What's New!

• Select Strategies for Increasing Awareness of ASEP by the ASEPNewsletter Co-Editor, Dr. Lonnie Lowery
• "17" new Board Certified Exercise Physiologists from the recent May 1, 2004 EPC test site at St. Scholastica.
• Article by a graduate student about exercise physiology.  The author's name is Nykole Grippe.  The title of the paper is Exercise Physiology Professionalism: Personal Reflections
• Thinking About the Recent 6th ASEP National Meeting by the ASEPNewsletter Co-Editor, Dr. Tommy Boone
• Additional articles by graduate students are published in this month's PEPonlinejournal. Click here for a review of our upcoming professionals in the filed.
• Quote of the Month:  “Never cease to pursue the opportunity to seek something different.  Don’t be satisfied with what you’re doing.  Always try to seek a way and a method to improve upon what you’re doing, even if it’s considered contrary to the traditions of an industry.” – Howard Marguleas
• Don't forget to check out JEPonline research articles.  The ASEPNewsletter "highlight" this month is: Nutrition and Exercise

JEPonline. 2004;7(2):37-44. ENERGY BALANCE DURING 24 HOURS OF TREADMILL RUNNING byJON K. LINDERMAN¹, and LLOYD L. LAUBACH of the University of Dayton, Dayton, OH, USA For a pdf copy, click here. 
• The “3-Cs” of Leadership:  Courage, Caring, and Commitment  ASEP members, there are three things we should remember. First, it takes courage to lead. Second, caring for the loss that academics suffer when asked to stop supporting sports medicine is a significant part of leadership. Third, commitment is vital to change. 
• The Torch Moves Forward by Dr. Jesse Pittsley.  He writes:  "While attending the 6th annual American Society of Exercise Physiologists (ASEP) national meeting this past month I came to a rather profound realization.  During the meeting, the young founder of the Wisconsin Association of Exercise Physiologists, Jason Young, gave a presentation regarding the value of creating ASEP affiliated state organizations.  Specifically, Mr. Young spoke about unifying Exercise Physiologists (EPs), he described some of the important topics surrounding EPs, and he outlined the steps to create a state organization. While listening to this speech, an interesting thought came to mind.  That thought was, I've heard this before.”

 

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Select Strategies for Increasing Awareness of ASEP
Lonnie M. Lowery, MA, MS, Ph.D., 
ASEP National Secretary, 
Co-editor ASEP Newsletter,
President, 
Nutrition, Exercise & Wellness Associates, LLC 
Cuyahoga Falls, OH 44222
 

A primary drive of recent Board of Directors (BOD) meetings has been improved promulgation (i.e. marketing) of the American Society of Exercise Physiologists. Stimulated by more than self-interest (ASEP growth for its own sake), the marketing of ASEP goes beyond the singular goal of business marketing that hopes to increase its "bottom line". The expansive new ASEP marketing plan is meant to save a profession from extinction. Several approaches have been included in the recently-formalized business plan, each with specific measurable objectives. Following are just two...

Expanded use of the ASEP E-News (email version of the longstanding web Newsletter) will be used to invite a wide variety of potentially interested students and professionals into ASEP. This invitation will include 10 critical reasons to join as well as benefits for those who make the commitment to ASEP and the Profession. Exercise science graduates looking to practice in the field need to know WHY they should join ASEP and become true exercise physiologists (EPCs).

Part of this marketing initiative can eventually focus on faculty "gatekeepers" as well...

A "faculty education" campaign on was also seriously considered at the recent National Meeting. Awareness among exercise-related faculty that recent graduates are entering a nebulous, unlicensed and multi-certification-polluted "profession", with extremely poor earning potential relative to other health professions, (Wattles, M. ASEP Annual National Meeting, April 1-3, 2004) is a key goal for this campaign. Is an exercise science degree currently worth its LARGE monetary / time investment when EP licensure is nearly non-existent among states? Is it worth it when other, established legalized professions are simply certifying themselves in our hard-earned, 4-6 year education/ skill set? 

Indiana recently considered legislation that would move EP opportunities to PTs. And despite a position paper that diet itself is ineffective for weight control, RDs have created weight management certificates that include physical activity. And why shouldn't these professions want to branch out from their traditional roots and get a piece of the growing wellness/ prevention/ treatment markets? They are simply protecting and expanding their charters. We must do the same to create a climate of proper referral to the best trained professional for each specific client's/ patient's need. 

