Professional
Autonomy
Patrick Riley, MA,
ATC, CSCS, EPC
Department of Sports Medicine
St. Mary’s/Duluth Clinic
Health System
Duluth, MN
IN RECENT YEARS this journal
has published numerous articles regarding the definition and categorization
of exercise physiology. One of the most prominent observations is
that exercise physiology is not sports medicine, and conversely, sports
medicine is not exercise physiology. Sports medicine, therefore,
should not govern exercise physiology.
Sports medicine is defined
as “the application of medical knowledge and science to the physiological
and pathological aspects of all persons who indulge in sports and athletics.
This includes not only prevention and treatment of injuries, but also scientific
investigation of training methods and practices (1).”
Clearly this definition encompasses more than just exercise physiology.
It is also obvious that exercise physiology is an integral part. Arnheim
and Prentice (2) name exercise physiology as a specialization
within sports medicine along with professions such as athletic training,
physical therapy, medicine, sports nutrition, and sports psychology.
All of these specialties, as well as others, come together to form the
sports medicine community with the common goal of better understanding
and, ultimately, optimizing the performance of the human body.
Though all of these disciplines
and professions join to create sports medicine, most have their own organizations
outside of sports medicine. The National Athletic Trainers’ Association
(NATA) (3), the American Society of Exercise Physiologists
(ASEP) (4), the American Physical Therapy Association
(APTA) (5), and the American Medical Association (AMA)
(6) are a few examples. These professional organizations
have accreditation bodies that establish requirements for educational curricula
that must be met before any certification or licensure can be granted.
Most also have specific requirements for membership, such as holding a
certification/license in the given field, or working towards that certification/licensure
(7).
In contrast, organizations
such as the American Heart Association (AHA) (8), the
National Strength and Conditioning Association (NSCA) (9)
and the American College of Sports Medicine (ACSM) (10)
have been called “interest only” professional organizations (7).
There are no requirements to become a member of these organizations.
A person only needs to have an interest in the field. Although these
organizations offer certifications, there are no specific curricular requirements
to obtain those certifications. In essence the end result is certified,
but there is no guarantee of an adequate academic background (7).
It therefore does not make good sense that a so called “interest only”
professional organization, such as ACSM, would be the governing body for
an emerging profession that requires a strong academic base such as exercise
physiology.
Exercise physiology through
ASEP has created, just as other professions before it, curricular requirements
followed by certification/licensure to ensure a competent professional.
This is not to say that the American College of Sports Medicine is an inadequate
organization. On the contrary, it is one of the finest around.
The contributions of ACSM over the past 45 years are countless. But,
in spite of all the contributions to the field of sports medicine, ACSM
remains a multi-disciplinary/profession, interest only organization.
It does not accredit educational programs for any of the disciplines/professions
within its realm. This is one reason why ACSM should not be the sole
governing body of any individual discipline/profession that falls under
its auspices, specifically exercise physiology.
The reason professional organizations
exist outside of sports medicine is to meet the needs of the professionals
they serve and advance the given field. Since there are many professions
within sports medicine, it stands to reason that all the needs of any one
profession cannot be met by sports medicine alone. Those with no
interest in exercise physiology would have no reason to further it.
The majority of sports medicine professionals are interested in their primary
profession first and foremost (whether it be medicine, physical therapy
or others), and are interested secondarily in the results that the melting
pot of sports medicine provides.
Let me give a real life example.
My present employer is a hospital/clinic-based department of sports medicine.
The professionals that staff this department consist of certified athletic
trainers, physical therapists, and physicians. Interestingly, there
are no exercise physiologists in this department, which makes sense given
its focus. The primary concern of this department is the prevention,
treatment, and rehabilitation of sports related orthopedic conditions.
But would it not stand to reason that if sports medicine were the parent
of exercise physiology, then would not exercise physiology and sports medicine
be synonymous? And if this were the case would it not also make sense
that exercise physiologists would be employed in a department named sports
medicine?
It is a safe assumption to
make that the majority of the individuals in this department have little
if any interest in exercise physiology. This is also interesting
since several are ACSM members and fellows. The former director of
the department, an orthopedic surgeon, is a fellow of ACSM. Though
he is an excellent physician and a top notch professional, he would not
work for the advancement of exercise physiology as a profession.
That is because he is a physician, not an exercise physiologist.
He has no reason to work for the advancement of exercise physiologists.
There are more like him.
Another physician with whom I work closely was discussing a presentation
he had attended at a recent ACSM national conference. The session
was geared towards team physicians and this particular presentation discussed
transient quadriporesis in athletes. This does not sound like it
would necessarily concern exercise physiologists, especially since the
session was meant for physicians. Yet it was sponsored by the organization
that wishes to be the sole governing body of exercise physiology.
It is not that ACSM should not provide such services to its members; it
is that a conglomerate organization cannot meet all the professional needs
of only one portion of its membership. An organization that is made
up of many professions/disciplines cannot adequately work for the advancement
of any one of those professions/disciplines.
One of the main purposes
of professional organizations is to give people an opportunity to work
as a group with a singleness of purpose, thereby making it possible for
them to achieve goals and objectives that, separately, they could not accomplish
(2). Members of ACSM are not working toward the
goal of advancing exercise physiology as a profession. Nor are they
working to advance the professions of physical therapy and athletic training.
That job is for APTA and NATA, respectively. In kind, the advancement
of exercise physiology should be left to ASEP.
References
1.
Thomas, C.L., editor. (1997). Taber’s Cyclopedic Medical Dictionary.
F.A. Davis Co. Philadelphia, PA.
2.
Arnheim, D.D. and Prentice, W.E. (2000). Principles of Athletic
Training. McGraw-Hill. Madison,WI.
3.
The National Athletic Trainers’ Association. Website available: www.nata.org
4.
The American Society of Exercise Physiologists. Website available: www.css.edu/asep
5.
The American Physical Therapy Association. Website available: www.apta.org
6.
The American Medical Association. Website available: www.americanmedicalassociation.org
7.
Borden, R. (2001). The Nature of Professional Organizations. National
Strength and Conditioning Association Bulletin, vol. 22.1, p.3.
8.
American Heart Association. Website available: www.americanheart.org
9.
The National Strength and Conditioning Association. Website available:
www.nsca-lift.org
10.
The American College of Sports Medicine. Website available: www.acsm.org
Copyright
©1997-2000 American Society of Exercise Physiologists. All Rights
Reserved.
ASEP
Table of Contents
Questions/comments
