Get Up and Get On With It
Kevin Ritsche, EPC
Board Certified Exercise Physiologist
Department of Exercise Physiology
The College of St. Scholastica
Duluth, MN 55811


IMAGINE a congregation preached at in church, meanwhile the congregation doesn’t believe in the word of God.  Then, what is the point of the pastor preaching if no one believes in the word of God?  Perhaps, it is because no one understands God.  Christianity is still young even though it has been around for thousands of years.  People continue to question Christianity and its relevance to society.  However, we know that Christianity exists.  And, there is a need for it because it brings us hope and justice. 

By comparison, it seems to me that exercise physiologists need to get up and get on with it!  Enough preaching to the congregation. You can preach and preach and preach, but if no one believes in your cause, "Why not just get on with it?"  Stand up and do something about it.  Christianity wasn’t formed in seven years (as is presently the case with the American Society of Exercise Physiologists), it was formed over the span of thousands of years and continues to be questioned and taught today.  In order for credibility to exist, certain key elements should be included.  The main element is leadership.  Without a leader, followers will have no common visions for their goals.  Moreover, this theory of leadership is exemplified throughout the Bible. 

Physical therapy developed as an organization in 1917 and continues to this day to constantly revamp its place in society through strong leadership and the ability to adapt to its changing environment.  Here, it seems to me that good leaders are made not born.  There is no reason to believe that physical therapy's professional status is the direct result of leaders born to lead.  Good leaders develop through a never-ending process of self-reflection, education, experience, and training.  Boone writes that, “tomorrow’s leaders must embrace change and be willing to work with friends, mentors, allies, and, in general, do whatever it takes to network and increase opportunities for their students” [1]. 

The ASEP organization was founded in 1997.  There is some sense that it is at a “standstill” regarding professionalism.  Is this true?  Or, have the ASEP leaders done extraordinary things in just seven years?  Both are interesting questions.  When will the next super-leader surface and, in fact, has there been any real “vision-driven” leaders in the field besides the founders of the Society?  It seems to me that no one else is talking about professionalism except the members of the ASEP organization.  How many more lost opportunities is it going to take before the academic gatekeepers (and students) realize the time that is being wasted.  Here again, Boone [1] concludes that:  “Unfortunately, the topics of image, leadership, and professional self-management have been largely ignored.  Had these topics been addressed earlier, exercise physiologists would have probably avoided mortgaging their future to sports medicine". 

I strongly believe that the leaders of exercise physiology should lead by example.  A good example is not preaching about leadership (or the lack their of it), but rather stepping up and becoming leaders themselves.  To this day, there is only one small book written on professionalism within the exercise physiology field.  Strong leaders need to evolve and publish books on the professionalization of exercise physiology that will continue to take it in the right direction before sports medicine can continue to cause any more damage for today’s students. 

In this regard, several important elements of leadership are discussed to help with the understanding of the importance of professional development of exercise physiology:

Mission Statement
Think about the following questions.  "What is it about exercise physiology that is important?"  Or, "Who is the intended audience?"  Simply put, the future of exercise physiology as a profession lies within a unified mission statement that acknowledges where the profession is headed.  This statement must provide direction while at the same time enhance motivation for its members to continue the professionalization process.  Until exercise physiologists can agree on a professional organization that will hold the exercise physiologist accountable for its services, it will continue to be neglected by other health professions along with the public sector as a true profession.  Boone [1] writes “before the public can grant professional status to exercise physiology, it must be recognized as being socially necessary.”  He also comments on another problem faced by exercise physiologists in that they do not understand the importance of setting agendas and making professional decisions about the future.  The founding of the ASEP organization has been helpful in aiding the process of leadership.  Not only does it create a name for exercise physiology, but also defines who and what an exercise physiologist is.  For example, according to ASEP [3], 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.”

The American Society of Exercise Physiologists has also set forth a mission statement and is the leading professional organization within its related health science field.  In the format of a vision [3], ASEP declares its mission statement and intends:

"To be recognized as the leading professional organization of American scholars and practitioners in the study and application of exercise physiology to fitness, health promotion, rehabilitation, and sports training.  Unify all exercise physiologists in the United States and worldwide to promote and support the study, practice, teaching, research, and development of the exercise physiology profession.  To empower its members to serve the public good by making an academically sound difference in the application of exercise physiology concepts and insights through proactive and creative leadership."

Vision creates reality and reality shows us the future.  Having this sense of reality through vision helps to lay the framework around building a credible background to a respected organization.  The absence of detailed information regarding a true mission statement is what hinders the American College of Sports Medicine (ACSM), and allows its members to congregate among a vast variety of different backgrounds of professionals on different pathways.  According to ACSM, their mission [4] statement is:  "...advance and integrate scientific research to provide educational and practical applications of exercise science and sports medicine."  But to whom do they hope to provide these applications to?  No where do they acknowledge who a member of ACSM is or what they intend to practice.  Vagueness stems from poor leadership and that’s the problem facing ACSM and its members.  Since the candidates for the different certifications are not limited to exercise physiologists, ACSM is only hurting exercise physiology as an emerging profession.   The answer does not lie within creating more certifications, but rather creating one certification for a group of individuals who have emerged from the same academic background and, therefore, share the same foundation of knowledge. 

