PEPonline
Professionalization of Exercise Physiologyonline

An international electronic
journal for exercise physiologists
ISSN 1099-5862

Vol 5 No 3 March 2002

 


The Third Alternative
Gary F. Gordon, PT, PhD
Department of Exercise Physiology 
The College of St. Scholastica
Duluth, MN 55811



I HAVE BEEN a physical therapist for 33 years.  During this period, I have worked in several clinics and hospitals, taught college students, and became active in the physical therapy state association as a vice president and member of the A.P.T.A. House of Delegates.  I have been involved with the creation of autonomous practice and academic program accreditation, while working under the scope of practice acts in various states. 

For the last 10 years, I have taught in a collegiate exercise physiology program.  Until recently, the distinction between physical therapy and exercise physiology has been defined by our academic training. However, all this is changing now.  Physical therapists are seeking jobs in our traditional practice arena (i.e., the exercise physiology arena) in order to increase their own employment.  They do this with insufficient academic background or practical experience in exercise physiology.

Physical therapists have long been associated with repairing and healing the body in the context of acute and chronic rehabilitation (e.g., neuromuscular, musculoskeletal, and cardiovascular).  They are experts in biomechanics and pathomechanics, and in the application of neurophysiologic techniques to the treatment of neuromuscular disease.  A small number of physical therapists are engaged in cardiac rehabilitation.  Some work with industrial ergonomics to prevent injury from overuse syndrome or faulty biomechanics.

The common thread in exercise physiology education is cardiovascular and pulmonary physiology.  We receive this information from day one.  Our practitioners understand how the human body functions, physiologically.  While physical therapists emphasize structure and dysfunction, we target physiologic change and health promotion.  For the most part, our task is to prevent disease and improve human performance (on land, in space and under water).  A great many exercise physiologists work in cardiac and pulmonary rehabilitation, human performance laboratories, industrial wellness settings and community outreach. 

As the nation discovers that it cannot afford health care for self-imposed illness (that which is related to lifestyle choices), it will become necessary to adjust our focus from the treatment of disease to its prevention.  The latter is ultimately cheaper and a better long-term solution to health care costs.  When this insight solidifies, exercise physiologists should be on the front lines for carrying it out.

It is not unusual for physical therapy programs to teach cardiac rehabilitation since a handful of therapists pursue this course, but it is surprising and alarming that some physical therapy program of study are teaching a single course in exercise physiology and expecting their students to apply this knowledge base in public settings.  What has just recently concerned me is that the physical therapy department where I work has sent their students to evaluate aerobic fitness and body composition of local firemen.  If this is typical, nationwide, it presents a direct threat to our profession and the inroads we have made into preventative medicine.

One cannot blame physical therapists for seeking new opportunity since we lack a recognized scope of practice (i.e., defined by state statute).  In addition, the public has only a vague perception of the services we offer.  With insight and vision, exercise physiologists can rectify this situation.  One state at a time needs to create a statute that clarifies our unique role.  This is how physical therapists began their quest for practice without referral.  It is how they delineated the roles of their practitioners from Chiropractors and others as a matter of law.  We need to promote our profession to the general public and other healthcare providers.  Our practioners have come of age. The creation of lateral referral between exercise physiologists and physicians is long over due as well.

Each of us must recognize the value of our product to the nation as a whole.  We represent a third alternative to raising taxes or depleting services in order to pay for health care. Exercise physiologists are in position to help people become responsible for their own health.  More than any profession currently in existence, we have the knowledge and skill to accomplish this task.  The vast majority of medicine operates on the disease model, our path is different.  It is time to celebrate this difference.




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