But back to the faculty awareness initiative. Without full disclosure to incoming students of the legally rare, underpaid and threatened exercise physiology profession, doesn't it become an ethical dilemma then, for universities to accept tens of thousands of dollars in tuition payments (and related Departmental benefits)? This question can be asked because ultimately, the unlicense-able exercise degree conferred is often unworthy of supporting even a lower-middle class lifestyle. Without ASEP, advisor referral to other Programs (PT, RD, and various associate degree programs) may well become the only ethical advice for any incoming student wishing to make a living in exercise, commensurate with his or her education/ time/ money investment. 

Although the BOD and many ASEP members at the faculty-level are aware that some students pursue knowledge for its own sake, as common to the humanities (indeed noble), it is also recognized that many (most?) students entering a health-related profession expect to earn a better living by actually utilizing their chosen profession. Exercise Science faculty advisors who eventually recognize this potential conflict of interest in which they participate should gain interest in ASEP. Hence the proposed "faculty education" initiative. That is, ASEP's informational flyers, meetings, structure, accreditation, and legal initiatives will create legal value and subsequent earning potential to an exercise physiology degree - and faculty can know they are justified in recruiting hopeful new students into their programs. Presently, however, accepting money/ enrollment and unwittingly encouraging an over-positive career outlook in an unrecognized "profession" (that is rapidly being annexed by other licensed health professions) seems unethical.

The faculty education initiative, in whatever form it takes, should open many eyes. The resulting "trickle-down effect", from fully-aware faculty "gatekeepers" to their students, of the REAL job market and its legalities should increase ASEP membership as this ethical/ legal awareness grows. It'll be an uphill battle; "fighters" are welcome.

In summary, you can see that much discussion has gone into the new and sweeping marketing initiatives of ASEP. Their results - which will be measured in various ways - should help everyone.

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Thinking About the Recent 6th ASEP National Meeting
Tommy Boone, PhD, MPH, MA, FASEP, EPC
Professor and Chair
Department of Exercise Physiologists
The College of St. Scholastica
Duluth, MN 55811

Having just returned from the 6th ASEP Annual Meeting, it occurred to me how much exercise physiology has changed.  At another time, the meeting would have been 100% about research and more research.  The only people who presented research were those with the doctorate degree or working on the doctorate.  This fact alone didn’t catch me by surprised having attended national meetings since the early 70s.  What caught my attention was the interest in professionalism and not just the research.  The generally unrecognized topics such as starting a state chapter, accreditation, board certification, the future of exercise physiology, and reasons for autonomy and accountability were interesting and the attendees wanted to know more!. 

Just think about it.  A decade earlier ASEP did not exist.  Times were just as difficult then as they are today.  During 1998, at the first ASEP meeting in Duluth, MN, everyone’s thoughts were new about the organization and, frankly, about what the presentations should be.  Then, as is still true today but less so, the majority of the presentations were about research and the physiology of sports training.  Gradually, the participants have come to expect the presenters to utter words more fitting for an evolving profession.  For exmaple, "What is the purpose of a vision?"  "What is a scope of practice important?"  "What is the value in having a code of ethics?"  "How is the ASEP certification different from other certifications?"  "Why should undergraduate academic programs be accredited?"  These questions and more need discussing.  Students and faculty alike need an understanding of what it takes to professionalize exercise physiology.

Lincoln, the President of the United States, said it best:  “The dogmas of the quiet are inadequate to the stormy present.  The occasion is piled high with difficulty, and we must rise to the occasion.  As our cause is new, so we must think and act anew….”  Just as an education is important to getting ahead in the United States, professional programs of study that are accredited are important in being successful.  However straight forward these concepts are, not all students understand them.  They may value getting a college degree, but have little understanding of the importance of credibility.  Academic programs that are not accredited may be viewed poorly in light of accredited programs much like accredited institutions.  We quickly recognize the value of academic accreditation.  The degree itself is inextricably linked to the department or institution accreditation status.

The striking and continuing unchanged fact regarding exercise science academic degrees (taken to mean exercise physiology) is that they are failures.  Unchanged from decades ago the degrees are not accredited.  Perhaps even worse yet, they fail students by not having a philosophy to guide programmatic changes.  And, one of the greatest mistakes is the idea that the undergraduate degree is nothing more than a transition into graduate school.  We need to remind ourselves continually and assist others in doing so that most exercise science degrees are actually kinesiology degree programs, which are actually one or two courses from a physical education degree.  We have not come very far from home plate, and our reliance is still on a traditional system of thinking that is entirely outdated for exercise physiology.  Challenges abound as more of us come to this understanding and support changes in the educational system.

