Professionalization of Exercise Physiologyonline     


ISSN 1099-5862   Vol 6 No 12  December 2003 
 



 
 



    Editor-in-Chief
    Tommy Boone, PhD, MPH, MA, FASEP, EPC
 

You Are Not a Healthcare Professional
Tommy Boone, PhD, MPH, MA, FASEP, EPC
Professor and Chair
Department of Exercise Physiology
Director, Exercise Physiology Laboratories
The College of St. Scholastica
Duluth, MN 55811
 
“Man is what he makes of himself.  And the courage to be as oneself is the courage to make of oneself what one wants to be.” – Paul Tillich, The Courage To Be
“You are not a healthcare professional.”  Who has not received this admonition?  Most exercise physiologists have heard it from employers, from professors, and from other healthcare professionals.  But what evidence is there to suggest that exercise physiologists are not healthcare professionals?  Perhaps, the misunderstanding stems from our recent past thinking.  For example, one can imagine, given the vast array of research published by academic exercise physiologist, that exercise physiology must be about the “acute and chronic adaptations to exercise”.  Clearly, this view is outdated. 

Part of the difficulty in accepting that exercise physiology is a healthcare profession also comes from within the academic setting itself.  Most academic, doctorate prepared exercise physiologists tend to think of “healthcare professional” as physical therapists, occupational therapists, nurses, and others with licensure.  Undoubtedly, the prevailing notion that licensure is necessary to earn the title, healthcare professional, is as incorrect as the thinking that only those with the doctorate degree can call themselves exercise physiologists.  There are reasons to argue that both kinds of thinking are consistent with the 20th century view of exercise physiology and healthcare.  The emphasis placed on research is important, but non-doctorates do research too.  The question of licensure, however important, doesn’t in itself define a healthcare professional.  Obviously, the differences of opinion regarding how best to apply exercise physiology knowledge in the midst of rapid changes defined by the American Society of Exercise Physiologists are mixed.

Change takes time.  No one person, group of individuals, or any particular organization can push change too fast.  Ideas need to settle in, evaluated, and acted upon.  So, while it seems reasonable that most exercise physiologists should understand the ASEP perspective, it also reasonable to argue the continuation of the views that define sports medicine.  Here again, it is just a matter of time.  Until then, that is, until exercise physiologists fully and completely embrace the ASEP organization, those of us who believe in the professional development of exercise physiology under is own mentoring, it is a matter of staying the course!  While common sense convinces us of the importance of sports medicine in the recognition of exercise physiology, what is also important is that exercise physiologists have increased the recognition of sports medicine.  The old perspective that exercise physiology belongs to sports medicine is incorrect, irrational, and seriously problematic for exercise physiologists.  This does not mean that ASEP exercise physiologists disrespects the sports medicine professionals. 

If one accepts the idea that exercise physiologists are healthcare professionals, then the need for increased academic preparation, accountability, and professionalism becomes apparent.  These specific points are addressed throughout the ASEP web site, among members who talk about the professional growth patterns evident in recent years, and the attention given to the thinking about professionalism.  Indeed, it is clear that ASEP represents exercise physiologists, argues for their professionalism, and has defined the future of exercise physiology.  Many of these points are illustrated in numerous articles published in PEPonline. 

Exercise Physiology is 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.” 

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.” [1]

Not only are the abovementioned definitions important to staying the course, the need for change is apparent within the ranks of the non-doctorate exercise physiologists.  They understand the distinction between them and the professors with doctorate degrees.  Ideally, one wants both to get on the same page.  The extent to which that is likely to happen is dependent on the assessment of ASEP and its efforts to communicate compulsory mandates of a professional organization.  It is also worth noting that members of sports medicine, exercise physiologists or otherwise, with an interest in immunology, biomechanics, nutrition, and psychology have formed their own professional associations.  Why, then, is there even a question that exercise physiologists should not have their own professional organization?  This ought to be a question of interest to all exercise physiologists. 

