Overcoming Institutional
Inertia with Leadership
Tommy Boone
Professor
and Chair
The College
of St. Scholastica
Duluth, MN
55811
“It’s
not the size of the army but the power within the army.” -- Napoleon
Bonaparte
Decades from now exercise physiology
will have a completely new look. It will be the healthcare profession
of the future. Students will go to accredited programs of study.
They will not only understand the importance of ethical standards and professional
development, there will take courses about legal issues, professionalism,
and leadership. The ASEP paradigm shift for change will be studied in
textbooks written by exercise physiologists. Our title and what we
do in the public sector will be common knowledge written all across cyberspace.
Meanwhile today’s
professors are faced with a dilemma. Their ability to resist institutional
(also called, organizational) inertia and the associated professional investments
and honors, including the gratitude of those who enacted it is in understanding
the impact of its inertia on the students of exercise physiology. Yet,
no one believes that the hard-earned conditions we now associate with our
dilemma will be easily given up. Rarely is it easy for people to put
aside the benefits of their work or to recognize where their thinking may
have gone wrong. Not until something comes along to destabilize its
political, social, and economic conditions is it possible to upset its inertia.
And, even then the emotions of many often remain unbroken for a considerable
period of time.
Shaped by tradition
and controlled by misguided dedication, members resist organizational change
by thinking they are maintaining the integrity of their work and the work
of those before them. The resistance is founded in their inability
to anticipate the paradigm shift shaped by the philosophic base of ASEP.
The dilemma is ongoing and will be for years as ASEP continues its current
movement toward a healthcare profession. During this time of change,
how are we going to deal with the institutional inertia? Who is best
suited to reform exercise physiology? The field emerged from one way
of thinking (research), and now it is defined by a different way (students).
While research continues to be important, the next logical progression in
the evolution of exercise physiology is an increase in the depth of caring
for our students.
In time, when
students graduate without the need to get the doctoral degree or to get a
completely different degree in another field, they will appreciate the ASEP
effort for change. All faculty, even those who are slow to step aside
from the our historical perspective, will eventually support the growth and
development of the ASEP educational standards. Together the force for
change will rock the foundation of the healthcare industry. Rather
than being part of the periphery, exercise physiologists will define the
quality and the implementation of programs (both educational and hands-on)
to improve the health (emotional and physical) and fitness well-being of
the public sector. Let us imagine this, believe it, and live it regardless
of the cost in effort, time, and energy. Let us also believe, just
as other healthcare professionals have done, that our one voice and one plan
will reach out to the young and old throughout the United States.
No more will our
non-doctorate exercise physiologists be left to fend for themselves.
Each will form an intentional alliance with all other exercise physiologists.
This is, indeed, the 21st century liberation that has been long in coming.
But, before the reality of our vision can be lived, we must stop dancing
the tango with our students who believe in us, if not initially for any other
reason, except that we are professors. We must be willing to take risks
when the opportunity arises. Full-fledged members of ASEP are not only
in a tug-of-war with institutional inertia and individuals who would rather
not see us threaten their power of monopoly, there is serious culmination
of work by physical therapists that has the potential to limit our professional
niche [1-2]. On one hand, our own colleagues are trying to maintain
status quo. On the other, physical therapists, in particular, have made
definite plans to include “cardiopulmonary” in their practice. This
reflects an “…expansion of physical therapy practice and education into health
maintenance, fitness, and disease prevention, as well as restoration of function
across the life span” [3, p. 51].
Fueled by the
decrease in physical therapy jobs and the continued interest in health and
fitness development and maintenance as well as the prevention illness and
dysfunction, physical therapists have rewritten their scope of practice.
Does this revision in their Guide to Physical Therapy Practice represent
a concern for the field of exercise physiology? You bet it is a concern.
As the range of physical therapy services grow, the current emphasis on health
and fitness led by exercise physiologists cannot help but be challenged by
their licensure. Clearly, with the introduction of the Doctor
of Physical Therapy (DPT) degree, the evolving profession of exercise physiology
can expect the proponents of the DPT degree to speed the development of the
physical therapy practice to include the exercise physiology niche.
This is a serious problem for non-doctorate exercise physiologists, especially
as physical therapists continue to bargain with third-party payers for reimbursement
without a physician’s referral.
Indeed, our own
institutional inertia is a significant challenge in itself. To put
on top of that the drive for autonomous practice by physical therapists is
understand why exercise physiologists must act on these social and political
points. We simply cannot continue to see ourselves within a view of
what we were years ago. Old thinking dies hard, but eventually
both students and faculty must assume the responsibility of ensuring that
the students’ will have a future in exercise physiology. Questions
have been raised about these very points by other exercise physiologists
[4-8]. They have argued that no substantive work has been done on behalf
of non-ASEP leaders in supporting curricular design to market and maintain
public trust. This leaves the profession with the question of why there
are so few academic exercise physiologists involved with the ASEP effort?
Of course, a big
part of the answer lies with institutional inertia. Few people will
attempt to standup against the majority rule. Another part is defined
by groupthink. Here, we have individuals who feel they may not be asked
to present a paper at a important meeting or be denied tenure if they were
to support beliefs other than the establishment. It is unclear why
others don’t get involved. Some believe that until the profession takes
on a life of its own, as in law, medicine, nursing, physical therapy, with
the power to regulate its members, a certain number of exercise physiologists
will always prefer to do their own thing. Regardless of the reasons,
college teachers can no longer be comfortable at their jobs unless they developing
“professionally credible” students. It is the teachers’ responsibility
to be proactive in providing valid information upon which students can develop
informed opinions regarding the future of exercise physiology.