In this new 21st century of exercise physiology within the ASEP perspective, the failure of not having excellent academic programs with consistency throughout the United States is critical to our success.  Improvement in the quality of the students’ education is highest on the list of the ASEP priorities.  It is instructive to note that the ASEP Board of Accreditation has accredited six college and university academic programs.  Both students and faculty benefit from the accreditation process.  Also, the continuing newness creates professional opportunities and a sense of urgency to move exercise physiology along.  Certainly enhancing collaborative and positive relationships with other professionals and organizations help to ensure independence and recognition of exercise physiology as a healthcare profession.

With these changes there is an increasing appreciation of the exercise physiology body of knowledge.  Having recognized the logical link between mind and body as well as the obvious need to integrate diverse subjects into the study of exercise physiology, our education (when properly constructed and implemented) is an excellent foundation from which to teach lifestyle management skills.  Virtually all conditions of health and illness can benefit from regular exercise, and who better to prescribe exercise than the “exercise physiologist”.  It is a model that isn’t just obvious but of considerable importance since it has great potential for influencing the healthcare system.  The results from our research are now being used as a "prescription" just as medicine is prescribed for diseases.  The knowledge for prevention, perhaps, better yet postponement, of many illnesses and diseases comes largely from understanding the role of exercise in markedly changing the body under acute and chronic exercise conditions.

It is beyond the scope of this article to demonstrate how our knowledge will be used to benefit society.  Tomorrow’s exercise physiologists will not look anything like the years of gym rat work for the low dollar.  Academic and hands-on skills linked to new course work are changing the face of exercise physiology application.  Emphasis on connecting with the client and using technology to describe and identify physiological functions are creating a culturally different definition of exercise physiology.  With increased diversity of technological application linked to unparalleled changes in the curriculum, the career opportunities are going to increase dramatically with prevention programs and sophisticated thinking about postponement and/or controlling of genetically linked diseases and/or dysfunctions.  All of this and more is an expected reality because exercise physiologists are now finally planning for their future.

The contributors to the 6th ASEP National Meeting moved exercise physiology forward a significant degree in just two days of presentations and meetings.  There is simply no way the participants could have walked away from the meeting thinking about yesterday.  The 21st century exercise physiologist is board certified to practice.  This difference between now, guided by ASEP, and before, guided by sports medicine, is appreciated by those who have taken the time to think critically about what it means to be a professional.  Although it is encouraging even though the change process is not at a phenomenal rate and force, it is nonetheless changing.  Everywhere there are signs that changes are occurring.  Exercise physiologists of the past decades are beginning to say: (1) "ASEP is here." (2) "It has done a lot in a very short time." (3) "I may not have liked their decision to develop a professional organization outside of the context of sports medicine." (4) "Frankly, they have proven that they have heart." (5) "From what I know about it, their actions have helped students and exercise physiology.”

Exercise physiologists need to think beyond the laboratory or, at least, take their laboratory thinking to the real world.  In the not too distant future, the number of elderly persons (those over 65 years of age) will increase dramatically.  These individuals will need accurate and timely information about exercise, rehabilitation, and cognitive strategies to keep themselves healthy.  I believe that this is an ideal market for exercise physiologists (as well as childhood obesity).  Instead of working just in the market places defined by the younger crowd, exercise physiologists will work in rural or remote areas and inner cities where their knowledge of exercise, physiology, anatomy, rehabilitation, biomechanics, nutrition, and cardiovascular assessments will be used to assist the elderly in developing and maintaining their mind-body health.  Exercise physiologists will be equipped to administer comprehensive anatomical and physiological assessments.  Their work will be based on solid, evidence-based, scientific principles. 

Of course not everyone will agree with my very brief look into the future and what I concluded from the meeting.  Many academics still resist change.  They are not comfortable with the notion that change is inevitable.  So, they will work hard to keep things as they have always been.  ASEP advocates should probably remember that it is human nature to resist change or to be skeptic about change.  We will need to learn how to deal with them and, thus help those who are experiencing a certain degree of chaos.  In time, I’m sure we will hear more positive comments from those who believed that it was fundamentally impossible to change.  They will be frustrated at first, but I believe they will commit themselves to exercise physiology.  There will be dozens of reasons for the change in how they think about ASEP and its leadership.  What is important to remember is that support for our students is critical and, wherever it comes from, we must always be grateful and ready to receive.  Eventually, shaped by diversity in our thinking as healthcare professionals, but driven by our desire to build exercise physiology, we will collectively benefit exercise physiology and society.

Change of this magnitude is the making of a profession.  It takes an entirely new shift in thinking; a model so different from the past that it fosters conflict and hope.  It is no wonder that exercise physiologists often experience a little bit of both feelings (even at the recent ASEP meeting).  What we must remember is that it is vitally important that we stay the course.  We cannot allow the tragedy of not having our own professional organization.  We need it to lead us as board certified healthcare professionals with academic training in health, fitness, rehabilitation, and athletics.