Fortunately, there is evidence that a consensus is forming that the ASEP “Vision” is unquestionably not just right but long over due [2].  This view acknowledges the normal course of development of emerging professionals.  The challenge is to stay the course, which depends on a systematic and contingent interaction between all exercise physiologists.  Members of ASEP understand that it is not a “one-shot, hopeful hit”.  The process of change began in 1997.  The change is ongoing, and it is accordance with the reinterpretation of what is exercise physiology.  The evidence from close examination of the ASEP initiatives indicates the distinction between technician-based performance and the possession of specific knowledge with practical implications.  It is reasonable, therefore, to think of exercise physiologists as healthcare professionals. 

Why then is there disagreement when the literature on the benefits of exercise is far too vast for us to overlook, and much of it is relevant to many facets of living (whether it is regarding fitness, health, wellness, rehabilitation, or athletics)?  Is it as simple as people are biased toward sports medicine?  If so, what do they fear?  Change is inevitable.   They may continue to ignore the exercise physiologists without the doctorate.  Or, they may think that accrediting fitness professionals is a responsible way to think.  In actuality, this kind of reasoning is not just incorrect, but restrictive as well.  It continues to suggest that the doctorate prepared person is an exercise physiologist while the non-doctorate is a fitness “something”  (possibly, a specialist, professional, or technician).  This view is not just disconcerting; it is demeaning.  It can be viewed as an attitude that confirms the bias of past thinking.

The view of covariation or correlation between sports medicine and exercise physiology is a mistake that the two are causally related when in fact they are only correlated.  The tendency to try and link them when in fact there is no causal relation at all between them is intuitively incorrect.  Exercise physiology is not about just “jumping higher, running faster, and getting stronger”.  Also, exercise physiology is not just about another research presentation and/or publication.  Exercise physiology is about serving the public’s needs.  But, here again, the apparent prevailing notion is “research” above everything else.  It is a view consistent with the old establishment thinking.  As an example of the confusion, if A (sports medicine) and B (exercise physiology) are not correlated, but B (exercise physiology) has for several decades associated with, if not, invariably followed A, it may seem natural for exercise physiologists (and sports medicine) to assume that B (exercise physiology) is caused by (or defined by) A.  The problem is that this type of thinking is not a reliable indication of a cause-effect relationship.  Similarly, as stated by Nickerson et al., [3, p. 129],  “Night invariably follows day; however, we would not say that day causes night.”

While sports medicine-exercise physiologists might be tempted to continue justifying their bias on the grounds that the sports medicine certifications motivate candidates to become fitness professionals or exercise specialists, ironically, the biggest problem of the sustained bias is the candidates’ illusion of professionalism.  This is also why clinging to the sports medicine hypothesis that disregards and overlooks ASEP is wrong for the obvious reasons.  Allowing for preconceptions to overwhelm the compelling evidence of why exercise physiologists need their own professional organization does not make sense.  It is as simple as allowing the flaws in our beliefs to blind us from new thinking.  Thus, we can now come to an understanding of the 20th century sports medicine view that states:  the non-doctorate exercise physiologist is not a healthcare professional.  This view is not surprising, and it is decades behind in critical reflection. 

This brings us to the ASEP perspective that exercise physiologists are healthcare professionals.  It is worth noting that considerable work has been written on this topic [4-23].  If one accepts this perspective, it urges the importance of communicating the ASEP role in the professional development of exercise physiology.  The discourse can take the form of listening, speaking, reading, and writing.  Pleading the ASEP case for healthcare career opportunities recognizes the fundamental shift in thinking from sports medicine to exercise physiology. 

