Change_Is_A_Process

ALTHOUGH "change" isn't the definition of the American Society of Exercise Physiologists, it certainly represents the work of ASEP as an independent non-profit professional organization. The goals and objectives [2] of ASEP are many. An example of one is: "To facilitate and promote positive public policy and professional, ethical behavior by providing ongoing peer review and quality assurance programs via the accreditation of the exercise physiology (science) academic programs." ASEP leaders see their work as going hand-in-hand with the historical events that transpired with physical therapy and other healthcare professions. They understand that change is a process, and their focus is to harness the professional creativity and personal imagination of a new generation of exercise physiologists for the 21st century.

ASEP is the new voice in exercise physiology. It is approaching 10 years of age this coming spring. ASEP is truly a very young organization compared to the American College of Sports Medicine or the National Strength and Conditioning Association. And, just imagine, the American Physical Therapy Association goes back further still. All of these organizations and others like them change over time. Change is critical for many different reasons. When change fails to happen, more often than not, there are problems. For example, if members of society would change their lifestyle from smoking, eating, and drinking too much to exercising more and controlling stress, there would be less disease and dysfunction. Even when it is obvious that change is necessary, it is hard to do.

In fact, think about what Deutschman [3] said when quoting the dean of the medical school and CEO of the hospital at Johns Hopkins University. "…patients whose heart disease is so severe that they undergo bypass surgery…can cost more than $100,000 if complications arise. About 600,000 people have bypasses every year in the

United States

, and 1.3 million heart patients have angioplasties -- all at a total cost of around $30 billion. The procedures temporarily relieve chest pains but rarely prevent heart attacks or prolong lives. Around half of the time, the bypass grafts clog up in a few years; the angioplasties, in a few months. The causes of this so-called restenosis are complex. It's sometimes a reaction to the trauma of the surgery itself. But many patients could avoid the return of pain and the need to repeat the surgery -- not to mention arrest the course of their disease before it kills them -- by switching to healthier lifestyles. Yet very few do. "If you look at people after coronary-artery bypass grafting two years later, 90% of them have not changed their lifestyle…."

By parallel, it seems that this is exactly the problem with many academic gatekeepers in exercise physiology. Changing their behavior about exercise physiology isn't just the biggest challenged faced by the ASEP leaders; it is the most important challenge they face. One way members of the Board of Directors have put some closure on the process is by thinking differently and speaking from the heart about why exercise physiologists must have their own professional organization. Isn't this exactly what the heart patients should do, too? That is, whether the problem is centered on heart patients or academic exercise physiologists, the total cost of failing to change is huge. And, very much like the bypass grafts that fail to work, the contemporary "quick fixes" like personal trainer certifications and group exercise certifications will fail, too. What is needed is a change in how exercise physiologists think about themselves and what they do, not more failed rhetoric [4]. And, speaking from the heart, this is a process – not an event.

The change "process" requires internalizing the reason for changing. Not doing so is very likely why many exercise physiologists have not changed. In fact, Berger [5] says, "Until the change…is internalized or integrated, becoming part of the person’s sense of self, the change is unlikely to take place." Berger also concludes that, "Ambivalence is a major reason why people don’t change. If they do not know what to do, how to do it, or do not believe they have the skills or resources to do what is necessary, thus change usually does not occur." Ambivalence is an excellent word for what stands in the way of change from yesterday's thinking to today's views. Some sports medicine exercise physiologists have simultaneous and contradictory attitudes or feelings (as attraction and repulsion) towards ASEP, its actions, and some ASEP leaders. Their ambivalence and indifference explain a great deal about their behavior that would otherwise remain a mystery.

As one looks at exercise physiology from different views, there is ambivalence about not having the doctorate degree and the title exercise physiology. There is ambivalence about what persons and organizations to include or exclude to lead exercise physiology, about which organization is "the" professional organization of exercise physiology, and about how respecting members of new organizations should be leaders of older organizations. There is ambivalence about the autonomy of the exercise physiologist to make up his or her own mind relative to established thinking, and about the relative importance of keeping things as they have been rather than change. All of this and more, when taken together, do indeed support the contention that exercise physiologists are divided, if not profoundly at odds with changing. Like universities noted for their resistance to change [7], is it as simple as concluding that academic exercise physiologists are a product of the same system? It might be and, in fact, within the academic system there is the ambivalence towards pursuing knowledge through research and applying the research to real life events. Clearly, exercise physiology is an applied scientific endeavor or, at least, it should be.

