PRACTICE SPOTLIGHT

March 2012

Gunter Dymkova-Fuchs, Dr.HSc. MPH

The Fox Group,

Consultants to the Healthcare Industry

Gunter Dymkova-Fuchs, Dr.HSc. MPH, is founder and senior partner of The Fox Group, Consultants to the Healthcare Industry.  Earning his Master’s in Public Health and Doctorate in Health Science at Loma Linda University, Dr. Fuchs was instrumental in founding several of the first Lifestyle Medicine programs at Loma Linda.  He created, designed, and developed the Center for Health Promotion, initially offering on-site and mobile services including risk assessments and lifestyle prescriptions.  The Center is still in existence today, providing primary and preventive care at the university and in the surrounding areas.

Dr. Fuchs also led the development of Rancho Loma Linda, a residential lifestyle center developed by the university outside of San Diego.  The lifestyle center made use of an existing 100-acre facility featuring lodging, a fitness center, pool, spa, and walking trails.  Staffed by graduate students and resident physicians and directed by a full-time physician, the residential program focused on weight management.  Promoted through the LA Times, the program attracted participants from around the world.  Studies conducted by doctoral candidates showed significant changes not only in weight, but also in a number of other clinical measures with significant reduction in risk factors.  Dr. Fuchs highlights the center’s financial and clinical success, noting that “the right clinical indicators were moving in the right direction.”

While in his doctoral program, he had the opportunity to tour self-supporting wellness-based physician practices and institutions across the country, an experience he found both rewarding and troubling. "What I found were very dedicated people with great attitudes and philosophy, but no sustainability. I cannot remember anyone who was truly self-supporting in the sense of not depending on donations to survive." During that time, he also visited several corporate settings, where he observed sophisticated employee-based wellness programs that not only provided an array of excellent fitness, nutrition, stress management and other services, but also generated revenue in the process.

A Focus on Sustainability

He began to question how to bring financial sustainability to medical and wellness-based practices.  “What became apparent to me was sustainability - my whole focus became sustainability.”  Seeing a lack of business planning and of due diligence, he set out to define success for medical and wellness practices and institutions.  “That became my focus and my passion, having talked with so many who were interested and so few who were approaching it from a hard core business development perspective – building a business enterprise that would ultimately be self-sustaining.”

Moving into leadership positions in medical, healthcare organizations, and academic institutions, Fuchs eventually founded The Fox Group, a select healthcare consulting firm that provides guidance and works alongside clients to implement necessary steps toward success.  The Fox group assists physicians, hospitals, outpatient rehabilitation clinics, and other healthcare providers to achieve strategic and operational goals.

The Fox Group has been involved in the development of a number of projects, nationally and internationally.  Fuchs describes his work with an employee wellness company that has now successfully moved into an international market, providing wellness assessments, education, and training among other services.  He points to the sense of satisfaction created upon seeing this and the success of other clients.

He describes the three-years of business planning toward developing a hospital-based free-standing wellness center in Berlin, Germany.  The Fox Group was able to negotiate a contract with the two largest insurance companies in Germany to cover the costs for members to participate in the wellness center programs.  “The biggest surprise, challenge, and reward was the insurance company participation, because the largest insurance company in Germany has their own series of centers for wellness, so their agreement was something I had not expected.”  The hospital-based wellness center has since expanded to include a multi-specialty medical clinic with frequent cross-referrals and collaborative relationships between the hospital, wellness center, and medical practices.  Dr. Fuchs firmly believes that clinical care greatly benefits from wellness services. “The best services are a mixture of therapeutic and lifestyle and wellness activities – all of these combined are likely the best package.”

Physician Practice Models

Having worked with many physician practices, Fuchs recalls one particularly successful physician-based practice model - a Lifestyle Medicine “collective” comprised of a network of independent practitioners. In this model, physician shareholders contribute a percent of their revenue to support chronic disease management, weight management and other lifestyle-focused programs.  Taught by wellness professionals, the programs are offered on-site at the physician offices and in community settings. The physicians provide pre- and post-assessments and take part in programs as their schedules allow.  Their shared financial contribution, along with participant payment for programs, allows this model to be financially sustainable and brings new patients to the physician practices.   