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Exercise Physiology Professionalism: Personal Reflections
Nykole Grippe
Board Certified Exercise Physiologists
Graduate Student
Department of Exercise Physiology
The College of St. Scholastica
Duluth, MN 55811

"Often the difference between a successful [person] and a failure is not one's better abilities or ideas, but the courage that one has to bet on one's ideas, to take a calculated risk -- and to act."  -- Maxwell Maltz

Having completed my undergraduate work at The College of St. Scholastica [1], professionalism of exercise physiology has always been a topic of discussion and reflection.  I was surprised to learn that this is not the case among many other college and university programs.  When I declared my major as exercise physiology, I knew I had found exactly what I wanted for my career.  But, I had no idea it was only in its beginning stages.  While many will choose to follow the paved path, I look forward to overcoming the challenges that the future holds for the development of exercise physiology as a well-known, respected, credible profession.

Credibility and respect are determined by the public, not only by other professionals.  To accomplish this, the public must understand what services exercise physiologists can provide.  It is difficult to expect the public to distinguish a true exercise physiologist from someone who is not academically prepared in the field but uses the title.  This may provide the public with a false image of exercise physiology.  The American Society of Exercise Physiologists has formed a strong organization of focused leaders and members to achieve professionalization and establish a vision for the future. Exercise physiology is defined by ASEP as: 

“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.” [2]

Many practicing professionals refer to themselves as exercise physiologists, although their degree is actually exercise science (or one of many other names).  A degree in exercise science, kinesiology, or biomechanics is not a degree in exercise physiology.  One cannot graduate with a degree in nursing and refer to him/herself as a doctor.  Not only is this illegal, it is unethical.  Therefore, why is it that so many are graduating with degrees in academic areas other than exercise physiology, and referring to themselves an exercise physiologist?

The American Society of Exercise Physiologists has begun the process of identifying exercise physiology as a profession.  Since its founding in 1997, the ASEP has developed a mission statement, vision, code of ethics, certification exam, accreditation process, and done much more to move toward professionalization.  This is the first and only organization designed specifically for exercise physiologists. 

The certification exam is currently designed as a two part process: a written portion and a practical portion.  The purpose of the certification is to test the candidate's competence, including adequate academic and technical knowledge, the ability to apply such knowledge skillfully and with good judgment, and an understanding of professional, ethical responsibility.  Successful completion of the exam allows the candidate to be legally and professionally referred to as an “Exercise Physiologist Certified".  This certification identifies those who are academically prepared exercise physiologists. 

Accreditation of exercise physiology programs has been developed as a way to standardize academic institutions.  This process ensures that students in accredited programs are receiving the highest quality of education, therefore, are worthy of the title exercise physiologist.  This process will improve existing programs and extinguish substandard programs.  Without accreditation, institutions are able to turn out students who will use the title without ever having hands-on experience. Accreditation benefits not only students, but also institutions, employers, and faculty.  There are currently six accredited programs, but I believe this number will increase greatly in time. 

The next step in professional development is the implementation of licensure.  Licensure is a legal credential conferred by an individual state.  Mandatory licensure forbids anyone to practice without a license, while permissive licensure allows anyone to practice as long as he or she does not claim to hold the title.  Licensure protects the public as well as the practitioner from unsafe practices.  It will increase the status level of exercise physiology in relation to other healthcare professionals and likely lead to increased coverage and recognition by health insurance.  One would not see an unlicensed physician, physical therapist, or nurse, so why do we expect the public to seek services from an unlicensed exercise physiologist? 

The American College of Sports Medicine is currently the most widely known professional organization for health sciences, which is expected as it has been around for 50 years [3].  The organization offers three certification options: Health/Fitness Instructor, Exercise Specialist, and Registered Clinical Exercise Physiologist.  Requirements to sit for the Health/Fitness Instructor certification are a degree in a related field and CPR certification.  This “related field” includes nutrition, biology, nursing, PT, and OT.  Why, then, can exercise physiologists not sit for a certification meant for dieticians (ADA) or physicians (AMA)?  The Registered Clinical Exercise Physiologist certification actually requires that candidates must have a degree in exercise science or exercise physiology, as well as 1200 hours of experience.  Because ACSM certifications require the purchasing of study materials (ranging from $105-140), one has to wonder what their motivation is behind certification.  Is it really to enhance the professional or money? Although ACSM provides an organization for many professionals, most also have their own, more specific organization.  ACSM, however, would like to keep exercise physiology under its control. 