As we look to
the future, we need a sense of direction. The ASEP leadership believes
our direction is defined by our vision; it is embraceable, realistic, and
inspirational. The ASEP vision encapsulates the very purpose of our
work and, thus it defines our destiny. After all, isn’t this what drives
the leadership of other organizations to change, to stop clinging to the
past, and to remain competitive. The world is constantly undergoing
change, and we must be committed to helping our students with their frustration
and fear about the future. This is exactly the reason for the existence
of ASEP. Its leadership has demonstrated credible foresight and faith
in ways to empower its members.
From the beginning,
the Board of Directors has had a plan to remain strong regardless of our
colleagues’ inertia and general unwillingness to take control of the profession.
The idea that we should sit by idly and let the evolving profession remain
locked in the past is not a consideration. Reminiscing about research
and professional meetings or not getting involved when change is imperative
is a form of giving up the fight. Perhaps, Pritchett and Pound [9] said
it best, “Some that recognize the need to change, deceive themselves, thinking
they can achieve cultural transformation without pain and chaos. But
it just doesn’t work that way. Overhauling the culture is an agonizing
process.”
Leaders within
ASEP must be strong. It is an agonizing effort mixed with inspiration
to create change. Those who have done it know that a high comfort level
doesn’t cut it. Status quo or belief that change is easy are misplaced
feelings. Optimism is good when shared with reality. There is
little room for not being serious about the work before us. We must
solidify our credibility and our contribution to the health and well-being
of the public. In is entirely our responsibility to change what we
have become to what we should be. Our educational curriculums must
be put in order through accreditation. Now is the time to improve critical
thinking skills, to put our knowledge into action, and to communicate that
change is needed.
“People
change what they do less because they are given analysis that shifts their
thinking than because they are shown a truth that influences their feelings.”
[10]
Listen to your heart. What
is it saying? Are your values and feelings speaking to you? The
only way you can take the significant step that encourages change is to understand
the leadership from within you. Imagine something that seems impossible
to you. Imagine setting a goal and being guided from within to paths
of opportunity previously believed impossible. That’s what leadership
is about. It about more choices, new ideas, and coming to understand
how you feel, what you think, and what you want. The power of feelings
and, thus what we believe to be true opens doors so that others can break
through the barriers of institutional inertia.
Leadership is
shaped by beliefs, feelings, attitudes, and behaviors. It is when we
realize that feeling that we fell better about ourselves, and knowing that
we expect more of ourselves that something shifts. We, then, find ourselves
promoting new ideas and a new self-image with the energy, stamina, and strength
to guide and inspire the community of exercise physiologists. Sounds
crazy. Not really. This is because our minds create reality.
The power we have comes from within. This is what drives change from
within the ASEP leadership.
Power within is
a great statement. It says something about how we create our future
as well as the challenges that we must deal with to make our dreams a reality.
That “something” is our ability to be courageous even though we know that
we will make mistakes. Change is not easy. There will be all
kinds of feelings and doubts. All we can do is understand that, when
we promote new ideas, we will always feel separated from our comfort zone.
Leadership is about taking action, keeping on track, being persistent, and
forever learning by doing.
In closing, at
the beginning of this brief essay, I said: “Decades from now exercise physiology
will have a completely new look. It will be the healthcare profession
of the future.” I hope I have said a few things to help you understand
how our reality will be achieved. To put a final touch on this subject,
consider the following steps to becoming an ASEP leader:
1. Type
out your “new look”.
2. Identify
every detail of your vision.
3. Imagine
yourself acting out the vision.
4. Live
your vision in your mind.
5. Do what
it takes to share your new look with others.
6. Sincerity
is important.
7. Learn
how to think outside the box.
8. Take
responsibility.
9. Know
yourself.
10. Stay
on target.
11. Embrace
possibility thinking.
12. Act
like you have it.
13. Communicate
the rationale underlying the paradigm shift.
14. Identify
key individuals with integrity.
15. Let
everyone know that you care.
16. Forget
about mistakes.
17. Take
risks.
18. Share
your passion.
19. Never
give up.
20. Never,
never give up.
References
1. Murphy,
W. (1995). Healing the Generations: A History of Physical Therapy and the
American Physical Therapy Association. Alexandria, VA: American Physical
Therapy Association.
2. Guide to
Physical Therapy Practice. (2001). Physical Therapy. 81:9-744.
3. Plack,
M.M. & Wong, C. K. (2002). The Evolution of the Doctorate of Physical
Therapy: Moving Beyond the Controversy. Journal of Physical Therapy Education.
16:48-59.
4. Seppala,
A. (2002). Developing a Private Practice. Professionalization of Exercise
Physiology-online. [Online]. http://www.asep.org/asep/asep/ExercisePhysiologyPrivatePractice.html
5. Jungbauer,
S. (2002). On Profession Building – Answering the Tough Questions. Professionalization
of Exercise Physiology-online. [Online]. http://www.asep.org/asep/asep/OnProfessionBuilding.html
6. Wattles,
M. (2002). The Dissection Of Exercise Certifications. Professionalization
of Exercise Physiology-online. [Online]. http://www.asep.org/asep/asep/DissectionExerciseCertifications.html
7. Tarr, J.L.
(1999). The Professional Amalgamate: A Ponderance. Professionalization of
Exercise Physiology-online. [Online]. http://www.asep.org/asep/asep/march2.htm
8. Robergs,
R. (1998). ACSM and Exercise Physiology: Past, Present, and Future. Professionalization
of Exercise Physiology-online. [Online]. http://www.asep.org/asep/asep/jan11.htm
9. Pritchett,
P. & Pound, R. (1993). High Velocity Culture Change: A Handbook for Managers.
Dallas, TX: Pritchett & Associates.
10. Kotter,
J.P. & Cohen, D.S. (2002). The Heart of Change: Real-Life Stories of
How People Their Organizations. Cambridge, MA: Harvard Business School Press.