Doctorate exercise physiologists are seldom the professionals who are working directly with the public sector, as in the actual application of exercise as medicine. Today's view is that the fitness instructor who has just graduated with a kinesiology degree or an exercise science degree can do that. After all, academic professorship is a time honored position within the academy. Keeping it this way is a big part of the ambivalence that is directed towards recognizing non-doctorates as exercise physiologists. It is not at all surprising that academics have developed ambivalence as an emotional wall between themselves and the obvious need for change for the pursuit of their own goals? Ambivalence provides a comfortable excuse to avoid supporting the change process that has been initiated by the American Society of Exercise Physiologists. Yet, it is obvious on many fronts that avoidance is seldom a good thing, especially when change is critical to the well-being of thousands of students throughout the

United States

No matter how important research is or one's attachment to sports medicine, to knowingly refuse to acknowledge ASEP as the professional organization of exercise physiologists is an integrity problem. Without question, this is true. It is a question of integrity, especially when you know the difference between exercise science and exercise physiology and you don't tell others the truth. Plain and simple, when such is the case, that person is not acting with integrity. If you tell the truth, you act with integrity. In other words, no matter what the circumstances, exercise physiologists with integrity speak the truth (and that means speaking the truth about ASEP). Exercise physiologists and other professionals with integrity adopt principles or standards that consistently govern how they pursue their work. In a very big way, academic integrity is the cornerstone of professionalism and academic scholarship. Members of the profession must depend on each other to work with integrity. This is the primary way the profession is advanced and knowledge that can be trusted is disseminated [8].

Yet, there are obvious issues (most are about professionalism or the lack of it) that exercise physiologists must face outside of academics. Integrity involves sacrificing something [9] to ensure that the right thing is done. An example of integrity is the exercise physiologist who says to the exercise science colleague, "I can't continue to promote exercise science as if it were exercise physiology because I know it isn't, and I'm not comfortable doing so." Okay, that is an interesting example, "But does that mean the exercise physiology may get fired?" Frankly, that is a great question, and often a person with integrity has come to understand that losing his or her job may well be a result of his or her decision to do the right thing. It is unfortunate that exercise physiologists have to make this choice, but integrity comes with a price.

Why not be the person to set the boundaries where you work? Why not stop hesitating about joining ASEP? Just think, your colleagues may be waiting for you to say something. Perhaps Marian Anderson [10] said it best: "There are many persons ready to do what is right because in their heart they know it is right. But they hesitate, waiting for the other fellow to make the first move-and he, in turn, waits for you." How true! It is getting harder every day trying to figure out the right thing to do, and it is likely to stay this way well into the foreseeable future. Nevertheless, it is clear that exercise physiologists must teach their courses and promote their ideas among their colleagues and students with the utmost integrity and professionalism. This, too, is all part of the change process. And, too, it is all about keeping your eyes on the big picture. And, while your doing so, start where you are and keep at it.

The ASEP "big picture" is its vision statement [11], which is to catalyze vital changes in exercise physiology throughout the

United States

. The vision is all about the American education of exercise physiologists. For some time now, the organizational infrastructure has been designed to support accreditation, professional development, research activities, and application of the exercise physiology body of knowledge. The philosophy of the leaders is grounded in a professional education of "one institution at a time." They promote the importance of accreditation and board certification that are linked and unique for exercise physiologists in the 21st century. They believe that true learning takes place when each student has the opportunity to engage in active hands-on laboratory sessions, and when his or her course of study is personalized by ASEP professional teachers, preceptors and mentors who are ASEP board certified and who understand exercise physiology as a healthcare profession.

To help students not question the importance of a college education, ASEP's vision is all about the quality of the student's education. ASEP leaders know that a college degree serves as the gateway to excellence and to better career options and more opportunity for higher incomes and healthcare benefits. A quality education encourages students to think critically, to ask questions, and explore possibilities. These are just some of these reasons for writing the 2005 article, "Dare to Dream: Boldness Has Magic." Please take the time to reflect on the following paragraphs from the article.

In today’s world, putting students first or at least taking the time to address accreditation issues from the exercise physiologist’s perspective is the ASEP commitment to restructuring exercise physiology. Non-ASEP members may not understand, but that is exactly why boldness is imperative. It makes perfect sense to do the right thing with respect to students. After all, students are the most important part of ASEP. In fact, when students graduate and become leaders in the profession, they pass on the ASEP passion for professionalism.

Students are ASEP’s greatest legacy. This is the lesson all exercise physiologists must learn. But, of course, we’ve known that from the beginning. The transition from physical education to kinesiology to exercise science and, then, our connection with sports medicine left us confused. Life is full of tricks. Thanks to our vision of the future, our perspective has changed. ASEP members have let go of their security with other organizations. Now, rather than getting by, they are designing their own future with their persistence and they are determined to stay on target.

Students in exercise science and related degree programs are being stymied not only by the inadequate scientific content in the curriculum, but also by their professors, both of which inhibit change and growth in exercise physiology. Yet, the power to change is within all exercise physiologists. All they have to do is to think as healthcare professionals, not as individuals who are just getting by in non-exercise physiology academic departments. Also, all they have to do is understand that leaders have the responsibility to facilitate and enable change. Leaders know that the resistance to change (e.g., fear of the unknown, fear of failure, disagreement and leaving the comfort zone, false beliefs, and lack of trust) will eventually resolve itself. That is exactly the belief of the ASEP leaders, who agree wholeheartedly with "staying the course" and making it happen. Why, because the distinguishing trait of all professionals is enthusiasm, preference for action, and bear hugging an idea as simple as, "The students come first."

