The Making of American Exercise Physiology
Tommy Boone, PhD,
MPH, MA, FASEP, EPC
Professor and Chair
Director, Exercise
Physiology Laboratories
The College of St.
Scholastica
Duluth, MN 55811
“He that
will not apply new remedies must expect new evils” -- Francis Bacon
Introduction
Let’s think about
it for a minute. Do we know without a doubt “what is exercise physiology”
and “who is an exercise physiologist”? There are probably several answers
to each of these questions. Some, I am familiar with. Others
are probably good indications of mis-information. What I do know is
this: Anyone from within the American Society of Exercise Physiologists
should know what is exercise physiology and who is an exercise physiologist.
Second, it is very likely that a high percent of the non-ASEP exercise physiologists
have no idea.
In the eyes of
many people throughout the health and wellness, fitness and rehabilitation,
athletic and sport performance world, the American way of exercise physiology
is laid out by the doctorate degree. If you have it, it means that
you may use the title. If you do not have it, then those with the doctorate
degree believe that you should not use the title. In effect, what they
are saying is that you are not an exercise physiologist. You may call
yourself an exercise specialist or a health/fitness instructor. This
is one of the best-kept secrets. Most students are not aware of this
distinction. After college, however, it becomes all too obvious.
Fortunately, the
American way of viewing what is exercise physiology and who is an exercise
physiologist is changing. Part of the reason is because of the financial
and professional insecurity that results from lack of professional status.
Another reason is the confusion in what is exercise physiology and who is
an exercise physiologist. The definition of each is long in coming,
but ASEP has defined both. If we
carefully examine the definitions, we can clearly see that exercise physiology
is not just about “the acute and chronic changes resulting from regular exercise”
or that an exercise physiologist is defined by the doctorate degree.
Exercise
Physiology means the identification of physiological mechanisms underlying
physical activity, the comprehensive delivery of treatment services concerned
with the analysis, improvement, and maintenance of health and fitness, rehabilitation
of heart disease and other chronic diseases and/or disabilities, and the professional
guidance and counsel of athletes and others interested in athletics, sports
training, and human adaptability to acute and chronic exercise [1].
Exercise
Physiologist means a person who has an academic degree in exercise physiology,
or who is certified by ASEP to practice exercise physiology [via the Exercise
Physiologist Certified exam (EPC)], or
who has a doctorate degree with an academic degree or emphasis in exercise
physiology from an accredited college or university [1].
By reducing the confusion
to the simple and saying, perhaps, for the first time in history, we are
able to set the stage for building a profession out of a discipline.
Wait a minute! Is it that simple! I am convinced that it is.
It is impossible for me to think otherwise. I wonder, therefore, why
others are slow in coming around. Are they waiting for a magic button
to press?
“The
beginning of wisdom is to call things by their right names.” -- Chinese
proverb
What’s in a Title?
Life is rather obvious.
You get what you give. You get in return the spirit of your work.
If we want exercise physiology to be what ASEP has defined it as, then we
must give of ourselves and involved. Sitting back in isolation will
not change anything. Life is a direct function of involvement that
is defined by our imagination, thinking, and hard work. Similarly, our
professional title is extremely important. It is not by mistake that
a nurse is a nurse or a physical therapist is a physical therapist.
There is the obvious understanding that the academic degree is directly linked
to the professional title. The idea that a title can be this or that
is nonsense [boone, title]
In order to understand
what is exercise physiology as a healthcare profession, we need to stop thinking
as a product of yesterday. If we are to understand who is an exercise
physiologist, we need to recognize the change that resulted from the founding
of ASEP. Freedom is a function of our imagination of something new
and better and commitment is a break from the past. Both are required
for full success.
Goals and Objectives
We will be
judged by what we do or fail to do. For this reason no organization
or no business can make it unless there is an agreement on goals and objectives.
Agreement is based on a certain faith for something better. At
the very core of the ASEP organization is the tough-minded, non-compromising
communication of our goals and objectives [2].
1. To
provide a powerful, unified forum and opportunity for exercise physiologists
to present and discuss current research in exercise physiology.
2. To promote
and encourage the exchange of ideas and information regarding all phases
of exercise physiology.
3.To promote
the advancement of teaching and research in exercise physiology within the
academic environment.
4. To encourage
and implement undergraduate and graduate education programs to meet the diverse
interests and career opportunities in exercise physiology, regardless of
age, gender, race or disability.
5. To promote
the growth and application of the highest quality research and professional
application of exercise physiology in health promotion, disease prevention,
rehabilitation, and sport fitness and training.
6. To promote
the development and exchange of scientific information between ASEP and other
professional organizations with an interest in exercise physiology.
7. To set the
agenda, determine the direction, and make the decisions about the future
of the exercise physiology profession.
8. To be a dynamic
and action-oriented clearinghouse for questions regarding the exercise physiology
profession.
9. To increase
visibility and enhance the image of the exercise physiology profession.
10. To represent
exercise physiologists whose professional work is mainly clinical.
11. To help
ensure that federal agencies and legislators understand their work and needs
of the clinical professional.
12. To participate
in the development and implementation of public policies and procedures concerned
with exercise physiology.
