At 66, Chuck Frazier said he has no plans to become the next Arnold Schwarzenegger.

His wife, Ann, 72, said she doesn’t see herself completing a triathlon anytime soon.

But the Bend couple has started working out with a personal trainer, on the advice of their physician, in an effort to combat chronic diseases.

”I have type II diabetes and a number of risk factors … I have a genetic propensity for hypertension and a cholesterol issue. Through medication, that is down to a normal range and my blood sugars are now under control,” said Chuck Frazier, a retired pharmacist. ”Exercise is the one part of the treatment equation that I have not been successful at doing.”

It’s a statement that Bend Dr. Rich MacDonell said he hears frequently. He knows most patients don’t exercise as much as they should, regardless of their physician’s advice.

So MacDonell has teamed up with personal trainer Kyle Will to offer a more complete package of health care services. When patients like the Fraziers agree to it, MacDonell gives their names to Will, who owns WRP Training Studio in Bend, along with a background on their medical history. Will then contacts the patients to set up a training evaluation and to get them started on a workout plan.

One of the goals MacDonell has for the Fraziers is to reduce their dependence on some of their medications – ultimately saving them prescription drug costs – through exercise.

”I think of it as proactive versus reactive medicine,” said MacDonell, an internal medicine physician who owns MyMD in Bend. ”I like to know I have someone who is going to hold them to the fire on their exercise.”

And from Will’s perspective, it’s nice to know his clients have been checked out by a physician and given a green light to push themselves to a certain level of exercise.

”It’s tailored to them,” Will said. ”I know what they are supposed to do.”

Since Ann Frazier began seeing MacDonell just a few weeks ago, he has already taken her off two of her more than 20 prescription medications, which she takes for a variety of reasons. She is hoping through exercise and some additional diagnostic tests, that a few more of her medications will no longer be necessary.

Ann Frazier suffers from sleep apnea and is now sleeping with a device that pushes air into her airway all night to give her better rest and more oxygen.

”We are adjusting her, looking at her medication, getting it so she can breathe better,” MacDonell said. ”From the physical standpoint that’s what Shannon (Ann’s trainer) is working on.”

A ruptured disk that resulted in back surgery a few years ago has kept her from exercising on her own, but Ann Frazier said having the support of both her physician and a personal trainer has given her confidence to try again. She hopes to improve to a point where she will be able to golf and keep up with her grandchildren and her dogs.

”Right now I want to prove to Doctor MacDonell I can do what he says I can do,” she said, explaining he holds her accountable to her training. ”Exercise is so critical now. I’m beginning to understand why. It can do so much for our bodies.”

By sending his patients to Will and his team of trainers, MacDonell said, he is thinking of it as an exercise prescription. So far, he has only referred the Fraziers and one other patient to Will. In the past, Will said, he has given his card to physicians and encouraged them to make referrals with little response.

Lori Brizee, a registered dietician, said when she started her business, Central Oregon Pediatric Nutrition Counseling, in August she sent out letters to every family practice physician and pediatrician in the area explaining her services and offering her help to patients. So far, she said, she has had only one referral from a physician.

”There is so much you can do diet-wise for prevention, starting when you are a little kid,” Brizee, who also counsels adults, said. ”It’s hard because insurance companies won’t pay for most nutrition counseling.”

The idea of physicians referring patients to personal trainers and nutritionists for services seems like a logical step, said Paige Webster, a spokeswoman for the Oregon Medical Association. But many physicians don’t have time to research different personal trainers so they know they are referring a patient to someone who will be a good fit.

”Physicians are always definitely encouraging exercise and diet,” Webster said. ”One of the challenges for a primary care physician, they have trouble knowing where to refer people based on where they live or the level of activity that would be appropriate for them.”

She also worries that personal training services may not be something that all patients can afford.

”It seems that it would be the type of thing where people have to be able to pay for it,” she said. ”This is the first time that I have heard of that specific of an arrangement. I think it is a fantastic idea and I think that most physicians would applaud the effort to take an angle that is a behavior-modification angle.”

Money is a factor in MacDonell and Will’s plan. MacDonell charges his patients a $2,500 annual fee, on top of their fees for services, to be members of his practice. He guarantees, in return, they will get more personalized service like his attention to their exercise regime.

His fee doesn’t cover the cost of Will’s training, which runs $65 an hour in his studio or $75 an hour for a session in the client’s home. For couples, Will said, he charges an additional $10 fee to work with them at the same time. And although MacDonell and Will are working together, they said they operate separate businesses and are not sharing profits based on referrals.

The Fraziers said they believe that paying to be members of MacDonell’s practice and for personal training are smart investments.

”I can’t think of a better way to invest in your future than to take care of your health,” Chuck Frazier said.

But they did think about the decisions seriously before making a commitment both to MacDonell and to Will.

”I think you associate a personal trainer with all the celebrities who have the time and the money to have this. You think, ‘I’m not sure I can afford all that,’” Ann Frazier said. ”My sister said, ‘Ann, it’s the best money you can spend.’”