Florida Gym Offers Medical Practice and Fitness Classes Under the Same Roof
“Nobody was getting better.”
Dr. Jeffrey Farrah, a nurse practitioner, doctor of chiropractic, and CrossFit L1 coach, says this referring to his time in clinicals during a nurse preceptorship.
- “None of my patients were happy, I wasn’t happy,” Farrah continues, noting that he was allotted about 10 minutes, per patient, to give care.
- “It wasn’t working…[We were] not connecting and ultimately, all the things I’m doing for [patients] on the chronic condition side weren’t working.” he says.
So, when he opened his own practice, Midtown Movement & Medicine in Tallahassee, FL, Farrah decided to do things differently.
The practice: Midtown Movement & Medicine, which Farrah runs with his wife, combines a medical practice – primary care services, bioidentical hormone replacement, IV nutrient therapy, and talk therapy – with fitness classes: CrossFit, striking and fitness, and personal training.
Farrah calls diet and exercise the “gold standard” for treating chronic conditions. Now, instead of prescribing a patient to exercise on their own, he can take them directly to his head trainer.
- “You say that ‘It’s a given that health and fitness go together,’ but it’s cognitively a given,” Farrah says. “But it is not practically a given, it is not emotionally a given, or practiced as a given. We as physicians, we as medical practitioners, we know this cognitively, but nobody does anything with that information.”
- “It’s one thing to tell a patient, ‘Ok, I’ve got one more minute with you… I need you to be exercising three to five times a week, I need you to be doing minimum an hour a day…. let me know how that goes,” he adds. “That is absolutely never going to work.”
- At his practice, things are different. Farrah can point to his gym and say, “here’s other people working out that look just like you, it’s not 20-year-olds who have abs and short shorts on, it’s a practical person’s gym,” and ask patients to make a commitment to a healthier lifestyle right then and there.
How it works: He runs the medical side like a concierge or Direct Primary Care service. Patients pay $100 per month to be a part of the practice, and Farrah doesn’t bill insurance. It’s a model much like that of The Drop-in Doc, a practice located in a CrossFit box in California.
- Farrah’s primary care patients are not required to be members of the gym, and vice versa, though he says it’s “starting to meld that way.” His rehab, chiropractic, and talk therapy and goal-setting services are wrapped into the cost of a CrossFit membership.
- Farrah says he “facilitates the use of insurance” if higher care is needed and recommends that his patients carry catastrophic insurance, in case of things like cancer, COVID, or an accident.
- But for routine actions such as blood work or an MRI, Farrah can often find his patients a cheaper option through cash. Farrah says one of his “pet peeves” is the overcharging of services. He explains: “I draw labs on you, and Quest sends you a bill for $600, which is your copay. Well, I know the cash price for that, the cash price is probably like $60. Why not just use cash?”
- “Patients who aren’t used to paying a monthly fee, they’re like, ‘What am I paying for?’” Farrah says. “And I say well, you call me and on the same day, I call you back. [The practice] is service-oriented, which the medical system really is not.”
Relationship-based medicine: Because Farrah sees many of his patients multiple times a week at the gym, he’s created more of a relationship with them, rather than diagnosing them with a chronic disease then saying “I’ll see you in a year.”
- “If I see you two to three times a week,” he says, “Even if it’s just passing, [I can say] ‘You just don’t look yourself today, Everything ok?”… if it’s something mild, we can just head it off much quicker.”
Farrah is also a huge proponent of focusing on mental health for both treatment and training.
- “We use it for treatment, crisis, traditional stuff, but we also use it for performance improvements,” Farrah says. “If you’re having a block of ‘I can’t do this or I can’t get to the gym,” we use it for treatment as well as optimization.”
Members, he says, are loving the combination of health and fitness Midtown offers. They’re able to stop in and see their primary care doctor, whether it’s for a B12 shot or to get blood drawn or just to check-in, on their way in and out of the gym.
- “I know them, I know their issues,” Farrah says. “I can be like ‘Hey, you need to stop and eat a quick carb [in this workout] because remember last time, you got light-headed, your sugar dropped, and we’re trying to manage that.”