The challenge for physical activity promotion in clinical contexts is finding ways of encouraging patients to become more active. Brief advice in primary care is effective, in the short term, in increasing physical activity, but is only provided by a few clinicians on a regular basis. The possibilities for public health approaches include others in the practice providing brief advice, or referral to community facilities and programmes. Even these have limited evidence regarding their population reach. Therefore, innovative and alternative solutions are required. This review discusses three potential contributors: clinician advocacy for and engagement in physical activity as role models, referral to mass community participation events, and encouraging attendance at health fairs. These will not solve the inactivity crisis, but could add new approaches for clinicians, in advising their patients to initiate and try to become more physically active.