“This is a Medical Necessity”: Dr. Karla Wolford and EHP Performance Prescribe Exercise and Nutrition Instead of Medication

For 2017’s Fittest Doctor in the United States, Karla Wolford, owning and operating a hybrid fitness and medical facility was a longtime dream. (Before the Occupational Games, this honor was awarded during the Open.)

“My vision of what I wanted my practice to look like developed in grad school and it was a version of what would ultimately become EHP Performance,” said Wolford, who is a Certified Chiropractic Sports Physician and Certified Strength and Conditioning Specialist in addition to holding a CrossFit Level 2 certification. “At the time [2008], it seemed really unattainable, too big, too audacious to tackle,” she continued.

Seven years ago, Wolford opened up a CrossFit affiliate–EHP CrossFit, which stands for “Elevate Human Performance”– and a separate clinic in her hometown of Moorhead, MN.

Then, in 2020, when the pandemic took hold and gyms around the world were forced to close their doors, Wolford, who was pregnant at the time, seized upon the moment as an opportunity and completely overhauled her gym.

“I started thinking, what if it ran differently, what if every single person here was actually a patient. What if I had everybody’s full health history, full mental health history, what if I had all that data,” she thought. “And the athletes would come to our facility like a doctor’s office because it would be prescribed. This isn’t just working out, this is a medical necessity.” 

During the initial revamp phase in late-2020 and early-2021, after meeting with healthcare lawyers and legally reestablishing the facility, Wolford brought in a registered nurse to perform physicals on all existing members, which has now become the standard of care for all new members as well. EHP currently has more than 150 active members and has grown steadily since the revamp.

“I follow the American College of Sports Medicine guidelines on exercise prescription and special populations, and because of my degrees, I can prescribe and use our system of tracking to actually follow through with how many times they are coming in per week, or logging at-home workouts. Because of this, we’ve had athletes that have been able to use their Health Spending Accounts and Flex Spending,” Wolford said. “Every ninety days they meet with me, we complete physical and mental health assessments, and maintain electronic medical records for each athlete.” Wolford hopes to begin working directly with health insurance companies too.

The intake phase now includes the full physical (and at times lab work needs to be ordered), an interview with Wolford to discuss goals, possible roadblocks (like schedules, family responsibilities, and more), and then a movement screening with Lucas Barge, the facility supervisor to assess mobility and limitations, followed by a baseline fitness assessment and body composition testing.

The intersection of fitness experts and medical care is an exciting trend developing across the industry. In Yorba Linda, CA, for example, Dr. Adam Schulte created The Drop-In Doc, a direct primary care clinic located in Resolution CrossFit. The clinic is a meeting point of both healthcare and fitness, where Dr. Schulte and the coaching staff collaborate regularly to optimize how exercise is used to fight against chronic disease.

CrossFit LLC has facilitated the intersection of fitness and medical care for several years, through the CrossFit Health initiative and CF-MDL1 program that focuses on medical doctors earning their Level 1 certificates. More recently CrossFit introduced the Precision Care program which offers “personalized healthcare from CrossFit-trained doctors and health professionals based on your unique goals and needs.” The program uses tech tools and focuses on a preventative approach to primary medical care.

At EHP Performance, Wolford has an in-house medical staff consisting of herself and Lizette Sunde, a doctor of physical therapy and board-certified, clinical specialist in orthopedics, as well as staff of six additional performance coaches, all of whom hold CrossFit, weightlifting and nutrition certifications. There is also an eight-member medical advisory board to assist with decision-making.

EHP offers a wide variety of classes, including CrossFit, Elevate (similar to CrossFit but no barbells or higher skill gymnastics) and Bootcamp for members who are new to fitness training or just coming back from an extended time off. In addition, Wolford’s facility holds classes for different age groups, Sober Sundays, which are for athletes in recovery and open to the public, body transformation challenges and “kid-sit” hours for parents lacking childcare.

Wolford also created three types of scholarships for members in need: ”Empowerment,” for women who are survivors of sexual assault or other types of domestic, family or intimate partner violence; “Pride,” for members of the LGBTQ+ community who want an inclusive space in which to be healthy; and “Kids,” for youth who may not otherwise be able to afford these opportunities.

“In order to keep your scholarship, you have to attend at least 10 times per month. We have some awesome people on those scholarships that are a great part of the community,” Wolford said. “When people reach out and say ‘hey, I really want this, I really need this in my life, I just don’t know if I can afford it,’ we are like ‘ok, let’s talk about it.’”

So how has being a successful entrepreneur, medical professional and agent of change for her members and community affected Wolford’s own fitness? Judging by her performance in the 2022 CrossFit Open, it appears only in positive ways. She placed sixth overall in North America and 13th in the world in the 35-39 division and this week will take on the Age Group Quarterfinals in a bid to move on to the next round of competition.    

“This whole time I’ve continued to compete, I just love that part…it fits me,” she concluded.