realm of conventional medical and
fitness programs. Misunderstandings about terminology can at
times lead to heated discussion and polarization, impeding
thoughtful consideration of such nontraditional treatment modalities.

To minimize this confusion, there are two constructs that are
defined as follows:

A) "Complementary and alternative medicine" (CAM) refers to
self-care products, nontraditional treatment modalities and belief
systems that are widely embraced by consumers today.
Collectively, these constitute the backbone of a multi-billion dollar
medical economy in which traditional healthcare and the fitness
industry have had only marginal participation.

"CAM providers" are those individuals and organizations that
supply selected products and services in response to consumer
interest and need.

Consumer interest in CAM has exploded in recent years:

Studies indicate more than 40% of the adult population has used
one or more CAM therapies in the past 12 months to manage a
health concern.

Expenditures on CAM-related products and services are now
estimated in excess of $20 billion annually, the majority of which is

A small but growing number of health plans and health systems
have responded with programs designed to capitalize on this trend.

B) "Integrative medicine" does not refer to a specific set of
products or modalities; rather, it encompasses a process that
seeks to combine the best ideas and practices of traditional and
nontraditional medicine into optimal therapeutic combinations that
serve the best interests of the consumer. There were a number of
major national surveys and published research reports
documenting consumer interest in and utilization of CAM therapies
in the year 1998. These included:

"Understanding Consumer Trends in Complementary and
Alternative Medicine: A National Survey". Stanford Center for
Research in Disease Prevention, Sept. 1998.

The Landmark Report on Public Perceptions of Alternative Care.,. January 1998.

J. Astin, "Why Patients Use Alternative Medicine: A National
Survey," JAMA, 1998, 279, 1548-1553.

D. Eisenburg, et. al., "Trends in Alternative Medicine: A National
Survey in the United States, 1990-1997," JAMA, 1998, 280,

All of these studies have documented that the following
interventions have all been identified as useful therapies by

Nutritional Counseling





Vitamin therapy


Yoga, Tai chi

Imagery or Hypnosis

Botanical/Herbal Medicine


If you are involved with operating an existing fitness facility, and you
are wondering whether you could integrate some of these services
into your present offerings, notice that all of these services and
programs are staged in passive component areas. In other words,
many can be operated out of existing passive program spaces, like
classrooms, massage rooms, low impact exercise or aerobic
rooms, offices, and other all-purpose spaces.

If you are building a new facility, then allow for additional,
all-purpose, acoustically sound proofed spaces that can be
individually mobilized for developing "brand value" programs which,
according to David Shore, associate dean of the Harvard School of
Public Health, create "strategic awareness plus perceived quality
plus singular distinction". These initiatives are what create a
competitive advantage.

Through each decade of change in the fitness industry, our
understanding of health has changed, and with it our program
dimensions of service have expanded. This subject is still in
transition, and predictions as to where it is all going is anybody's
guess. Nevertheless, everyone seems to agree that whatever
changes come, they will be driven by the new consumer.

So stay tuned! There's going to be a lot of interesting things
happening in this area as the millennium moves forward. Ignore it at
your own peril!
For more information about
Donald DeMars International, Inc.,
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All contents contained herein,
Copyright ©2003 by Donald DeMars International, Inc.