“More profound changes lie ahead.”  --The Smithsonian Institute, The Phenomenon of Change 
References
1. American Society of Exercise Physiologists. (2003). ASEP. [Online]. http://www.asep.org/
2. American Society of Exercise Physiologists. (2003). ASEP Vision. [Online]. http://www.asep.org/asep/asep/vision.htm
3. Nickerson, R.S., Perkins, D.N., and Smith, E.E. (1985). The Teaching of Thinking.  Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers. 
4. Boone, T. (2003). You Can’t Blow an Uncertain Trumpet. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 7).  http://www.asep.org/asep/asep/AnUncertainTrumpet.html
Boone, T. (2003). A Shared Vision Precedes Reality: A Personal Perspective. Professionalization of Exercise Physiologyonline [Online], Vol.  6 (No. 6).  http://www.asep.org/asep/asep/SharedVisionPrecedesReality.html
5. Boone, T. (2003). The Role of ASEP in the Professional Development of Exercise Physiology. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 6).  http://www.asep.org/asep/asep/ProfessionalDevelopmentOfExercisePhysiology.html
6. Boone, T. (2003). Ethical Thinking:  What Is It and Why Does It Matter? Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No.  6).  http://www.asep.org/asep/asep/EthicalThinkingANDexercisephysiology.html
7. Boone, T. (2003). Values Clarification in Exercise Physiology. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 6).  http://www.asep.org/asep/asep/ValuesClarificationANDExercisePhysiology.html
8. Boone, T. (2003). Strategic Management and Decision Making in the American Society of  Exercise Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 5). http://www.asep.org/asep/asep/StrategicManagementANDexercisephysiology.html
9. Boone, T. (2003). Introduction to Professional Ethics.  Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 5).  http://www.asep.org/asep/asep/ProfessionalETHICS.html
10. Boone, T. (2003). Leaving the Old Reality Requires New Thinking.  Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 4).  http://www.asep.org/asep/asep/LeavingTHEoldREALITY.html
11. Boone, T. (2003). The Power of Individuality. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 4).  http://www.asep.org/asep/asep/powerOFindividuality.html
12. Boone, T. (2003). Doctorate of Exercise Physiology:  An Excellent Idea or Is It? Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 3).  http://www.asep.org/asep/asep/DoctorOfExercisePhysiology.html
13. Boone, T. (2003). Organizational Code of Moral Principles and Values. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No.  3).  http://www.asep.org/asep/asep/OrganizationalCodeOfMoralPrinciples.html
14. Boone, T. (2003). The Role of the ASEP National Office in Transforming and Renewing Exercise Physiology. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 3). http://www.asep.org/asep/asep/RoleOfASEPNationalOffice.html
15. Boone, T. (2003). The Entrepreneurship of Exercise Physiology. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 3). http://www.asep.org/asep/asep/EntrepreneurshipOfExercisePhysiology.html
16. Boone, T. (2003). Why Teach Anatomy? Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 3).  http://www.asep.org/asep/asep/WhyTeachAnatomy.html
17. Boone, T. (2003). The ASEP Organization is a Paradigm Shift. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 2).  http://www.asep.org/asep/asep/TheASEPparadigmShift.html
18. Boone, T. (2003). Creating a Better Academic Degree for Our Students. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 2). http://www.asep.org/asep/asep/betterACADEMICdegree.html
19. Boone, T. (2003). Overcoming Institutional Inertia with Leadership. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 2).            http://www.asep.org/asep/asep/OvercomingInstitutionalInertiaWithLeadership.html
20. Boone, T. (2003). BEEFING UP PROFESSIONAL DEVELOPMENT: A Top-Priority Initiative. Professionalization of Exercise Physiologyonline  [Online], Vol. 6 (No. 1). http://www.asep.org/asep/asep/ProfessionalDevelopmentEXERCISEPHYSIOLOGY.html
21. Boone, T. (2003). Frequently Asked Questions About Exercise Physiology. Professionalization of Exercise Physiologyonline [Online], Vol. 6  (No. 1). http://www.asep.org/asep/asep/QuestionsAboutExercisePhysiology.html
22. Boone, T. (2003). The Making of American Exercise Physiology. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 1).           http://www.asep.org/asep/asep/AmericanExercisePhysiology.html
23. Boone, T. (2003). The COURAGE to QUESTION what is exercise physiology in the 21st Century. Professionalization of Exercise Physiologyonline [Online], Vol. 6 (No. 1). http://www.asep.org/asep/asep/COURAGEtoQUESTION.html
 
 
 
 
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