Credibility
In order to gain credentials from other health related fields and the public sector, members of the exercise physiology profession need to stand up and put their name on the map.  Everyone needs to understand that a credible organization is needed to provide expertise and trustworthy care for its services.  That is why leadership in exercise physiology also deals with doing the right things for the right reason and commitment to strive for perfection [5].   The question that lies within the public sector is:  "Can exercise physiology as a profession hold academic credibility?"  Boone [1] writes:

“...can the exercise physiologist do a better job of teaching and graduating high-quality professionals?  Yes, they can. Can they covert the emphasis in exercise science to an cademic degree in exercise physiology and indeed, the exercise physiology faculty?  Could it all simply disappear?  Yes, it could!  It has happened to other programs and faculty when students could not locate a meaningful job in the public sector.”  

When is the faculty and students going to stand up and realize their potential for academic credibility?  If the opportunity exists, why are so many failing to take advantage?  Perhaps, exercise physiologists need to understand what builds credibility and what destroys it, and once understood they must protect it because once it is damaged it will be hard to fix.  This is the problem facing exercise physiology as a profession today.  Leaders know what needs to take place in order for the job to get done.  When will they come together and do something about it on a larger scale?  

Class
If exercise physiologists want to start being treated like professionals, they need to take the necessary steps of being professionals.  Exercise physiologists need a sense of belongingness and pride that will come only with great and sustaining leadership.  Physical education instructors and fitness buffs dress like they do because that is where they belong and it is what they do.  There is nothing wrong with their profession.  There is integrity in the physical education profession.  However, if exercise physiologists desire equal treatment to other health care professionals, they need to start acting with a sense of class and accountability that you would recognize in a physical therapist or an occupational therapist.  This means showing up to work everyday dressed appropriately and being professional.  It means being confident and, at the same time, understanding the importance of networking and working together.  It also means maintaining a healthy lifestyle.  By doing so, we provide an ethical and achievable example to the public sector [6]. 

Loyalty
When there is a lack of loyalty, members will leave an organization. [1].  Exercise physiology needs to prevent this from happening by building credibility for its members in order to keep them motivated and on the right path.  Too many exercise physiologists are inclined to take the easy way out or do whatever it takes to receive an income to support themselves or their families.  Sports medicine guarantees no credibility and, therefore, we see the decline in loyalty to the exercise physiology field.  The inability of exercise physiology students to find excellent paying jobs should not cause disloyalty to the profession.  Instead, through strong leadership, loyalty should not be questioned.  Exercise physiology students should have the confidence and direction to go out and find a job if not create one that fits the degree.  ASEP has already begun its process of providing credibility to its members and developing standards for keeping jobs within the profession to increase loyalty and to decrease the outflow of educated, yet loyalty-laden members to other health care professions.  Through continued leadership within ASEP, I'm confidence that loyalty will no longer be questioned and the field will grow exponentially.

Acceptance of Responsibility
Even with all the work that is still being done by exercise physiology on a leadership level, we need to understand that today's leaders in this initiation phase of professional development will not remain in charge forever.  Recent graduates from exercise physiology programs still question what they can and can’t do in medical field settings [7].  I believe that this comes from the absence of vision and the exercise physiologist not accepting their responsibility to belong in the medical field.  Elizabeth Domino [8] writes:

“The interdisciplinary health care teams with which these nurses are collaborating consist of colleagues educated at the master’s degree or higher levels.  These teams include physicians, pharmacists, speech pathologists, physical and occupational therapists, and others” 

Where does the exercise physiologist fit in with the above statement?  In all truth, in most situations, the exercise physiologist does not exist as part of the interdisciplinary health care team.  Why?  Because they have not taken the necessary steps to make themselves known by the public sector.  In order for exercise physiologists to continue their scope of practice, gain respect from the public education and expand their expertise into the field of health, they must first commit to higher or advanced education.  They must also get involved in professional organizations, such as ASEP, to influence others to join and enhance exercise physiology as a true profession.  This will help exercise physiology gain autonomy and gain political insight into issues affecting cardiac rehabilitation, physical fitness, nutrition, and behavioral changes to mention a few. Today, pressures are placed upon professional organizations to promote educational advancement because of legislation that allows higher professional boards the authority and autonomy to develop, implement, and evaluate continuing competency requirements [8].  Jean Gray [9] states “no one would deny that the government has done well to boost numbers of nurses entering and returning to their profession.”   When will the exercise physiologist gain the respect at the federal level to ensure the replacement of members entering its field? 

No doubt, the professionalization of health care work seems to most nurses and allied health professionals to have been both hard won and well-deserved [2].  The leadership role played by all levels of health care providers within the field of exercise physiology should stem from taking responsibility for the quality and care of service they provide [10].  Martin states “you (regardless of setting) are in the leadership role.  Nobody else can influence the quality of service that your provide to that particular patient.   You are in control of that” [10, pg. 7].  It is now time for the individual exercise physiology to act on behalf of themselves and accept the responsibility for what is right for their emerging profession if they wish to be part of any professional organization in the future.