"Nothing in this world can take the place of persistence. Talent will not; nothing is more common than unsuccessful people with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan 'press on' has solved and always will solve the problems of the human race." -- Calvin Coolidge

Persistence is generally defined as, "as the ability to continue in spite of obstacles or objections." Again, that is the key to the "change process." To stay the course regardless of the obstacles or objections is to ensure that exercise physiologists will achieve their goals and objectives. Dunbar [14] says, "Whenever you feel like throwing in the towel, think of these words, and 'press on', just one step at a time. You will reach your destination with persistence and determination. Make that one extra phone call, write that one extra page, and give that hug. Just do that little extra. It will pay off in the end. When things really get tough, take a break, but NEVER GIVE UP!"

The unshakable fact is that change is a process, not an event. But, of course, most people think of change as an event, not a process. When the challenge gets tough, the weary and fainthearted move on and say, "It is easier to go the sports medicine way." Such thinking hardly commands respect. Above all, it should be understood that laying the foundation for a profession of exercise physiology was not intended to be a picnic. It requires dedication and hard work. Oprah may have said it best, "The big secret in life is that there is no big secret. Whatever your goal, you can get there if you’re willing to work." If you want to win a tennis match, you must be willing to go after the opponent, and you must be willing to take risks. Getting your nose bloodied, so to speak, is part of the process of change. Of course it is not likely to you will get a bloody nose, but be ready for friends who will stop speaking to you. Others will send discouraging, if not, mean emails and engage in political maneuvering. Still others will act as though you don't exist. Indifference is a big part of politics and wrong-headed analysis.

The bottom line is that if exercise physiologists want their own professional organization, they must be willing to go after it. That means analyzing, talking and writing about their opponents, and getting their nose bloodied. ASEP exercise physiologists, therefore, must be willing to face the sports medicine challenger or they have no chance of being themselves. Losing friends isn't fun. What can ultimately be worse is realizing that you could have done something to encourage and help students and exercise physiology, but chose not to because you were afraid. How many times have you heard someone say, "If only I had done something to put an end to what was going on." Or, "I now know what exercise physiology could have been years ago. If only I had done something before now." The world is filled with people who look back and are sorry. These are people who could have lost weight, started an exercise program, earned a college degree, helped a friend, or made any number of choices in their lives.

Isn't it time to get involved? Isn't it time to get your nose bloodied to achieve success and correct the shortsightedness, and the lack of care for the student's education and career? If not, why not? Why aren't you willing to get serious about the professionalism of exercise physiology? Why not get past the insecurity of knowing that there are other people who possibly have more knowledge than you or more skills than you. My point is that the idea of being perfect is an illusion. Do what you can with what you have, where you are, and you will see great things happen. Finally, remember that change is not about talking or thinking about it only. You must do it and, be the change process.

Recently, someone asked, "What are you willing to sacrifice to see the ASEP vision become a reality?" My first thought was that ASEP is already reality. The rest is a matter of time, as is true with the building of any organization. My second thought was that, "Although it is certainly hard work for many different reasons, it is not a sacrifice per se." As a professional and as an exercise physiologist, it is my responsibility to work towards the professionalism of exercise physiology. And, it is worth noting that controversy, along with efforts towards professionalism, exists in all professions (particularly in medicine and law). In the real world, there seldom exist issues that are purely black or white. The critics of ASEP may, too easily, overlook this fact. Whatever this point may mean to onlookers, professionalism is our of necessity a socially consensual activity. Indeed, the supporters of this view know that it must be shared and experienced. In fact, the only way out of the sports medicine and exercise science dilemma is to recognize that it is an inaccurate portrayal of exercise physiology.

Ultimately, people are all too self-centered and suckers for praise. Exercise physiologists are no different. And, understandably, most are strongly driven from within to be successful. This behavior is natural and often required to get ahead. But, the greatest value of an exercise physiologist is not the number of publications a given professor has on his or her curriculum vitae. And, while it is true that nothing succeeds like success, publishing 100 research papers should mean very little if the professor cares about his or her students. After all, implicit in the existence of colleges and universities is the "education of students," not a job per se for the professor. This thinking should be intuitive, but it isn't. Some professors have literally taken leave of their senses, believing that their research is more important than their job to teach. Why more administrators don't pay attention to this point is hard to understand.

