Should Personal Trainers Accept Insurance

Imagine a world where new personal trainers don’t get tossed onto the gym floor with a textbook and a shrug. We take on a bold thought experiment: what if personal training operated inside an insurance-backed, supervised system—more like a residency—so rookies could learn under experienced clinicians, earn steady pay, and develop real confidence before jumping into premium coaching?

We start by pulling apart the broken pipeline: pass a multiple-choice exam, struggle to get hired by high-end clubs that want experience, then get thrown to the sharks at volume gyms with no mentorship. That pathway erodes confidence, confuses pricing and assessments, and drives injuries and burnout. We contrast it with the physical therapy model—formal education, supervised clinical hours, high patient volume—that, despite flaws, reliably builds baseline competence. Then we map a practical version for fitness: structured hours, interdisciplinary collaboration with PTs and physicians, and case-based learning focused on strength, behavior change, and safe progressions.

From there, we connect the dots to career capital. A couple of years in an insurance-based setting creates the reps and feedback loops trainers need to command premium rates, move into respected clubs, and branch into online coaching or entrepreneurship. Clients benefit too—especially those facing obesity and metabolic disease—because coaching happens within a medical team that aligns goals, scope, and communication. We also get honest about the barriers: certification companies and big-box incentives aren’t built for mentorship, and red tape is real. But if fitness wants respect as an allied health profession, supervised practice and clearer standards are the way forward.

If you’re a coach who’s felt lost after a cert, a PT curious about partnering with trainers, or a gym owner who wants to reduce churn and raise quality, this conversation lays out a path that puts learning and client outcomes first. Subscribe, share with a coach who needs a roadmap, and drop your take: should personal training move toward a supervised, insurance-backed model?

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Chapters

• 0:00 Welcome & Housekeeping
• 0:27 The Prompt: Insurance In Fitness
• 1:02 Why The Current Trainer Pipeline Fails
• 2:14 What Insurance-Based Training Could Look Like
• 3:46 PT Pathway vs Trainer Pathway
• 5:05 Confidence, Career Capital, And Pay
• 6:34 Public Health Need And Reality Check
• 8:04 Industry Incentives And Barriers
• 9:08 Closing Thoughts And Listener Prompt