The American Association of Cardiovascular and Pulmonary Rehabilitation offers two certifications: a Cardiac Program certification and a Pulmonary Program certification [4].  Many of these professionals are also members of ACSM.  Why are cardiopulmonary professionals also seeking additional membership in an organization for sports medicine and not exercise physiology?  I believe the answer is simply that many are not aware that they have the option.  AACVPR was founded in 1985, much later than ACSM and only a few years before ASEP.  Yet, the public and other healthcare professionals know and respect AACVPR. 

This shows that acceptance of ASEP is just a matter of time.  There are many barriers for exercise physiology to overcome on the road to professionalism.  We must remember that life is changing; therefore, professions must evolve to meet the needs of the people.  Our specialized body of knowledge must be known by the public and ASEP must be recognized as our professional organization.  Without this regulation, we will not be acknowledged as professionals.  Professions have autonomy.  Many exercise physiologists do not have independence in the clinical setting.  ASEP’s development of certification, accreditation, and efforts toward licensure will lead to a monopoly over services, and, in turn, autonomy.  To achieve a monopoly, exercise physiologists must establish an understanding of what services we can provide that will benefit the public.  We must then demonstrate a strong commitment to retain this specialized area as our own. 

Professors are partially responsible for the lack of discussion on the topic of professionalization.  Many institutions fail to make students aware of what to expect after graduation.  Many come out of college with student loans and find it difficult to find an adequate job.  This leads many to search for another career, but this is not the answer; we cannot give up what we have a passion for in exchange for an easy future.  We simply have to take action for what we believe in.  And, frankly, I understand that it is difficult for those who have been working as exercise physiologists to accept change.  They have spent years under the ACSM umbrella without being recognized for their vast amount of knowledge.  While it is not easy to leave the comfort zone, it is necessary if exercise physiology is to become a profession of its own. 

Established professional organizations took many years to become what they have, and continue to change with the changing needs.  In a few short years, ASEP has nearly caught up to some of these organizations due to the strong drive behind its members and leaders.  We must realize that advances such as these take time.  We have to talk about ASEP.  Students, faculty, and practicing exercise physiologists should be discussing ASEP and their goals for the future with each other, as well as with other healthcare professionals and with the public.  This is the most efficient form of advertising.  We need to network with other healthcare professionals and form alliances with other professional organizations. .  Doctors, nurses, physical therapists, and occupational therapists need to know what services can be provided by exercise physiologists.  They need to be aware that we are not taking their clients, but adding another aspect to their treatment with our specialized area of knowledge. 

It is a difficult time for supporters of ASEP.  While many want to encourage ASEP as the organization for exercise physiology and become EPC, it is not the required certification for many job opportunities.  I am certified through ASEP, yet I feel obligated to get another certification that will be more recognized by employers to increase my likelihood of finding the career I want.  I would prefer to support ASEP and encourage employers to accept the EPC, as I believe it is the superior certification, but coming out of graduate school, I do not have the luxury of turning down any job that I am offered.  I may have to do things I would rather not do in order to get where I want to be, but once I get there I will be in a much better place to have a voice and make changes.

In the short time ASEP has been around, it has made huge advances in the development of a profession.  However, it is impossible for any organization to grow without support from members and other organizations.  It is the exercise physiologists who would like to be considered professionals that are responsible for its growth and advancements.  This will only happen if we take action; we cannot sit back hoping for something better and expect others to carry out a plan to improve our lives. 
 

References
1.The College of St. Scholastica. (2004). [Online]. http://www.css.edu/ 
2. American Society of Exercise Physiologists. (2004). [Online]. http://www.asep.org/
3. American College of Sports Medicine. (2004). [Online]. http://www.acsm.org/
4. American Association of Cardiovascular and Pulmonary Rehabilitation. (2004). [Online]. http://www.aacvpr.org/

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Congratulations to "17" 
Board Certified Exercise Physiologists!

Elizabeth L. Abbey, EPC
Nicole Beachman, EPC
Jonathan Berger, EPC
Jason A. Brabec, EPC
Stephanie Fleming, EPC
Desiree J. Granowski, EPC
Jonathan C. Gullett, EPC
Jillian E. Johnson, EPC
J. Rob Lovrich, EPC
Jessica McGregor, EPC
Jesus Medina, EPC
Gloria R. Olguin, EPC
Kevin Ritsche, EPC
Mel J. Sando, EPC
Elizabeth A. Schultz, EPC
Andrew Sieberer, EPC
Jocee M. Volk, EPC

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