Most acronyms stink. Not KISS: Keep It Simple, Stupid! And, this is exactly the case for exercise physiology. Keep it simple and exercise physiologists will improve who they are and what they do by quantum steps. In short, they must pay a price for their freedom from sports medicine, for their professionalism and especially for their future as healthcare professionals. That price may require that they give up certain relationships, even certain lines of inquiry where the distinction of thinking is entirely opposite that of the ASEP perspective. Relationships with colleagues are not lifeless. They require harmonious and supportive dialogues. There is talk, disagreements, and paradoxes. Much of it is trivial and largely personal. For relationships to be beneficial, they must be inherently good and legitimate. When relationships are not beneficial and when each half of the relationship struggles to protect and legitimize its own views, often there is discord and obvious discrepancy between the two halves. Nothing about this thinking is original or restrictive. This is simply the truth. Exercise physiologists who are less inclined to deal with the change process are less likely to be helpful.

It should be clear from all that has been said that exercise physiology and sports medicine are different species with different objectives. The time has now come for exercise physiologists to recognize their role in professionalism and in regulating themselves and what they do (i.e., exercise is medicine). Certainly, their role is indispensable to their accountability and credibility. The key issue is whether or not they will step up to the plate, and how they will do it. Ultimately, ASEP leaders argue that every exercise physiologist should be an ASEP Board Certified member. It is doubtful that this will become a reality soon. After all, ASEP was founded in 1997. It is still a young organization. Stated simply, however, the illusion of control through the relationship with sports medicine and the proliferation of hundreds of organizations threaten to drown the exercise physiology community in a flood of useless information and certifications. Clearly, no opportunity to express the world of exercise physiology is too small. ASEP is trying everything, admittedly sometimes slower than expected on some fronts, but members of the different ASEP Boards are willing give most anything a try, then, if necessary, correct the problem, and get on with the idea. The process of managing change isn't easy and, at times, even ASEP members can get down on themselves. Everyone tends to do so -- feeling less than appreciated or the usual -- I am not as good as they are kind of thinking. Please appreciate these feelings come and go for all human beings, regardless of the organization he or she supports. The only thing for sure is that feelings of self-worth are continuously be evaluated by the members. After all, nowhere is it so evident that one's self-worth is commonly measured by association with others.

There is nothing inherently problematic with the feelings just described. In a time of reordering priorities that underpin exercise physiology, it is natural for members of the evolving profession to question many things (including themselves), often without a true understanding of the change process. The question then arises, what should be the role of exercise physiologists in dealing with the members of other organizations and their salesmanship tactics? Why not bring to bear YOUR full capacity of academic training, personal desires, and expectations about exercise physiology as a healthcare profession (i.e., as defined by ASEP)? Why not believe as Fishbein [15] does: "Somewhere inside of you is a natural sense of "I am" or identity. Permanently stamped or imprinted deeply in your mind is the certain knowledge that "I am me, a person of worth." Even when you make a mistake, experience failure, or feel worthless, your natural sense of self-worth says, "That's okay, just try again."

The secret of success is that there is no secret per se. People accomplish their goals simply by believing in their self-worth. There is a magic in believing though. Remember always, as Bristol [16] said, "Whatever man can conceive mentally, he can bring into materialization." The power of ASEP is only as good or strong as the members who believe in the change process. They understand that their subconscious mind always brings to reality what it is led to believe. Exercise physiologists become what they think, what they contemplate, and what they believe is true, which reminds me of a story an exercise physiologist shared.

"John met him at a meeting and they talked for several minutes. He offered John the opportunity to visit him at his university, which was only a day's drive from John's work. When John arrived at the university, he realized that other faculty members were talking about sports medicine and exercise science. From one classroom to the next and into the laboratories students and faculty members were discussing exercise science as if it was exercise physiology. John became uneasy, wanting to say something about the differences between the two but didn't for fear of offending someone. He began to question his trip. "Why did I take a day off from work and drive for hours to visit this place?" John's stomach was in a mess. He was sweating and visibly uncomfortable. Then, as in a blink of the eye, the faculty member who John had traveled to visit took him out of the building into another building. Smiling, he said: "I knew you wouldn't like what you heard minutes ago. But, I wanted you to know the problem we have on this campus. You just left the building that houses the Department of Exercise Science or, as it used to be called, the Department of Physical Education." He smiled and said, "John, this is the building where the Department of Exercise Physiology is located. Let me introduce you to several of my department chair and colleagues. They are all exercise physiologists."

How did this story influence you? Did it end the way you thought it was going to? Think about what you were feeling early in the story and, then how your beliefs changed later. Perhaps, you might have felt that John's new friend was an exercise science faculty member who referred to himself as an exercise physiologist. But, as you now know, he was an exercise physiologist and now your beliefs about him are entirely different from the earlier thinking. Beliefs influence people in many ways, and most go entirely unnoticed. At first, when John thought his friend was not an exercise physiologist, at least by association and from the discussions he overheard, he concluded that he wasn't and, therefore, doubted his trip. Later, John found out that his was an exercise physiologist and, then, his perception about him changed again.

