PEPonline
Professionalization of Exercise Physiologyonline

An international electronic
journal for exercise physiologists
ISSN 1099-5862

Vol 6 No 2 February 2002

 


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.

 




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