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How Do Doctors Stay Healthy Enough To Practice A Full Career? The Physicians’ Personal Trainer

Your practice’s most expensive equipment is you. Your CBCT has a service contract. Your compressor gets maintained on a schedule. Your practice management software updates itself while you sleep.

The one asset in the building with no maintenance plan is the doctor.

We talked about that on the Dentelligentsia podcast with Mike Coval, owner of Coval Fitness in Ann Arbor and author of The Physician Vitality Playbook. Coval has spent years as, in effect, the physicians’ personal trainer — at one point roughly half his client roster was doctors, referred by other doctors — and he hears the same two complaints on nearly every intake: my energy is terrible, and I hurt all the time.

That should get your attention, because every plan you have — the buildout, the associate, the transition in your 50s — quietly assumes your body keeps showing up. Clinical careers are physical careers: hours of static posture, bent-over precision work, the same loaded positions repeated thousands of times a year. Nobody hands you that bill monthly. It arrives all at once, somewhere in your late 40s, as a shoulder that won’t quiet down and a 3 p.m. energy crater — right around the decade when the practice needs the most from you.

Here’s what Coval sees breaking, and how the ones who fix it do it.

The three mistakes smart doctors make

Doctors are Coval’s favorite clients for the same reason they’re his hardest: they know how to grind. Give them a program and they’ll execute it into the ground. The problem is what they’re executing.

Mistake one: the generalized solution. The group class or cookie-cutter program works for anyone who hasn’t trained in years — for a few months. Then it plateaus, because it was never built for your body, your career, or your goals. “They’ll have those generalized solutions that aren’t really moving the needle,” Coval said, “because nothing is addressing the things specific to them.”

Mistake two: grinding as a metric. The type-A instinct says pain is weakness and exhaustion is proof of effort. Coval’s response: “Just because you’re lying in a puddle of sweat and can barely breathe doesn’t mean it was a good workout.” A real program targets a specific adaptation — strength, lean muscle, athleticism that carries over to the tennis court or the operatory. Effort without a target is just wear.

Mistake three: the 20-year routine. This one is sneaky because it looks like virtue. The doctor who’s done the same workout since residency has actually mastered the two hardest things in fitness — consistent training and portion control — which is why they still look fit and can’t figure out why everything hurts. “You’ve won the hardest part,” Coval tells them. “Now let’s give you something specific to you, and your progress is really going to accelerate.”

If you recognize yourself in all three, you’re the typical intake, not the exception.

What an actual assessment looks like

Coval’s onboarding will feel familiar, because it’s how you’d want a new patient worked up.

Before the first session: a full history. Not just training background — sleep hours and quality, stress, family load, what they believe their biggest problem is. That last one matters because it’s often wrong. “What they think their biggest struggle is might not actually be their biggest struggle,” he said. The doctor convinced they’re not training hard enough is sometimes training plenty hard on four hours of sleep and 1,100 calories a day. No workout fixes that.

Then a movement screen and orthopedic testing on the table — joint ranges, structural limitations — so the program only asks the body for what it can currently deliver. The shifted squat gets diagnosed before anyone loads a bar on it. Risk versus reward, every exercise.

Then one habit, chosen because the client is confident they can hit it consistently — not five habits chosen by ambition. His app does the nagging: the 6 a.m. smoothie reminder, the programmed workouts, a coaching video for every one of the 400-plus exercises so form doesn’t decay between sessions. And the expectations are set honestly up front: consistent execution buys roughly three to five pounds a month for a weight-loss client, not a miracle. “Consistency over time gets you the result you want,” he said. “None of this happens overnight.” Sound like anything else in your life? It’s the recall-list logic, the marketing-pipeline logic, and the practice-growth logic, applied to the practitioner.

Small wins, measured in careers

The stories Coval tells aren’t before-and-after photos. They’re function.

A mother whose son has cerebral palsy came in because her back and knees were failing from lifting him — and he was only nine, and growing. Six months of training and the pain was gone; when his wheelchair got bigger, she handled it.

A client in his seventies with a neurological condition — his lower legs work at a fraction of capacity — walked in one morning and announced he’d tied both his own shoes every day that week. For years his wife had tied one. “You say that out loud and someone thinks, okay, he can tie his shoes,” Coval said. “But put yourself in that position. Something that basic can be completely life-changing.”

And the one for this audience: a physician told Coval about an emergency in the OR that required twisting into a position he simply could not have achieved three years earlier — and holding it long enough to help save a life. “He said: I would never have been able to do that before. And my body didn’t feel destroyed afterward.”

That’s the real product. Not a number on a scale — the ability to keep doing the work, at full capacity, without paying for every procedure in your lumbar spine.

The smartest person in the room still needs a coach

Here’s the tension: the same training that makes doctors excellent makes them skeptical of a trainer with a bachelor’s degree. Coval doesn’t resent it. He wins them over the slow way — conversations about biomechanics detailed enough that one brilliant, resistant physician finally started connecting the dots mid-squat: remember what I said about the hip? It’s happening right now.

Nick’s version of the same confession, from the episode: more than 1,100 transactions into a career, the biggest jumps came after hiring a coach — someone to push, check up, and ask the hard questions. Expertise in your field doesn’t exempt you from needing structure in someone else’s. The doctors who accept that in their finances and their real estate but not their health are protecting every asset except the one none of it works without.

Coval’s advice to his 20-year-old self applies at any age: “Find somebody you really respect for the way they live their life, and be around that person as much as you possibly can.”

The career-length math

Let’s make the business case with the same arithmetic we’d use on a building.

A practice producing a million dollars a year is worth its sale price plus every additional year you’re able to run it well. If chronic pain or an empty tank pushes your exit from 62 to 58, the cost isn’t a gym membership — it’s four years of your peak earnings and a sale negotiated on your body’s timeline instead of yours. Two of our recent guests told sellers to ramp up in the five years before a sale, in marketing and in the facility. None of that ramping happens if the doctor is running on fumes.

Coval runs a solo shop by design — he scaled a team once, hated the distance from clients, and went back to doing the work himself during COVID. Premium price, waitlist, no long-term contracts beyond a three-month start, and honest referrals when he’s not the right fit: if a prospect walks away, he asks what he could have done better and points them to someone he trusts, because the referral carries his reputation. (If that client-first posture sounds familiar, it’s the same one every good advisor in your orbit should be able to describe without rehearsing.) You don’t have to train with him to take the lesson: the doctor is infrastructure. Budget maintenance for it like you’d budget for anything else that produces revenue — because nothing else in the building produces any without you.

The full conversation with Mike Coval is on the Dentelligentsia podcast; his book, The Physician Vitality Playbook, is out now. We’ll keep handling the buildings. The operator is your department.