Transcript

SPEAKER_00: 0:00

Welcome to the Show Up Fitness Podcast, where great personal trainers are made. We are changing the fitness industry one qualified trainer at a time with our in-person and online personal training certification. If you want to become an elite personal trainer, head on over to showufffitness.com. Also make sure to check out my book, How to Become a Successful Personal Trainer. Don't forget to subscribe, rate, and review. Have a great day and keep showing up. Haddy all, welcome back to the Show Up Fitness Podcast, day five, 30 podcasts in a row. And we're going to be taking a tweet from Dr. David Skolnick. I've had him on the podcast in the past, physical therapist, also teaches at MPTI. And his quote says, If the insurance industry got involved with fitness and personal training, would it make things better or worse? I have my opinion. I want to hear yours. And I love this thought experiment because I knew right from the get-go, and I went through the comments, a lot of people were saying no. And matter of fact, everyone said no, it's going to make it worse. Well, that's where the belt buckle trainer comes in to challenge the status quo. I think it would make the industry respect it. And here's why. What does the average trainer do? Goes to the Google machine, how to become a trainer. Pops up NASAM ACE ISSA. They choose one of them. They get a textbook. Or maybe they do it all online. Without access to a professional, they don't get asked questions. They don't know how to program. They don't know how to assess. They're reading multiple choice test questions and prepping for that test without ever training a human being. They pass it. Most people are going to wait six, 12, two plus years before they even take the damn test. They go out there, they try to go to a high-end gym, Equinox Lifetime. Nope, they're not going to get hired there because they want two to three years of experience or a qualified certification, like the SUF CPT. So where do you go? An F 45, Orange Theory, LA Fitness, EOS, a lower hanging fruit gym, meaning it's high volume but low price. So then they throw you to the sharks. They don't even look at your resume. You walk into these gyms with your resume and you say, I want to become a trainer. Are you hiring? They say, Yep, sign right here. Start tomorrow. And you're like, what the hell? Are you serious? And then what happens? They say, Oh, you have five clients today. Well, what do I do? Train them. Uh, I don't know how to train. Figure it out. You got to gain experience. So, guess what happens? You're not able to actually help people properly. You're hurting people. That's why 90% of trainers quit within the first year. They're completely lost. So, what insurance-based training would look like is with a physical therapist, they get approved on X amount of sessions. And now you're seeing a client who is under the proper supervision of a medical professional. Even if they don't have an injury, it would be from a physician. So you are now in conversations with medical professionals, understanding the scope of our profession. You get 40 hours per week, 20, 25 bucks an hour. You're making four or five grand a month, maybe. But then after a couple of years of doing this, earning your stripes, you have the confidence to move into the higher-end gyms, like an Equinox or Lifetime, where you're charging 120 to 200 plus. So your confidence is building and you're developing systems for what you want to do next: streams of revenue, online coaching, opening up your own gym, whatever it may be. But now the process, there's a flow where right now there's not. It's frustration because you get that certification and you try to go to a gym and they don't hire you because you don't have experience. So now what trainers would do is they go into these insurance-based clinics or gyms or whatever we want to call them, and you're getting paid by the hour training people with supervision. There's a head PT there, there's a gym owner, whoever. It's going to get messy. Yes, it does with insurance. I get it. But on paper, this would be one of the fastest ways to lower the dropout rate for trainers. On the other side of the equation, if you look at physical therapists, they go to DPT school. You have to have an undergrad in kinesiology and nutrition. That's four years. DPT school, three years. While you're in school, a diadetic internship, you are working on patients under supervision. And then what's the first job that you get? You go into an insurance-based clinic. And you're seeing 10, 15, 20 patients per day, 10, 15 minutes. But what this does is it really builds up your experience. And then most therapists are going to leave, start their own clinic. They're going to do cash-based, and they're able to make it if they go that route. But also, a lot of therapists quit because they're thinking, I don't want to do this for the rest of my life. I have$300,000 in debt and I'm only making 80K. This blows. There is a high turnover rate in the physical therapy industry. It's just not nearly that of personal training. But you look at the expectations upon entry, BS and kinesiology, DPT school, go work at a clinic. Now look at injective position personal trainers. You get a textbook. A lot of times they're outdated. You got upper cross syndrome, bounce on the stability ball. You're not confident because it doesn't make sense. Now you're supposed to go out there and experiment on people. No shit, you have no confidence. I have so many freaking emails and I feel for the individuals because they're lost in the whole mist of it all. They want to train, they want to help people, but they don't have guidance. Probably the most common one I get, I got the certification bundle in 2022, 2023. I've been sitting on my ass, I study a little bit, but I'm just confused. I don't know what to do. I'm not confident. The trainer who does post with that photo, I got my NASA, my ace, my ass is hey. I'm ready to start training people. I'm looking for people to train. And they don't know how much to charge. They don't know how to assess them. Or when they do assess them, they're doing the FMS or overhead squat. And the clients like, what the fuck is this? This is stupid. They take them through workouts at high intense bosu ball battle ropes. Clients are like, okay, you ask for money, but not confidently. So you're not able to sell, you're not able to close. So guess what? You're not able to turn your passion for fitness into a career. That's why I wrote my book. 20 years of experience, seeing the industry in the states internationally as well. It's the same problem. There isn't a clear path for success. So by getting into the insurance aspect, we're going to be able to help people who can't afford the premium personal training like you would at Equinox and Lifetime. This is a luxury for those people. You're working with individuals who are really battling with obesity and metabolic disease, but you're in a clinic with a medical team. So while you're going through this, gaining your experience under proper supervision, you're able to build that confidence. So you can go to those higher-up gyms, and now you're going to be getting 50, 60, 70 bucks per hour. You get about half of what you're charging. Depends on how many sessions you're doing per month or week. Yeah, I get it. But you're going to be making significantly more than you were in the insurance-based aspect. Now, after five years, the amount of career capital that you have, you're going to be in a great position to open up your own gym, to start one of these clinics, to buy into a company that has a franchise with these types of styles. Because this needs to be done, our nation is fat, sick, and unhealthy. We don't move nearly as much as we should. Our hormone levels are all jacked up. We eat whatever we want, whenever we want. We're not even getting 3,000 steps a day. The average person in America does not exercise one and a half hours per week. You and I, we do that daily. Our nation and our world needs help. And when you're a qualified coach and you're learning this through the process, two, three years in one of these insurance-based companies, and then you move into a bigger, more respected gym. That's how we would fix this. Is it going to happen? No, it won't. Why? Because these big profit organizations, these certifications that are out there, they have their hands in everything. And it wouldn't set them up for success. They're not looking out for your best interest. That's my opinion. But when you're backed by a billion-dollar company, you just care about those widgets. They want more people to get textbook certifications. Try to reach out to one of these companies and ask them a question. Can I get some help on designing a program for a client who has metabolic disease? Yeah, we'll get back to you in 48 hours. Or they put you on hold for a half hour, and now you're on with a representative who doesn't even speak your language. You don't even understand the dialogue. Like, what the heck did I just experience right there? They just want you to buy, buy, buy. And then when you're out there, they don't care. And the irony behind it is there's no blame for them. What happens? Go to YouTube, go to Google, go to Reddit, how to become a personal trainer. Boom, boom, boom, boom. Those certifications pop right up. Ask a trainer, how do I start training? Just get any certification and start gaining experience. 90% quote within a year. If we want to change the industry statistics and if we want to become a respectful profession, this would be one of the first steps. Because while you're in the trenches, you are doing it under proper supervision. That's what we need more of. I love this thought experiment. Thank you, Dr. Dave. Let me know what your thoughts are. Comment, let us know other topics you'd like to hear about. And remember big calves are better than small ones and keep showing up.