If we just listen, we can hear them saying “We are professionals and we want our own professional organization.” I learned that exercise physiology as a discipline isn’t enough. I learned also that being a member of a discipline falls short of being a member of a profession. I learned that thinking differently is disruptive to the status quo, and that change takes time, persistence, and faith. Change itself begins with seeking satisfaction for one’s work, and in realizing that if a person wants to be some place different, then, he or she must figure out how to get there. People seek solutions when they want to change, when they want respect and, simply, when they want something different from what has been. [18]

Isn't that the truth? If exercise physiologists just listen, they can hear their students crying out for a better undergraduate education. Students know that it is wrong to graduate with an exercise science and, then, call themselves exercise physiologists. They understand that such behavior makes no sense at all. WiseGEEK [19] writes that, "Most people consider the act of lying to be fraudulent…." Now consider this. "There must be a deliberate misrepresentation of the product's condition…." The product marketed to consumers is the person him- or herself. Professors should inform their students that calling themselves exercise physiologists is a deliberate misrepresentation that is "lying" and, therefore, fraudulent. That is the bad news. The good news is that ASEP exists to point out that the intentional perversion of truth is wrong. ASEP has defined who is an exercise physiologist [20]. Namely, an "Exercise physiologist is a person who has an academic degree in exercise physiology, or who is certified by ASEP to practice exercise physiology [via the Exercise Physiologist Certified exam (EPC)], or who has a doctorate degree with an academic degree or emphasis in exercise physiology from an accredited college or university."

If students can graduate with a degree in kinesiology with a concentration in exercise science and call themselves exercise physiologists, why stop there? Why shouldn't the same students be allowed to call themselves, for example, nurses? If so, think about the following quote from Answers.com Health [21]: "All

U.S.

states and territories require RNs to graduate from an accredited nursing program and to sit for the NCLEX-RN, a standardized examination, the successful completion of which is required for state licensure as an RN." Now do you see the difference? First, the exercise science students have not graduated from an accredited nursing program. Second, the students have not (and, frankly, cannot) sat for the NCLEX-RN exam. Interestingly, at least for the time being, although there are accredited exercise physiology programs [22], the same exercise science students could graduate from a non-accredited exercise program and still qualify to sit for the EPC exam. If the student can pass the EPC exam, he or she can earn the title, Exercise Physiologist (more appropriately, Board Certified Exercise Physiologist).

Okay, how about physical therapy? Please note the following definition [23], "…PTs must have a graduate degree from an accredited physical therapy program before taking the national licensure examination." The story goes on. It is the same for every credible profession (e.g., dietitians, occupational therapy, respiratory therapist, social worker). This, in brief, is the reason why non-exercise physiology students cannot refer to themselves as exercise physiologists. They may be credible at doing other things, but they cannot be labeled as exercise physiologists. Interestingly, the word credibility comes from the Latin credere meaning "to believe." Credibility as an exercise physiologist is based upon such qualities as competence, professionalism, trustworthiness, and credentials (e.g., an accredited degree and certification). Credibility is also centered on being a good leader, and good leaders need courage. The way Edersheim [24] describes courage makes a lot of sense, and it applies to exercise physiology, too.

As you might imagine, acting with courage isn't easy. Courage, like leadership, is personal. It is unlikely that ASEP members can help others become members unless they have the courage to show them the way. Be willing to commit yourself to helping others deal with the change process. Help others deal with the ever-changing politics of sports medicine. Stay rooted in the ASEP perspective, stay authentic, and communicate your passion for exercise physiology. Remember, the change that ASEP members are interested in does not occur overnight. It takes discipline to change. There will be distractions, hard work, and problems. No one should underestimate the challenges in creating today what is believed to be important for the future. And, remember something else, too. Members need to understand that change is a process – not an event. The only way ASEP can help members realize their dreams is when they face the reality that they will need to work on the professionalism of exercise physiology for the rest of their lives. Professionalism is an ongoing process that does not stop. It involves friendships with colleagues that change, and it means letting go of the way that things have always been done. Adjusting to both is not without constant work. Bridges and Bridges [25] highlight this point with the following statement from their 2000 article in Leader to Leader.

The first requirement is that people have to let go of the way that things -- and, worse, the way that they themselves -- used to be. As the folk-wisdom puts it, "You can't steal second base with your foot on first." You have to leave where you are, and many people have spent their whole lives standing on first base. It isn't just a personal preference you are asking them to give up. You are asking them to let go of the way of engaging or accomplishing tasks that made them successful in the past. You are asking them to let go of what feels to them like their whole world of experience, their sense of identity, even "reality" itself.

Regardless of the challenges in asking colleagues to let go of what may be comfortable, the first responsibility of the ASEP members is to tell it like it is. Exercise physiologists need their own professional organization. Colleagues may not like what they are saying, but when it is the truth it is the right thing to do. The reality is that there will be conflict, and there will always be conflict of some kind or another. There is no reason to believe everyone is going to be happy. Every idea has someone who disagrees with it. Thus, the reality is that colleagues will resist even though ASEP members are doing everything right. Above all, every ASEP exercise physiologist must think constantly in terms of "we are doing the right thing, and we will prevail." If you believe you can, then you have already won! The word "impossible" is not in the future of ASEP members. They have a dream of something better, so beware of those with the mind-set of success.