Synergism
Everyone in the profession makes a difference regardless of their degree status and everyone should be respected as a professional [2].  Martin [10] agrees that segregation within the field is wrong and that their should be professional leadership between entry level personnel and directors of any part of an organization with no barriers between them.  The PhD exercise physiologist should not be recognized as the only “true” professional because, in actuality, its the combination of the master and bachelor-prepared exercise physiologists that make the profession what it is in the public sector.  The meaning of synergism is “the whole is greater than the sum of its parts.”  How this applies to exercise physiology as an emerging profession is that exercise physiology as a whole is stronger as a unified organization than a combination of different organizations with different visions working under one chaotic health field. 

Heightened Awareness
Exercise physiologists of the future will have heightened awareness about who they are as professionals.  They will accept themselves for who they are as an exercise physiologist and not as a physical therapist, doctor or nurse.  They will understand their place within the health field as well as know the places of others.  They will do this on behalf of the fact that they will know where exercise physiology now stands as an emerging profession and that the profession will always be changing to meet demands.  However, they will remain aware that the vision and mission of exercise physiology remains the same. 

Transfer of Trust
A transfer of trust needs to take place between exercise physiology and all emerging and ever-changing professions among the health-related fields.   This will include an obligation to secure practices within their intended realm.  No longer will kinesiologists with a concentration in exercise science refer to themselves as exercise physiologists without the proper academic background or ASEP board certification.   It is important that these differences are understood and resolved.  After all, the objective of all health care professions is to provide services to the public and engage in research that will make the world a better and safer place to live. Also, more doctorate prepared exercise physiologists will need to put down the pen and take charge of changing department offerings.  Where possible, they need to change the academic degree from exercise science to exercise physiology.  And, yes, they need to join the ASEP organization.  Exercise physiology is in desperate need of those who can instill a sense of pride, respect, hope, and trust in academic programs of study, in what we do, and in our future.  Students, in particular, need to feel competent and fully capable of breaking away from the dependency and security that sports medicine so falsely advertises. 

Planning for Success
Planning for success is virtually non-existent in healthcare organizations.   By creating a plan for success, it enhances the ability of members to maintain productivity levels and to ensure that qualified leaders will be available when others step down.  Bolton and Roy [11] point out that, “there are several ways to identify potential leaders, however, just because they are high-performing clinicians do not necessarily mean they posses the attributes of a good leader."  When looking for potential leaders to expand on what had been developed by those before them, “one must look for individuals willing to assume the leadership role with visions of enhancing the current standing of the organization and possessing certain leadership qualities such as emotional intelligence, decision-making, organizational behaviors.....”  [12].  Once new leaders have been established, it is necessary to implement a plan of action that will prepare the future leaders [13].   It's this kind of thinking and attitude in planning for success that can be the difference between professional organizations that thrive and those that strive for existence [11]. 

Conclusion
Leaders in the profession should be visible and accessible in all aspects of their work [10].  A set of shared principles (and code of ethics) developed by a credible, professional organization can serve as an axiom from which exercise physiologists can be judged [7].   The code of ethics will be based on the beliefs that: “Exercise physiologists are self-regulated, critical thinkers who are accountable and responsible for high quality competence in the practice and the delivery or preventative, rehabilitative, educational, and research services [7].  It is time for all exercise physiologists to step up to the plate and act responsibly on behalf of the professional development of exercise physiology.  


References

1. Boone, T.  (2001).  Professional Development of Exercise Physiology. Lewiston, NY:  Edwin Mellen Press.
2. Colyer, H.  (2004).  The Construction and Development of Health Professions: Where Will it End?  Journal of Advanced Nursing, 48(4):  406 – 412.
3. American Society of Exercise Physiologists.  Online Source, http://www.asep.org
4. Boone, T.  (2002).  Exercise Physiology Quackery and Consumer Fraud.  Professionalization of Exercise Physiologyonline.  5(5)
5. American College of Sports Medicine.  Online Source, http://www.acsm.org
6. Boone, T. (2005). An Essay on Professionalism and Exercise Physiology for Students and Teachers.  Professionalization of Exercise Physiolongonline.  8(3).
7. Boone, T.  (1995).  Code for Exercise Physiologists-Medicolegal Considerations for Ethical Practice, 9(1):  1-7.
8. Domino, E.  (2005).  Nurses Are What Nurses Do- Are You Where You Want to Be?  AORN Journal,  81(1):  187-201.
9. Gray, J.  (2004).  Keep the Ball Rolling.  Nursing Standard.  10(19).
10. Black, S.  (2004).  Leading by Example: Interview with Paul Martin.  Nursing Management.  11(7).
11. Bolton, J. and Roy, W.  (2004).  Succession Planning. JONA.  24(12):  589-593.
12. Goleman, D. Boyatzis, R., and Mckee, A.  (2002).  Primal leadership:  Realizing the Power of Emotional Intelligence.  Boston, Mass:  Harvard Business School Press.
13. Smith, E.  (2002).  Leadership Development:  the heart of succession planning. Seminars for Nurse Managers.  10(4).