|
|
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 Clearly, this view is outdated.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
 |
|
