The Dreaded Gym Physical
Here in Argentina, if you want to join a gym for any length of time, they make you get a physical from a doctor.
Up until today, we had avoided this by signing up for short stints at the gimnasio, and then moving on to a new workout place every few months (this was easy to do given that we’ve lived in 4 different apartments).
Most recently, we had joined the tennis club where the girls take lessons because they had a gym facility as well. We gave that up after a month though, because the weight lifting and cardio equipment was soooooo bad. (It was too expensive to maintain just for tennis.) Not happy with any of our local options, we decided to return to the Always Club in Palermo, because it presented the best cost to benefit ratio of any of the gyms we have frequented.
That was our fatal mistake. Returning to the same facility we had used before apparently triggered their “take a physical” requirements.
So this Wednesday morning, we went to see the doctor (who was an asshole). What a waste of time. He asked us about 6 questions, took our blood pressure, and then gave us each an ECG — yes, a resting electrocardiogram. Which, as I understand it, is pretty useless. But, he was shocked that neither of us had ever had one for screening purposes. I explained that they generally weren’t used unless a person had heart problems or was experiencing symptoms related to heart disease.
On the bright side, the office for visiting said doctor was upstairs at the gym, so we could pop in before a workout. Still, I found the whole thing to be ridiculous — just a stupid bureaucratic hoop to jump through.
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I’m also surprised that neither of you have ever had an ECG. In my experience it’s routine before any procedure that involves anesthesia — eg, getting all 4 wisdom teeth out at the same time, knee surgery, etc.
Concerning the usefulness of ECGs, it is possible that a resting ECG could show a significant abnormality that had no clinical symptoms, but the real trick is getting an ECG read correctly. I think it is still sort of an art. The machine interpretation is not necessarily that good.
I have never received an ECG while conscious, so unless it was given to me when under anesthesia, I am afraid this was my first. Also, the Argentine doctor’s surprise stemmed from the lack of use of the ECG in the US for routine screenings, such as required by the gym, not in advance of a serious medical procedure or in the presence of heart condition symptoms. Obviously, a proper resting ECG can catch certain problems, but it can also miss a lot, is not definitive, and is certainly subject to the “art” component you discussed earlier. The harried MD in the dirty office with the shitty equipment rushing through a ten minute exam, including an ECG, hardly qualifies as artful. Therefore, my assessment that this is a pretty useless exam stands.
Not arguing over whether an ECG was appropriate or not in your case — when it is done by the on-staff doctor, it is probably just a procedure to ensure that they don’t have someone with a serious heart condition (which would be detected on the ECG). I suspect that in most cases, the would-be gym member just goes to their personal doctor and gets a note. That’s what I did here. That has the advantage that the doctor writing the note does actually know something about the person and can make a fair assessment.
In my opinion, the requirement is a good one — but the way it’s carried out is not necessarily that useful. Likewise the requirement that motorcyclists have a helmet is a good requirement — but kids comply just by buying a helmet and carrying it on their arm.
Well, I probably shouldn’t beat a dead horse, but it’s my blog damn it, so I’m going to beat the crap out of the poor deceased equine!
On this we disagree. An ECG will detect serious heart abnormalities that have already affected the generation or conduction of electricity in the heart. But, one can have other serious conditions, like severe narrowing of vessels supplying the heart, which the resting ECG will not always detect.
On this we agree. The implementation of the policy requiring a physical for gym membership is less than perfect.
Indeed it’s your blog, and a fine one at that — so you can delete this comment and have the final word, or post another comment, as you wish. I also choose to beat the dead horse because I am killing time at the moment, waiting for the banana bread to finish cooking.
Actually, I don’t disagree with what you just wrote about ECGs. ECGs are not generally useful as a routine screening test. However, in clinical studies, ECGs have been useful in detecting abnormalities such as prolonged QT interval that may have no clinical symptoms (but that are VERY serious abnormalities). Doubtless there are people in the general population walking around, apparently perfectly healthy, with prolonged QT interval. They’re fine until they suddenly drop dead — there was a famous case in Boston in the 1990’s in which a basketball player suddenly died, and it turned out that he had an underlying heart condition that had gone undetected. An ECG would have detected it, but it is not cost-effective to screen the general population for such an unlikely abnormality. In clinical trials, however, it is possible that prolonged QT interval can be a drug side-effect, so a baseline ECG and follow-up ECGs are routinely performed.
More than you ever wanted to know about ECGs and clinical trials, right? The banana bread is now ready. 🙂
On this we agree. Banana bread is good!
you know, the name argentina comes from the latin argentum, which means “land of stupid bureaucratic hoops to jump through”.
*laugh* I love etymology!!! I hate icky dirty suction cups being attached to my body by a dickhead doctor.
HAH. dickhead doctor.
I love alliteration too!
I think I’ve averaged a gym a year since I moved to Buenos Aires. It’s not the compulsory check-up that makes me jump ship. I just get embarrassed rolling up (I choose this phrasal verb deliberately) to the same place month after month without manifesting any improvement in either body shape or general fitness.
Some, but by no means all of these gyms have insisted on the check-up. The first of these, when I was fairly fresh off the boat, has stuck in my mind.
Basically, I flunked every indicator. What was supposed to be low was high, and what was supposed to be high was low. I was as close to dead as a person with no apparent symptoms can be, and she didn’t mince her words telling me so. “You need to shape it up, Mr Matt,” she said in her try-hard English. “From now on you’re going to be an activity man.” “You mean I should go the gym?” I said. “Absolutely. You need to do the regular exercises and eat no more than four red meats a week.” “But if you don’t give me a clean bill of health they’re not going to let me join the gym!” I said. “Aha,” she said and started tapping her bottom lip with a ballpoint pen.
Eventually we hammered out a compromise. But this is a rare example of a near-perfect Catch-22 in the real world.
Matt,
May I say that you have broken the cardinal rule of blog commenting — you have posted a response that is actually much funnier than the original post could ever hope to be! (*laugh*) Seriously though, I like the gym hopping as a response to lack of progress — I had never really thought of that approach. We Americans lack imagination, in such a situation, we maintain our rarely used gym memberships in perpetuity out of guilt. It never occurs to us to just go to a new facility. So, tell me, have you ever successfully embraced your inner “activity man?”
Well, as Kingsley Amis once said, inside every fat man there’s an even fatter man trying to get out. But I think I’m more or less breaking even.
But that’s not enough for Dr Pérez from whom I receive a severe dressing-down every six months. I’m not sure whether it’s because she’s a doctor or because she’s a woman, but whatever I do to improve myself is never. quite. enough.
That is weird!! I have signed up to many gyms and the never asked for any physical exam!!! They are ripping u off! It is absolutely ridiculous and I think it is also illegal. Though I do agree that u guys should get checked up every so often, they cannot MAKE you do so. I hope they did not charge you for the doctor’s appointment!
Lola,
Thanks for the support!!! Unfortunately though, as I understand it, most gyms require the physical if you are going to join for any length of time. I have no idea if it is illegal or not, but they did charge us a nominal fee to see the quack upstairs.
I think woman-kind needs to thank Dr. Pérez for keeping the male gender in line, one man at a time!