Fuchs notes that there are a number of unique models underway.  “The network groups I’m aware of are more interested in enhancing the services they provide in their private practices, which is a great thing and I don’t want to minimize that, but it’s not quite the same as developing an independent and self-sustaining company that offers clinical and wellness services.  I’m a proponent of having strong clinical, research, and wellness education and counseling.  To me that combination should be the strongest feature of any true Lifestyle Medicine activity.”

He also advocates for what he calls a foundation model, asserting that Lifestyle Medicine practices might look to community clinics as examples of medical practices that are donation-supported but otherwise self-sustaining, and suggests looking online for foundation support.  “The foundational model I believe should be more widely promoted because there are many organizations willing to provide support on an ongoing basis.  I believe we have not effectively utilized a foundation model in which donors sponsor participants to go through lifestyle programs.  I see this as a trend, along with the trend to move programs online to make them much less costly.” 

One question yet unanswered is what would a sustainable specialty Lifestyle Medicine practice look like?  Fuchs observes that in the classical practice of medicine, there are revenue streams generated through therapeutic interventions, with additional revenue generated through preventive services.  He argues that successful Lifestyle Medicine practices will likely need to optimize multiple revenue streams. “I would certainly harvest anything in existence, including some of the services covered under healthcare reform.”  A primary care physician, for example, may choose to offer lifestyle programs paid for by participants with some components – such as pre- and post-assessments - covered by insurance. “That’s a good approach, but still not completely self-sustaining.  We cannot expect all of the modules we want to apply in Lifestyle Medicine to be paid for by insurance or government.  If they do pay, terrific, but it cannot be the sole source – I have not seen that work.”  He maintains that in order to create a self-sustaining institution, we have to go beyond that, and not rely on insurance or employer payment.  “We have to put various pieces together.”

Healthcare Online

He also sees the need for more internet-based programs, stating “I believe that many of the services - especially education and wellness - should, can, and will happen online and we should be the first to design these programs.   We’re on the cusp of a completely new future where much of this needs to happen online…whole programs offered on line.” 

Viewing the internet and social media as the most significant change in healthcare, The Fox Group has launched a new company, Symplur, which was recently recognized in Forbes magazine as on the cutting edge of online healthcare.  Symplur focuses exclusively on assisting medical and wellness professionals enter the online universe.   “We do not just help them set up a website.  We help people enter the internet to be part of a conversation so that new patients, new traffic, and new clients can find you online and sign up that way.  This becomes critical in Lifestyle Medicine.”

Fuchs points to the growing numbers of people engaged online.  “Imagine that you have a Lifestyle Medicine practice.  The majority of clients, patients and customers are online now; they are looking for you.  But they can’t find you unless you’re in the middle of that conversation.”  He recommends that health care professionals be “right in the middle of that conversation,” attracting new patients who are seeking lifestyle-based approaches to treatment.  “This is a very exciting model - whether you participate or not, it happens anyway and happens worldwide.”

The Fox Group and Symplur are willing to offer assistance and tools at discounted rates to ACLM members to help create a robust online presence and sustainable Lifestyle Medicine practice.  Fuchs highlights his personal interest in Lifestyle Medicine.  “I know from experience that the Lifestyle Medicine community is looking for people with a similar attitude and mindset, and certainly we have that here.  But we also feel strongly about doing it right – building on the rock and not on the sand.”  He maintains that The Fox Group partners only with those willing to do the work needed to fully develop a solid business model, whether for a clinic, a company, or an organization.  “We want to look back and be able to talk about success stories.”

He also expresses his willingness to have an initial conversation on a free basis to anyone with an interest in building a Lifestyle Medicine practice.  ACLM members receive discounted services through the Fox Group (more details to come) and can contact Dr. Fuchs personally and directly at: 909-931-7600 or email at gfuchs@foxgrp.com

For more information on The Fox Group - http://www.foxgrp.com/

For more information on Symplur - http://www.symplur.com/