EPCs and a Proactive
Health Model: The Relay
Shane Paulson, MA, EPC
ASEP Board Member
Introduction
Imagine a simple relay race,
where the first runner picks up the baton and starts the race with a first
step, followed by another and yet another, gaining speed and momentum toward a
steady pace that should carry the runner to the second runner who will take the
hand-off and continue to the next. Each
consecutive runner stands poised to accept the baton and continue with his or
her own contribution of speed and endurance. Future runners are not even on the track at
this point, but will get into position and carry on when the appropriate time
presents itself.
For more than 100 years,
scientists have been researching the human body and its adaptation to exertion
stimuli. Dr. Per Olaf Astrand was one of
the first to pick up the baton, the idea that physiologic efficiencies could be
elicited and measured. More recently,
researchers have focused on how the body adapts to a lack of stimulus which
leads to the premise that exercise is like medicine, that it can counteract
dysfunctions of the human organism. In
this relay, the baton is the growing body of knowledge. Naturally, the baton has been passed from one
generation of researchers to the next, remaining primarily in the academic
setting. We are at a point in time now
where the body of knowledge can serve the public at large and must be carried
to them by some profession.
EPCs, Professionalism, and Preventing Disease
This is a critical point: Board certified exercise physiologists need
to get on the track now, because a hand-off is happening. EPCs have an advantage in carrying the baton
for the next leg of the relay. Having a
professional organization [1], code of ethics [2], standards of practice [3] and
the growing recognition as healthcare professionals, EPCs [4] are poised to
take the baton of knowledge to the public in a standardized, safe, effective,
and efficient way.
EPCs should feel confident in
their ability to understand the disease, injury, and detraining processes of
the body. They must become keenly aware
of opportunities that surround them to network with other healthcare
professionals to intervene in the disease process and prevent disuse adaptations. They must insert themselves and impress the
systems of care provision, payment, and legislation with their unique academic
and laboratory training and abilities.
While medical doctors diagnose
and treat disease states with medicine, EPCs are poised to provide a new tool
in the fight against disease. EPCs use physiological
testing and interpretation of outcomes to identify weaknesses or inefficiencies
that can be positively affected by exercise.
Based on individual outcomes, EPCs can determine and prescribe safe,
effective, and efficient exercise protocols suited to each individual’s
circumstance and goals. In the earliest
stages, with the provision of exercise physiology-based education and
intervention, EPCs can help individuals maximize their health through
prevention of disease and injury. As a
reaction to existing conditions, we know the highest natural potential for
recovery or control of disease states rests in an individual’s ability to
maximize physiologic efficiencies that provide for better, more maintainable
homeostasis.
To prevent a disease entirely is
the most desirable, but preventing an established disease from progressing is
similarly important. The momentum of
this logic is growing. It has become
common knowledge that our medical treatment model will not handle the chronic
disease epidemics facing the United
States.
Left unchecked, predictions of insolvency threaten our care systems, our
economy, even the fabric of our communities.
People are looking for solutions!
Usually in ‘bureaucratic’ systems
like government or the medical treatment system, established and accustomed to
working a certain way, change is slow and painful. However, there is a sense of urgency now that
makes change necessary. This urgency
frees up money which is being spent to develop new ways and new tools. EPCs understand that our knowledge base is
not “new” but its application in and around the current medical model is. A good question is how do we fit into an
already overburdened/under-funded medical treatment model?
Proactive Health Model
One answer may be quite simply, we
create a completely new Proactive Health
Model where exercise physiologists are in front of the medical model rather
than inside it. If you will, imagine the
current medical treatment model as the clinic/hospital you are familiar
with. Now consider dentists who have
their practices outside of the hospital/clinic environment. They certainly provide reactive care for
individuals when accidents or disease occurs, but primarily dentists have
convinced us that prevention is our best treatment and we visit them regularly
to ‘check-up’ on our dental health.
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<>Similarly, exercise physiology
clinics can provide assessments and outcome qualification/quantification for any
individual. The services may be slightly
different for individuals with or without a disease diagnosis or for different
age groups, but remain equally important to all. The first visits to the EPC will be
screenings and initial baseline assessment where information is used to educate
the individual about their physiologic profile and how their physical
activities, exercise habits, and lifestyle behaviors affect their health, fitness,
disease risk, or their disease progression/regression.
Regular follow-up appointments
repeat testing processes where outcomes quantify changes resulting from the
individuals efforts in the period since their past test. EPC services will be recommended from other
healthcare professionals who have an interest in their patient’s physiologic
profile and test reports and updates to the exercise prescription would be
provided to the physician or referring care provider. The individual’s goals and situation would
determine if they do the daily work of the exercise prescription within the EP
clinic, in their home, or at a traditional gym. The EPC has become the
qualified, recognized, and accountable source for these services and
information.
Like dentists and other healthcare
professionals, there are expectations of proficiency, skill, and knowledge. These expectations can not be waived or
trusted to a multitude of different certifications. Doctors, nurses, physical therapists, dieticians,
and even the most frontline staff such as certified nurse assistants meet
standardized educational requirements which allow the medical treatment system
to recognize and trust that individual to work within their scope of
practice. With the American Society of Exercise Physiologists (ASEP) as a national
organization that stands behind the board certified exercise physiologist (EPC)
with a defined standard of practice and code of ethics, the EPC is able to work
within these systems, alongside and in partnership with other healthcare
providers to affect the health of the American public.
Now…Is the Time!
The time has presented itself for
EPCs to get on the track. Exercise
physiologists must be ready to take the baton of knowledge and apply it. After all, they are established, and they are
credentialed. Moreover, they are
organized, and they are capable of affecting health in human beings. Those
first runners, the scientists and researchers, will continue to run alongside
with encouragement and guidance as they continue to study and uncover the
mysteries of how the body works. The
work of application is the next leg. It
was inevitable that exercise physiologists would come to this, that they would
come to a point where what they know and continue to learn is not the objective
of our existence. Their objective now is
to do what they can with what they know, because they are the ones best suited
to do it.
Final Word
As a final thought, this brief article
isn’t about beating other ‘exercise professionals’ to some brass ring. This is about the need for appropriate professional
preparation and a willingness of the EPC to meet the responsibility and
accountability that comes with being a recognized healthcare professional. The vast variety of degrees and certifications
in the exercise science/fitness professional world are mind-bending. The
inertia of that system is immense, but for those interested in the
opportunities that exist for a brand new uniform healthcare profession, it
should be obvious that change has begun and we are in need of all the help we
can get. If you are not an EPC already, begin your efforts to become one and be
a part of the new Health Model.
<>References
- American Society of Exercise Physiologists. (2008). Home Page.
[Online]. http://www.asep.org/
- American Society of Exercise Physiologists. (2008). Exercise
Physiologist’s Code of Ethics. [Online]. http://www.asep.org/organization/ethics
- American Society of Exercise Physiologists. (2008).
Professional Standards of Practice. [Online]. http://www.asep.org/services/standards
- American Society of Exercise Physiologists. (2008). Board
Certified EPCs. [Online]. http://www.asep.org/people/certifiedEPs