ASEP members understand that the change process is a long road to success. They understand that success is not easy. What makes ASEP exercise physiologists different from all the fitness professionals that want to succeed can be summed up in four words – they never give up. They understand that success is a process and, as Maxwell [26] pointed out, "…you cannot have growth without change." Exercise physiologists cannot become the healthcare professionals they are without seeking the truth, however uncomfortable or angry it may make them. Part of the search for truth is recognizing that far too many academic exercise physiologists spend more time planning their next research paper then planning the future of exercise physiology. This is most unfortunate because thinking and planning for the future helps to link where they are to where they want to be. Change is necessary to realize a new way to be, to think, and a new cultural awareness of exercise physiology.

Perhaps this was best pointed out by Chakrabotry [27] who wrote, "Doing the same old thing and expecting different results is the definition of insanity." The change process requires a new state of mind, which naturally requires new leadership in exercise physiology. Without leadership, people tend to do the same old thing and, therefore, nothing changes. It is insanity. Change should be the agenda of all exercise physiologists, but it isn't. The point here is that since the 1997 founding of ASEP, exercise physiology faculty have said “no” for seemingly ridiculous reasons, most of them related to a refusal to allow change to occur. It is the definition of insanity. At the heart of the problem is that change is hard but necessary. It is perfectly clear that exercise physiologists who live from day to day without expecting different results, without joining ASEP, without a vision of the future – are preparing beforehand for inevitable distress.

In fact, Mahony [28] said, "If you only think of the present it is a sure means of sacrificing the future." This is exactly why the sports medicine philosophy is so dangerous. St. Augustine asked, "Do you wish to be great?" Well, there is no way to be great as a profession of exercise physiology from within sports medicine. In fact, the false philosophy expressed in the sports medicine community has slowed the change process. It has not destroyed it, especially among those who have kept their minds open to the opinions of the ASEP leaders. But, by far the most correct conclusion is this: Those who live for self alone are professionally dead. It is folly to lose direction in life. Most sports medicine exercise physiologists still find it essential to deny the ASEP wisdom and perspective.

All anyone can expect from sports medicine is sports medicine. Never lose sight of this fact. That is why sports medicine can slow the change process but it cannot confine it. Only exercise physiologists can give rise to exercise physiology. And, then, exercise physiologists must have the will to change as well as the ability and self-confidence to bring happiness to graduates of exercise physiology. For most, they understand the hardest thing is to get beyond yesterday's thinking (i.e., forgetting the old ideas). Yet, it is a requirement of change -- that is, to get beyond the old structures and conflicts and work to increasingly control the new thinking for the right outcomes. Think for a moment about some of the ways in which the new thinking is being played out in the ASEP organization:

These are just a very small sample of the transformations that have occurred in exercise physiology. And these transformations are only the beginning of possibilities. ASEP is leading change. The role of today's leaders is to help other exercise physiologists with the change process. Indeed, exercise physiologists must make a commitment to change and work hard to incorporate the changes in their work place. They must witness to others the changes and show them how to make changes in their lives. They must take whatever action is necessary to impress upon department chairs, deans, and other faculty that this is the time to make commitment to support ASEP. Students, in particular, as stakeholders in the profession must support the new view of exercise physiology. All exercise physiologists must work together. They must be able to communicate to other professionals their vision of the future, and they must learn to adapt to the new responsibilities before them as healthcare professionals. After all, adapting to a new way of thinking is a process (i.e., often a never-ending journey). It is not an event.

In the next 10 to 20 years, a large part of the ASEP leadership role will involve facilitating the new way of thinking and working as an exercise physiologist. Leaders will increasingly devote more time helping colleagues adapt to the thinking that the power of exercise goes beyond sports and athletics to healthcare. They will help colleagues with the new age commitment of focusing on "exercise as medicine." And, too, they will keep pressing the point that change is a journey and, therefore, the professionalism of exercise physiology is on a journey in itself (i.e., the professionalization process).

One critically important role of the professional organization is to keep the profession on the right journey and to help the members understand what that means to them. Naturally, there will be uncertainty along with consensus-building, chaos along with new roles and challenges, and conflict, tension, and indifference along with truth, understanding, and adaptation skills and learning. These challenges cannot be met by staying outside of ASEP under the procedures and rules of another organization. There is nothing worse than continuing to fit exercise physiology in the old sports medicine model. It is not viable or sustainable and it is wrong, however emotionally difficult it may be to give up the past. ASEP leaders are obligated to help those with their eyes fixed on the past to adjust to the fact that change is inevitable and, therefore, constant and endless.