13. To make
a commitment to quality and integrity in exercise physiology through adherence
to the Society's Code of Ethics.
14. To facilitate
and promote positive public policy and professional, ethical behavior by
providing ongoing peer review and quality assurance programs via the accreditation
of the exercise physiology (science) academic programs.
15. To expand
federal and private funding of exercise physiology research and training.
Commitment and dedication
are the backbone of the desire to make the goals and objectives come true.
Commitment helps with the blank stares and foot-dragging. Commitment
is necessary to change behavior. Commitment, therefore, requires a
change in one’s psychological state of mind. This means letting go
of the past reality and the old academic identity. There must be an
ending of the old establishment to allow for the new [3].
Making Transitions
Ending what
used to be the best way to think about exercise physiology is not easy.
The new way means that some of the old ways will have to change. Those
who have the most to let go of something are the most challenged to change.
We must not be surprised when they fail to accept the new reality [1].
They may even overreact with the losses that associate with change.
ASEP should find ways to help with the transition.
“Unless
the reformer can invent something which substitutes attractive virtures for
attractive vices, he will fail.” -- journalist Walter Lippmann
We need to recognize
that it is natural to feel uncomfortable or confused when people ask questions.
My point being: Most exercise physiologists believe that since it has
always been done a certain way, it must be right. They are not accustomed
to asking questions and making decisions outside of the original identity
[4]. Charles Kettering, an American inventor, said it best: “If you
have always done it that way, it is probably wrong.”
New Thinking
We should
be encouraging experimentation in how we govern ourselves. After all,
new beginnings require new ways of thinking. For exercise physiology,
there are many new ideas. First, there is the recognition by the community
of exercise physiologists of the need for a code of ethics [5]. Then,
there is the agreement of what constitutes the exercise physiology theoretical
body of knowledge basic to its niche in the public sector [6]. Third,
there is the establishment of a national board certification, accreditation
(and where appropriate, licensure) for controlling and defining the professional
niche. Further, the professional organization reserves the right to
enforce, by its own means, discipline, and maintain ethical standards.
These new ways of thinking define the process of professionalization.
The public expects
professional, high-quality service from members of any profession, including
exercise physiologists. While this is obvious, if we do not do what
is expected of new occupations, the public sector will not grant us respect
for our work. A sentiment often overlooked by exercise physiologists.
For this reason, society looks to exercise physiologists for leadership if
the members of the professional are accorded a high status. Hence, the
control exercised by the professional organization of exercise physiologists,
ASEP, is largely responsible for improving conditions in the application of
its scientific body of knowledge.
Criteria for
a Profession
To determine
whether an occupation is a profession, Flexner [7] published the following
criteria common to professions. Note the relationship of these criteria
to exercise physiology, a profession:
1. Involves
intellectual operations accompanied by a large degree of individual responsibility.
There
isn’t any question that exercise physiology is intellectually driven [8].
2. Is learned in nature, and its
members constantly resort to the laboratory and seminar for a fresh supply
of facts.
The
exercise physiology body of knowledge is defined by significant hands-on
laboratory experiences. Students of exercise physiology have the opportunity
to develop new facts and information generated from their own laboratories
[9].
3. Is not entirely academic and
theoretical; however, it is definitely practical in its aims.
The
awareness of the practical side of exercise physiology is unique and impressive
[6].
4. Possesses a technique capable
of communication through orderly and highly specialized educational disciplines.
Students
of exercise physiology can attend accredited academic institutions for a
credible education [10]. The academic courses are well defined with
decades of research to support it.
5. Is a brotherhood of individuals
whose activities, duties, and responsibilities tend to completely engage
them. It is well organized.
The
emergence of ASEP as the professional organization of exercise physiologists
establishes exercise physiology with formal rules and standards of ethical
behavior [5].
6. Is concerned with the public
interest, and its motives are altruistic.
The
two principal characteristics of the exercise physiology body of knowledge
are the application to sports and lifestyle management.
7. Has a definite status – social
and professional.
Note:
This is the primary weakness of exercise physiology. That is, the lack
of the public’s understanding of the application of exercise physiology to
healthcare issues and concerns.
Code of Ethics
Professionals, including
exercise physiology, must have a set of rules and standards for its members.
The rules and standards are incorporated into their code of ethics.
The first such code for exercise physiologists was published in 1995 [11].
It was later accepted as the official code of ethics for members of the ASEP
organization.
The
significance of the Code is that both students and professionals in the study
and application of exercise physiology to health, fitness, exercise, preventive
and rehabilitative services can turn to it for guidance in professional conduct.
Adherence to the Code is expected, and is based on the belief that exercise
physiologists are self-regulated, critical thinkers who are accountable and
responsible for their high quality competence in the practice and the delivery
of exercise physiology concepts, ideas, and services [5].
1. Exercise physiologists
should accurately communicate and provide health and fitness, educational,
preventive, rehabilitative, and/or research services equitably to all individuals
regardless of social or economic status, age, gender, race, ethnicity, national
origin, religion, disability, diverse values, attitudes, or opinions.
