Crossfit.
It is both the darling and the devil of the fitness industry. It offers a simple exercise methodology of ‘constantly varied functional movements at high intensity’, yet its success has been powerful enough to reach many people.
Despite its exercise-focused methodology, its success is not in the burpees or workouts. CrossFit’s success is through supporting people and fostering community.
It is embodied by fitness success stories. The internet is filled aplenty with case studies of personal development, rejuvenation of health, or even reversal of common and sinister afflictions of the Western world, ranging from chronic disease, metabolic poor health, dysfunctional lifestyle and addiction.
You can access this community of CrossFitters virtually; by immersing yourself in reading material, feel good stories. Just plug into the CrossFit Facebook page, or follow them on Twitter or Instagram. For more ‘official’ reading, delve into the archives of the ‘CrossFit Journal’.
Better yet, experience it physically. Find a CrossFit ‘box’/gym, join the workout and work hard – but be aware that the subsequent camaraderie, endorphins and spirit will sweep you along – you’ll be slapping sweaty, chalkdust outlined handprints on each others backs and giving salutatory fist-bumps in no time.
There is a 24/7, worldwide, intense CrossFit community. And it rocks!
What does this have to do with primary care? Or healthcare, in general?
—> On the superficial level, group-based exercise promotes physical activity and exercise, social interaction, teamwork and cultivates relationships and friendships. All of these are activities are investments that provide incredibly rich returns; cutting physical and mental disease, promoting self confidence and positivity, growing support networks, developing positive lifestyle habits.. the list goes on.
If primary care could share this ability to get people off their seats and into circles of people that spiral upwards, the landscape of a GP population would be revolutionised.
—> Going deeper, we need to dissect what makes CrossFit successful.
What makes people come back for more?
To give you context; Crossfit gets people to take control of their health. Which other institutions provide the same service in your area? GPs and Gyms..
If you go to you GP practice for help, chances are you won’t want to return back for more. Even if your return is to pick up something valuable to you, such as a repeat prescription, you probably put it low on the list of desirable chores you have to do.
Likewise, where does going to the gym sit on your list of chores to do today? If it’s even on there, I bet it’s below taking the recycling out or toilet cleaning.
How does Crossfit do it?
Membership Psychology.
Membership can be a powerful thing.
I’m a patient at my GP practice. I’m a client at the gym. I’m a member of my CrossFit box.
I go to my GP practice rarely. I no longer pay for the ‘normal’ gym. When I’m away, I miss my CrossFit box sorely.
I can’t say I’m friends with my GP. I can’t say I have many friends at the treadmill and weight-rack ‘normal’ gym.
At CrossFit, I’ve got smiles, encouragement and a sense of purpose that is shared with others.
1) Being friendly goes a long way in providing a positive user experience. A friend called it the ‘high-five culture’; celebrating effort and achievement. Physical contact. The freedom to praise other people. Praising is positive. The more everyone praises, the better every one feels, the more everyone praises everyone else. The better everyone feels. Combining this social induced pheromone release with an exercise induced endorphine release, a truly good thing is created. CrossFit breaks down barriers.
2) Being a member means sharing a purpose. Call it teamwork, call it a cult. My mental image of Crossfit is of a group of people under the same corrugated roof, all working, sweating and suffering for a workout sketched up onto the whiteboard. CrossFit builds camaraderie.
3) People invest their worldly possessions into it. It’s worth sacrificing for.
3a) If an individual who is on the fence about this new CrossFit lark shells out for a month’s membership, they’re not going to let that membership escape without getting their hard-earned money’s worth. They invest, they feel the benefits and then they are sold.
3b) Repeating this monthly transaction process keeps even “the converted” on board. Directly handing over money for a service reinforces its value in an individuals mind. I love my CrossFit gym. I pay for it and will spend all my time there.
3c) I believe that this transaction makes an individual engage with the service more. More engagement => less likely to skip a workout => more time engaging with friends => better results => go and buy the next monthly membership. Ta-da, a great self-sustaining business model.
3d) Don’t get me wrong, I am not criticising the price of CrossFit. You pay for a gym with a large footprint, expensive equipment and the supervision of coaches. The cost of a monthly CrossFit subscription might be cheaper than its 1-on-1 personal training equivalent. What I am saying is that the large price paid for CrossFit has the added benefits of ‘sunk costs’ psychology, creating better membership retention. More retention means a larger community with more social interaction. More retention means longer gym memberships and therefore better physical and social results from the gym.
So what does this have to do with healthcare?
CrossFit and the NHS have many fundamental similarities. They both attempt to benefit a wide and varied population with the intention of improving the population’s health.
CrossFit is a global business manifested by its physical ‘boxes’ and the communities within them. The NHS is a global business, manifested by many levels of healthcare – but the closest similarity is to a GP practice – your local healthcare box.
The approach to community between a CrossFit Box and a GP practice are yet so different. I believe that CrossFit is onto a successful formula.
1) Create facilities that are community focused and accessible.
2) Allow the buildings to be inhabited and overrun by a social community, creating a positive feed-forward mechanism that perpetuates good health behaviours.
3) A CrossFit membership can be an expensive outlay, but the benefits to membership retention and health benefits make it worth it.
Why don’t we flip this around. Think about being at the GP practice, right now, and test the simulation with these questions:
You are there for your free healthcare. What would you pay for it?
Yes, you pay taxes and the cost of a prescription – but these are still subsidised by the government.
When you leave the consulting room, do you feel like you’re a valued member of the community?
Do you feel like anyone wants to empower you to be better?
Do the same exercise if you’re a GP.
Did you take the time to understand your patient, to get to know them?
Did you empower them to own their health?
Did you properly create a friendship? How did your smile feel?
Did you emphasise the importance of lifestyle choices? Probably. Did you tailor your advice to that persons fears and dreams?
Dr Rory Heath 