Today, the goal is not to turn out more "instructor" or "trainer" certifications. Also, the goal is not simply to ensure membership in an organization. Indeed, too much emphasis is placed on "size" of an organization as though that in itself is equal to integrity or importance. Honestly, what is most striking about the leadership of some organizations is the "dance of popularity" and so-called "gold standard certifications" that in actuality make no sense at all. Much of the knowledge and information that is believed to be developed by sports medicine is actually scientific information derived from decades of research by exercise physiologists. Unfortunately, too many exercise physiologists get so sucked into the sports medicine way of thinking that they actually lose sight of the daily activities of their own profession. All their efforts are directed at pleasing the wrong people. As a result, they fail to see the emerging circumstances, shifts in thinking, and insights about the new exercise physiology.

Exercise physiologists must stop living the work of other disciplines. Their presence and service are required to move the profession forward. In fact, what they do or don't do is critical to the infrastructure of professionalism in exercise physiology. Today's challenge is to get exercise physiologists involved in ASEP and professionalism. One person cannot do it him- or herself. O'Grady and Malloch [29] made this point clear in the following statement: "Leaders and staff need to recognize that no one person can make a sustaining contribution through his or her own efforts alone. While an individual's efforts can achieve incremental improvements, the sustainability of these improvements depends on the degree of interface between the individual's efforts and the consolidated efforts of the whole. The ability of leaders to make this fact clear to the staff is critical to the effectiveness of their activities."

It is the convergence of effort by all exercise physiologists that ultimately drives the change process, thus contributing to congruence in the practice of exercise physiology. This interface of effort and ability becomes the impetus for dynamic and sustainable change along with the integrity of organization itself. Appreciate that convergence of effort is not convergence of opinion, as though members of the organization cannot or should not have their own ideas about how things should be done. Members with different thoughts, ideas, and way of doing things are a necessity for any organization to examine the depth and breadth of important issues and conflicts. In this way, the future's unfolding is consistent with the best thinking of many individuals. But, having that, what drives the organization must be consistent with the vision and mission statements [11]. It is for this reason that the leadership in ASEP is interested in diversity of opinions, particularly if the opinions have the potential to promote the credibility of exercise physiology. Obviously just any idea, especially those that are ethically inept or lack professional substance [30], will not (and should not) be tolerated to threaten the integrity of the organization [24]. Hence, when it becomes apparent that the direction of the organization is being mismanaged by errors in judgment that threaten the integrity of the organization, leaders must engage in a concerted and correct action.

All organizations are living entities that are given life by the membership. That is why the integrity of the members is so important. Leaders must study the change process so that they can know what is going on and why. They need to help others adapt to the new ideas that define the updated thinking and organizational environment. And, while all of this is complex, it is not without guides and experts in the field who help discern the convergence of forces, effective and ineffective responses and outcomes, and the degree of complexity and chaos that should be tolerated to accomplish the goals and objectives of the organization. It shouldn't come as a surprise that much of what is happening in ASEP is revolutionary in nature. The very foundation of exercise physiology is being transformed by the impact of new thinking. The role of the ASEP leader is to focus on the implications of the revolutionary changes occurring, including particularly the application of exercise as medicine to the public sector. They must define the new professional roles, processes, and behaviors that will be expected of the Board Certified Exercise Physiologist.

Here again, exercise physiologists must recognize the importance of the move from sports medicine controlling exercise physiology to exercise physiologists controlling the profession. It is both dramatic and congruent with what other healthcare professionals have done, thus it is both timely and appropriate. The role of ASEP is therefore no different from the revolution decades ago that took place in physical therapy, occupational therapy, and nursing. In a time of revolution, the leader's ability of earlier organizations anticipated critical events that led to new strategies. Leaders of these professions acknowledged the conflict and necessity of the change process and journey itself. They understood that conflict management is part of the resolution of differences of opinion and the revolution of new ideas. The failure to understand this point is problematic and simple. All organizations have problems. To fail in acknowledging this point and the unpredictability of the change process is to fail in understanding the underlying challenge and history of other organizations.

Maxwell [32] said that, "Learning begins with listening. But it doesn't end there." Change always requires learning. Why not become genuinely interested in learning about the American Society of Exercise Physiologists? Why not believe the best in the ASEP leaders? All students have a right to the best education possible. Think about what exercise physiologists can do to make a difference. They can help their colleagues make a commitment to the ASEP professional infrastructure. This can be done through better communication between ASEP exercise physiologists and non-members. After all, it isn't good business to neglect making friendships with colleagues who can help with the journey, who can help move exercise physiology to a higher level of success in healthcare. Why not a change of heart towards ASEP leaders and members? Working together exercise physiologists can create a win-win relationship. Why not invest in students, exercise physiology, and the profession? Working together exercise physiologists can create growing professional relationships that will help fulfill their values, build character, and set the stage for tangible results for every person who needs an exercise prescription. Working together is part of the learning (change) process. For certain, it increases the odds of winning as a collective body of professionals. Why not make a difference through increased partnering with other academics? As Maxwell [32, p. 224] concludes, "People who embrace the high road make excellence their goal. That's something that can be accomplished if we:

What do you think about Maxwell's "high road" to excellence? Frankly, to believe in words like "care more, risk more, dream more, expect more, and work more" requires courage. If you are willing to dream more and expect more from yourself and your colleagues, you have reason to expect great things to happen. Why not dream about a great education? Why not risk more of ourselves to be more than we have been? Why not believe in your own style of thinking? Unfortunately, there isn't a lot of discussion about these things in exercise physiology.