2. Exercise physiologists
should be responsible and accountable for individual non-medical judgments
and decisions about health and fitness, preventive, rehabilitative, educational,
and/or research services.
3. Exercise physiologists
should maintain high quality professional competence through continued study
of the latest laboratory techniques and research in preventive and rehabilitative
services.
4. Exercise physiologists
are expected to conduct health and fitness, preventive, rehabilitative, educational,
research, and other scholarly activities in accordance with recognized legal,
scientific, ethical, and professional standards.
5. Exercise physiologists
should respect and protect the privacy, rights, and dignity of all individuals
by not disclosing health and fitness, rehabilitative, and/or research information
unless required by law or when confidentiality jeopardizes the health and
safety of others.
6. Exercise physiologists
are expected to call attention to unprofessional health and fitness, preventive,
rehabilitative, educational, and/or research services that result from incompetent,
unethical, or illegal professional behavior.
7. Exercise physiologists
should contribute to the ongoing development and integrity of the profession
by being responsive to, mutually supportive, and accurately communicating
academic and other qualifications to colleagues and associates in the health
and fitness, preventive, rehabilitative, educational and/or research services
and programs.
8. Exercise physiologists
should participate in the profession's efforts to establish high quality
services by avoiding conflicts of interest and endorsement of products in
the health and fitness, preventive, and/or rehabilitative services and programs.
9. Exercise physiologists
should participate in and encourage critical discourse to reflect the collective
knowledge and practice within the exercise physiology profession to protect
the public from misinformation, incompetence, and unethical acts.
10. Exercise physiologists
should provide health and fitness, preventive, rehabilitative, and/or educational
interventions grounded in a theoretical framework supported by research that
enables a healthy lifestyle through choice.
Recently, several
articles have been published in the PEPonline
journal regarding the ASEP Code of Ethics [12,13]. My response to the
student or colleague who has not read the Code is to do so. It is important
for exercise physiologists if we are to be accepted in the public sector as
credible healthcare professionals.
Summary
In regards
to the introduction and my "What I do know is this" brings my comments full
circle. The most scarce ingredient in exercise physiology for the past
50 or so years is a commitment to professionalism. The price is high.
It takes courage to label exercise physiology for what it is today.
In other words, it takes candor to call a spade a spade. It takes even
more courage to ask "why must be stay this way?" The making of American
exercise physiology begins with translating knowledge into action. It
takes deep conviction and courage to cast out of our minds the obvious roadblocks
to new thinking and new possibilities.
References
1. American
Society of Exercise Physiologists. (2003). ASEP Board of Certification Standards
of Professional Practice. [Online]. http://www.asep.org/asep/asep/EPCManual.html
2. American
Society of Exercise Physioloigsts. (2003). Goals and Objectives. [Online].
http://www.asep.org/asep/asep/goals.htm
3. American
Society of Exercise Physiologists. (2003). Mastering New Thinking About Exercise
Physiology. Professionalization of Exercise Physiologyonline. Vol 4, No 12 December 2001 [Online]. http://www.asep.org/asep/asep/MasteringNewThinking.html
4. Boone,
T. (2003). The COURAGE to QUESTION what is exercise physiology in the 21st
century. Professionalization of Exercise Physiologyonline.Vol 6, No 1 January [Online]. http://www.asep.org/asep/asep/Professionalization.html
5. American
Society of Exercise Physiologists. (2003). Code of Ethics. [Online].
http://www.asep.org/asep/asep/ethics.htm
6. American
Society of Exercise Physiologists. (2003). ASEP Board of Certification Standards
of Professional Practice. [Online]. http://www.css.edu/ASEP/StandardsofProfessionalPractice.html
7. Flexner,
A. (1915). Is Social Work a Profession? New York, NY: New York School of
Philanthropy.
8. American
Society of Exercise Physiologists. (2003). Guidelines for Accreditation of
Undergraduate Programs in Exercise Physiology. [Online]. http://www.asep.org/asep/asep/accredit.htm
9. American
Society of Exercise Physiologists. (2003). Journal of Exercise Physiologyonline. [Online]. http://www.asep.org/asep/asep/fldr/pro1a.htm
10. American
Society of Exercise Physiologists. (2003). Exercise Physiology Accredited
Academic Programs in the United States. [Online]. http://www.asep.org/asep/asep/accreditedINSTITUTIONS.html
11. Boone,
T. (1995). Code for Exercise Physiologists: Medicolegal Considerations for
Ethical Practice. The Exercise Standards and Malpractice Reporter. Vol 9,
No 1, p. 1, 4-7.
12. Boone,
T. (2002). Exercise Physiology Quackery and Consumer Fraud. Professionalization
of Exercise Physiologyonline. Vol 5, No 5 May
[Online]. http://www.asep.org/asep/asep/ExercisePhysiologyQuackery.html
13. Boone,
T. (2002). The Exercise Physiology Code of Ethics: A Dilemma or a Standard
of Conduct? Professionalization of Exercise Physiologyonline. Vol 5, No 11 November [Online]. http://www.asep.org/asep/asep/EXERCISEPHYSIOLOGYCodeOfEthics.html
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American Society of Exercise Physiologists All Rights
Reserved.