Medical Exercise Training eBook Tip 52: How & When to Discharge A MET Client

Welcome back to the MET 101 eBook series! In Tip 52, Dr. Mike addresses a transition that separates general personal trainers from true Medical Exercise Professionals (MedExPROs): How and when do you discharge a Medical Exercise (ME) client?

If you want to be fully integrated into the healthcare network, you must understand that ME clients are not meant to stay ME clients forever.

The Goal is Independence, Not Dependence: The fundamental goal of every healthcare provider—from surgeons to physical therapists—is to get the patient to a point where they no longer need intensive care, requiring only supervision or periodic check-ins. The exact same holds true for MedExPROs.

A trap that many fitness professionals fall into is wanting to hold onto a medical exercise client indefinitely because they can charge a higher premium for those specialized services. However, once a client's function, power, strength, and proprioception have significantly improved, they no longer require the advanced critical exercise thinking you learned in your Medical Exercise Specialist training. At this point, they are essentially a regular exercise client.

Discharging Does Not Mean the End: When you discharge a client from a medical exercise program, it does not mean you throw them away. Instead, you transition them into a Functional Maintenance Phase (as discussed in Tip 51).

In this phase, you can apply standard personal training skills at a lower level of intensity and, ideally, at a more economical price point for the client. You might transition them into a "medical membership" at your facility, where they simply maintain their function without a heavy focus on their previous medical issues.

The Medical "Step-Down" Model: To truly understand this, look at the traditional medical model. When an individual has a total hip replacement, the hospital may only keep them for 48 hours because it costs $3,000 to $4,000 a day. Once stabilized, they are "stepped down" to a skilled nursing facility costing $1,000 a day. Eventually, they step down to home health care, which is vastly cheaper but still ensures the client makes functional gains.

MedExPROs must play by these exact same rules. Insurance carriers are increasingly recognizing that smart money involves paying for functional maintenance provided by MedExPROs to prevent clients from regressing and ending up back in the expensive hospital system.

The 48-Hour Discharge Rule: To maintain professionalism and solidify your referral relationships, there is a strict administrative rule for discharging: A discharge summary must be forwarded to the client's referral source (their physician or therapist) within 48 hours of releasing them from MET services. This summary should include their outcomes and your recommendations for their continued exercise.

By discharging properly and stepping clients down into maintenance, you prove to the medical community that you operate with clinical integrity.

Ready to elevate your practice? Watch the full Tip 52 video below to hear Dr. Mike’s insights directly.

Be sure to download your free copy of the MET 101 eBook—built on 28 years of global MET experience—at www.met101ebook.com. If you have any specific questions about client management, you can email DrMike@postrehab.com.