ASEPNewsletter
Vol
2 No 2
February,
1998
ISSN
1097-9743
TheASEPNewsletter
is devoted to informative articles and news items about exercise physiology.
It is a monthly magazine of news, opinions, exercise physiology professionals,
and events that shape exercise physiology. While it contains views and
opinions of the Editor
who
oversees the ASEP Internet Websites, visitors can have a voice as well.
We welcome interested practitioners, researchers, and academicians to e-mail
the Publisher their thoughts and ideas or to respond directly via the ASEP
Public Forum.
March,
1998
Exercise
Physiology and Health Care: A Field Perspective
Eric
P. Durak, MSc
Director,
Medical Health and Fitness
Santa
Barbara, CA
"The most reliable way to anticipate
the future is by understanding the present" -John Naisbitt
I am
sincerely happy to be a new member of the American Society of Exercise
Physiologists. I believe that this organization, via the Internet, will
serve a vital function that was not realized by working in segregated groups
through ACSM, NSCA, and other fitness organizations.
I have
been involved with the licensure movement in California for about four
years. I have been on the consortium for the California Coalition of Health
Promotion that programmed Senate Bill 891 into the state legislature in
January of 1998. Unfortunately, the bill was killed by the California Physical
Therapy Association before it ever reached the Business and Professions
Section. The power of allied health groups in the current health care system
is mind boggling.
The
reason the bill was killed was due, in part, to the perception by physical
therapists that the upper level of fitness licensure (the Physio-Technologist)
was in direct competition with their professional status. The author of
the bill, Mr. Wogbe Ofori, was disappointed because, as he told them, the
current health care system is not divided into a pie, whereby new allied
health professionals (such as massage therapists, acupuncturists, Rollers,
etc.) are not "taking away" a piece of the pie - as most health care workers
see it now. Wogbe believes (and I concur), that the future health care
system is more akin to a raging river, and if we don't have additional
health care workers (alternative and allopathic) to work with the ever-increasing
senior population, health problems will manifest, and health care costs
will cripple our economy.
Exercise
stands alone as the most efficacious complimentary treatment for many types
of diseases because of the vast amount of research published in the medical
literature (thanks in part to the work of many exercise physiologists!).
Licensure may take quite a long time based on two points of importance.
First, legislatures may only grant licensure status when they feel first
and foremost that public health is at jeopardy - and that NOT having that
professional at hand would be detrimental. The statistics don't really
point to that yet - depending on how you look at it. Second, other allied
health care professions must "accept" the incoming profession in terms
of not directly competing with their job description.
Since
exercise physiology is a blend of many professions, it may be compared
to physical therapy and occupational therapy in a sense, even though it
is not either one of them. My experience with exercise physiology from
a field perspective is that physicians (our greatest allies) already have
an interest in exercise physiology, and are willing to work with EPs in
certain areas as long as it makes them money. That is the crux of this
entire argument! In order to compete successfully in the changing health
care market, exercise physiologists MUST have a rudimentary knowledge of
managed care, insurance reimbursement, and health care trends. This knowledge
will supersede the perceived value of licensure status as a means to an
end to be a true allied health professional.
We
need only to look at Louisiana as a state of licensed professionals who
still are not accepted in the health care system. Why? Because they are
still looking at the system from a classic standpoint - that of an outsider
trying to get in. One view of the future of exercise physiology and health
promotion will be to facilitate growth within managed care via the following:
First, an understanding of the basics of a managed care contract and using
that information to market exercise and health services to physician practices,
clinics, and hospital based wellness programs is imperative. Second, forming
networks with existing organizations that will promote the cause and abilities
of exercise physiology is equally imperative. Groups that come to mind
include: (1) Medical Fitness Association (located in Evanston, IL, formally
known at the Hospital Health and Fitness Association); (2) National Fitness
Therapy Association (located in Denver, CO, the NFTA promotes standards
of care in health clubs and is expanding its reach nationwide in 1998 -
they have secured managed care contracts for many of their regional affiliates);
and (3) IHRSA - the International Health Club Association has had a health
care provider task force for over eight years. They were the first to secure
insurance reimbursement for club memberships in 1989. They would welcome
the input of clinical professionals on how to upgrade the professionalism
and increase the exposure of their clubs to the post rehab and health promotion
sectors.
The
future looks only as bright as where we are looking. The changes in health
care today will not have any effect on exercise services if contacts are
not made at local and regional levels. In keeping with the format of the
ASEP, exercise professionals should think about health care relationships
as one of their #1 goals for 1998 and beyond. They will achieve recognition
and increased job opportunities through networking as well as building
upon their membership in ASEP. I welcome feedback from members and look
forward to a rewarding experience with ASEP.
References
1.
Abraham, A.S. Delagi, E.F. The contributions of physical activity to rehabilitation.
Research Quarterly. 31;2:365-75, 1960.
2.
Borzo, G., McCormick, B., Somerville, J., Voelker, R. Pulling for a piece
of the health care market. American Medical News. pp-3,9,47, April 19,
1993.
3.
Durak, E.P., Shapiro, A.A. The Ins and Outs of Medical Insurance Billing:
A Resource Guide for the Health and Fitness Profession. 2nd Edition. Medical
Health and Fitness Publications, Santa Barbara, CA, 1996.
4.
Ellwood, P.A. The Shattuck Lecture - Outcomes Management. New England Journal
of Medicine. 318:23:1549-56, 1988.
5.
Fershein, J. Picture alternative medicine in the mainstream. Business and
Health. pg. 29- 33, April, 1995.
6.
Herbert, W.G. The outcomes movement in health care: Causes and consequences
for cardiac rehabilitation. Exercise Standards and Malpractice Reporter.
8;5:1-4, 1994.
7.
LaForge, R. Health reform and the future of fitness and health promotion.
ACE Insider Newsletter. 1993, 3;3:1-4, Winter.
8.
Nasibitt, J. The wellness re-dux. Trends Newsletter. pg. 1-4, October 13,
1994.
9.
Pashkow, P. The application of outcomes to the clinical exercise physiologist.
Presented at the American College of Sports Medicine Meeting, June, 1,
1996, Cincinnati, OH.
10.
Schuck, C. Outpatient outcomes. Rehab Management. 1996, April/May, pp.
105-07.
11.
Ware, J.E. Sherbourne, C.D. The MOS 36-item short form health survey (SF
36). Medical Care. 1992, 30:473-83.
About
the author: Eric Durak is an exercise physiologist and health educator
in Santa Barbara, CA. He is Director of Medical Health and Fitness, a consulting
firm, and serves as Director of the Fitness Therapist CEU course through
the International Sports Sciences Association. He is involved with exercise
and health care issues, and is currently researching the effects of chronic
exercise on patients with cancer. His email address is edurak@sb.net
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