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.
Copyright
©1997-2007
American Society of Exercise Physiologists All Rights
Reserved.