May [33] said, "…if you do not express your own original ideas, if you do not listen to your own being, you will have betrayed yourself." Here is an important point. One's willingness to dream more should be original, having resulted from one's own thinking. It is a truth, recognizable in all aspects of growing and learning, that when exercise physiologists do not get involved, when they are unwilling to think for themselves, they betray themselves, their colleagues, and their profession. Hence, as May [33] states in The Courage to Create, "…the most prevalent form of cowardice in our day hides behind the statement…"

The process of change or that of making or bringing into professional status requires courage. Roger Bannister showed courage in May 1954 when he ran the mile in 3 minutes and 59.4 seconds. It seemed that no one could run the mile under four minutes until he did it. Two months later, John Landy ran it in 3 minutes and 58 seconds. Within three years, 16 other runners did what was previously believed impossible [34]. Exercise physiologists must emancipate themselves to guarantee their dignity and their future. They must "risk more than others think is safe" [32] if they are to transform exercise physiology. What journeys of thought can you engage in to gain the perspectives you need to understand the change process? How can you cross the boundaries of yesterday's sports medicine thinking to see the exercise physiology from the ASEP perspective? What would happen if you stopped to design exercise physiology from scratch as ASEP leaders did just prior to 1997? It is tempting to think that you may arrive exactly where they are today. The reality is that you may have made better sense of things.

Another reality underscored by those who fail to get Maxwell's point is their unwillingness to get involved or, according to May, their cowardice, which leads to a simple question: Why are they so afraid? Isn't it obvious that the road they are presently on is going nowhere? Their attitude towards this point seems to be one of hoping sports medicine political leaders will reach out to them. Maybe they will be asked to become a member of the Board of Trustees or a Chairperson of an important committee. Politics is all about power relationships and being in control to make decisions. Politics is one of the oldest academic disciplines, often viewed as a study in power. Still, another more important reality is one of leadership. In many ways, that is exactly what is missing in exercise physiology.

Re-engineering how exercise physiologists think about themselves, who they are, what they do, and exercise physiology is a part of the change process. In some ways, it is at the heart of change even when they do not see it. It's about people, especially students. After all, as an unknown author said once, "Statistics don't bleed. People do." Frankly, there are too many students broken hearted, disappointed, and depressed because the career options they were led to expect at graduation did not materialize. The problem is simple:

The change process within exercise physiology is about students. It is about being the person they can be, and about changing the old form of exercise physiology. The sports medicine view is outdated. It must be changed, and the biggest mistake exercise physiologists can choose is not to change. Failing to look clearly at their circumstances and changing what has not worked for decades are simply mistakes that cannot be allowed to happen. Change is inevitable, just as the original founders of other present-day organizations understand. They had the confidence to change. They found the energy to think differently and even to feel differently. They understand the power of a vision, and they had the guts to go after their dreams. As Bender concluded in his book, Leadership From Within [35], "True leaders think for themselves. They take responsibility." Put another way, true leaders are driven from within to help others and to foster change. They are driven by a passion to change from within.

Passion is everything and more! When change is driven by a dream, nothing is more important or too big to slow the process. It makes all the difference in the world. So, the next time a big-time doctorate of sports medicine tells you "It can't be done," smile and walk away because you know differently. Understandably, not everyone is in a position to change the world of exercise physiology without help from others or to change the entire face of academics without help from the college professors, but exercise physiologists are able to do certain important things as long as they wake up to the reason. That is, as long as they put foundations under their academic thinking, and as long as they proclaim before the world that they are fully in charge of their profession. Ultimately, they must learn to think as exercise physiologists and to behave as exercise physiologists.

Passion that results from faith that neutralizes all doubt is power. How many times have you witnessed first-hand in your own life or while watching a movie about people who set out to do something against all odds and they did it? Just as a vision gives direction to an organization, disciplined thinking directs the mind in ways to allow the flow of positive and passionate feelings [36]. All exercise physiologists have to do is believe that they have the power and, then, they do! Few people ever accomplish anything important without the willingness to believe in the possibility of their work. The belief itself is empowering and, perhaps, disturbing, too. Of all the healthcare practitioners, exercise physiologists should recognize the truth in conviction more so than most. Not until exercise physiologists know in their hearts that they will make it will their minds come together in absolute truth and understanding that they have made it. Change is work. It is also a vision of something better and it requires a willingness to risk something to gain something. In conclusion, remember what Leo Buscaglia said: