What is Our
Business?
Tommy Boone, PhD,
MPH, FASEP, EPC
Professor and Chair
Department of Exercise Physiolgoy
College of St. Scholastica
Duluth, MN 55811
“Whoever claims
authority thereby assumes responsibility. But whoever assumes responsibility
thereby claims authority.” -- Peter F. Drucker
DURING THE LAST several days,
it has become obvious that the concept of an emerging profession isn’t
necessarily a concept that even ASEP members fully understand. Yet,
every major idea is always complex, emotionally a challenge, and either
knowingly or unknowingly resisted. Even the idea of what constitutes
a profession is singularly difficult, and some simply don’t permit the
possibility of new thinking. It is, indeed, almost incompatible to
think differently when controlled by learned and/or acquired beliefs.
One reason for the incompatibility is self-preservation. Therefore,
business as usual is always the reality of the believer.
The problem is that the reality
of yesterday may very well be a dead vision. Very few visionaries
rely on the past to create an awareness of what lies ahead. This
means, above all, that tools for change exist in the present and in the
power of dreams. The Internet is one such tool. For this reason,
the ASEP web pages are directly related to the specialized accounting of
exercise physiologists. The new exercise physiology boom of
today is not fitness related but based in professionalism. There
is no comparison either in politics or direction. One might say that
exercise physiologists have learned to practice their own thinking.
To them the future lies not in the “other organization” but rather in the
organization that markets exercise physiologists. Such thinking is
a long time in coming.
Similarly, the need for professional
innovation is greater than the need for research innovation. Professional
innovation is the first step in organizing a return to professional accounting.
Equally important, and perhaps even more so than issues of research, is
the demand for a far higher level of professionalism. ASEP has taken
the first step. However, we need more steps forward and, in particular,
we need more exercise physiologists who are willing to look for ways to
put professionalism ahead of their own personal and/or professional interests.
There are few things as important as professional credentials. Institutions
understand this point. We also know that profitable business enterprises
understand the importance of regulations and credentials. The issues
of professional credibility are the reasons for the existence of ASEP,
the determinants of its work, and the grounds of its authority and legitimacy.
ASEP does not exist for its
own sake, but to fulfill a specific social purpose and to satisfy a specific
need of professionalism, individually and collectively. It has no
function in itself, indeed, no importance at all in itself; rather, it
is the means to new dimensions of exercise physiology. Dimensions
that are no longer divorced from professional credentials imply a distinct
mode of action requiring responsibility, motivation, and participation.
In each of these areas also, there are new beliefs and values to reach
the future from the present. And yet the drive for integrating the
present and future is directly related to the uncertainty of the unknown.
Part of the uncertainty comes from one of the new dimensions of exercise
physiology: professionalism and entrepreneurship. The exercise physiologist
has to slough off yesterday’s views of just corporate wellness and cardiac
rehabilitation jobs and create tomorrow’s new business markets and services.
This, we can see rather easily,
has to some extent already been done with sports psychologists, sport biomechanists,
sports nutritionists, and sports managers. Many of these professionals
have a much stronger concept of business than exercise physiologists.
It means that we should consider integrating business courses with exercise
physiology courses to optimize in-roads into the business world.
We must create new markets to realize the economic results consistent with
our education training. This does not deprecate the importance of
what we are or have been doing. It is about a way to overcome our
vulnerability in the cardiac rehabilitation community. Clearly, there
many examples where our graduates work for relatively little money by comparison
even to the graduates of two-year academic programs. These examples
are cited in egroups, chat rooms, and extremely well done in an interesting
article published in this issue of PEPonline.
Making exercise physiologists
into entrepreneurs is the business of individuals interested in making
the future a better place for exercise physiology. Success in cardiac
rehabilitation is tentative at best. It requires too much of the
medical-hospital tradition to survive. In fact, we know of a certain
percent of exercise physiologists who go on to get either the nursing degree
or the physical therapy degree so they can continue working with cardiac
patients. Success in the hospital setting is consistent only with
the understanding of tradition, and it isn’t a minor understanding.
Until academic PhDs come to appreciate this point, business (or the lack
of it) will continue and so will the bureaucratic management of exercise
physiologists in the healthcare setting.
“What is our business?” is
the question that every college professor must be able to answer.
Suggesting that the bachelor’s degree is simply a transition step to the
master’s degree doesn’t work any more. Most students and their parents
operate on the assumption that the college degree is about accessing a
job, leaving home, and becoming financially independent. While graduate
degrees are important for all the obvious reasons, they don’t exist as
a capstone experience for deficient or poorly planned for undergraduate
degrees. Today’s emphasis has steadily shifted toward a degree that
means something. It is about anticipating what tomorrow’s job opportunities
will be and what the academic major will require in both academic design
and hands-on experiences to meet the needs of the public sector.
The lack of a proper focus
on the public sector job market has yielded a combination of degrees without
sufficient specificity to mean much. It is time to change, and to
become responsible to our students. Satisfaction guaranteed or your
money back isn’t a bad way to think. But, first, the right questions
have to be asked and, then, there must be good people with the willingness
to work hard. Asked “What is your business?” and the typical exercise
physiologist is hard pressed to answer. In short, to know what exercise
physiologists do is to realize that their purpose lies with the public
sector. Society is our business, and only the members of society,
as customers, create our purpose. We need, therefore, to define our
customers, their needs, and our means of satisfying them. Only then
is there a reason for the existence of exercise physiology as an emerging
profession.
It is the customer who determines
what our business is as exercise physiologists. It is the father
with an obese child, an athlete with the passion to win, a heart patient
who needs an exercise prescription, a mother who needs a cardiovascular
profile for management of risk factors, the business around the corner
with employees who suffer from repetitive work, and so forth who are willing
to pay for a professional service. They are the customers, and they
determine the professional business of exercise physiology. The customer
alone gives life to a business (and/or profession). Because this
point is so important to the survival of any business, including the business
of exercise physiology, college professors should consider the customer
central to the function of the academic major. Hence, the shift from
just learning about exercise physiology to one which considers using the
information in the public sector is the central perspective in receiving
compensation in the form of a fee for service.
It is not enough for the
professors to teach good courses to their students; they must also provide
better and more economically sound concepts and ideas to market exercise
physiology. Every professor should be responsible for contributing
to innovation in the application of exercise physiology services.
Not only do they need a new yardstick to measure innovation, but it follows
that managing exercise physiology must be entrepreneurial in character.
This latter point is consistent with a common vision and standards of professional
practice. This sounds obvious once it is said. But first there
had to be the realization of an entire organization that understands the
definition of “what our business is and what it should be.”
There is one other question,
and that is “What is the customer’s view of the exercise physiologist?”
It is important for customers to value services rendered by professionals;
the greater the value the more profitable the service. Since service,
value, and the business of a profession are linked, it is increasingly
important to identify the unmet needs of the public sector. The service
dimension is a survival dimension. As exercise physiologists understand
their service to society, they increase their understanding of what is
necessary to make a rational decision now. This is the way to improve
public service and entrepreneurial opportunities that allow for new views
by the customers. This is the one basic difference between a service
profession and a research profession; a difference that is compatible with
new professional priorities. In fact, it is a difference that is
likely to deflect academic resources from research into a customer-driven
definition of what the business of exercise physiology is and, therefore,
the development of professional standards and service-satisfaction standards.
It would help if we learned
to think and speak of the needs of the customer and of the customers’ views
of exercise physiology. This does not mean that research becomes
less important. On the contrary, while working directly with members
of society, there is likely to be an increased opportunity for researching
ideas that may have had marginal utility in the formal laboratory.
The simple fact that not everyone wants a PhD or can get a PhD suggests
that research may fall outside of the traditional view, which may seem
to be quibbling. But the realization of continuing to mass produce
exercise physiologists, as defined by the PhD, is wrong, out-dated, and
inherently inflexible. This is probably the first thing to know in
changing what has been the key point in not realizing profitability in
the public sector.
The argument for educating
undergraduates as exercise physiologists makes sense. All that is
needed is an academic degree in exercise physiology, just as the nurse
with the bachelor’s degree has unlimited potential in nursing. The
undergraduate prepared exercise physiologist has full power, full credibility,
and is expected to become employable. This is much more than the
learned behavior of our tradition. It means taking responsibility
for improving our understanding of the exercise physiologists outside of
the context of a college environment. The rationale is simple, and
the difference is real.
Finally there is the health,
fitness, rehabilitation, and sports performance worker who is a highly
educated and a knowledgeable professional. This means that members
of society who worry about lifestyle factors can find help outside of the
traditional view of healthcare. The new exercise physiologist will
be equipped with business and management skills along with traditional
academics geared toward a social healthcare responsibility. At the
same time, because it is a business responsibility, it will add very substantially
to the professional’s financial base. Hence, in the end, actions
taken to deal with social problems (i.e., the degenerative diseases of
society) become in actuality career opportunities.
Above all, the exercise physiologist
is a servant to society. This, to be sure, is not necessarily a very
popular view. It raises questions about the path exercise physiologists
have taken for decades, and yet it is honorable and economically correct.
It is almost certain to position exercise physiologists on the same status
as other professionals without the doctorate degree. The most important
beginning point is the awesome understanding that as exercise physiologists
assume responsibility they claim authority and thereby justify their legitimate
involvement in social matters.
By contrast, the best illegitimate
authority for taking responsibility is led by non-academic prepared exercise
physiologists. To discharge them of their involvement requires a
determined effort to demonstrate publicly the credentials developed by
ASEP that go beyond the historic model of exercise physiology. This
applies particularly to non-exercise physiology certifications, including
but not limited to, the popular week-in certifications. The mere
hypocrisy and complete sham of these certifications explain a lot.
It is no accident they exist and society isn’t better off because of them.
The certifications are simply a difficult fit in an academically grounded
society.
What is needed are criteria
by which individuals and occupations rise to the level of professional
and profession, respectively. What is needed, and is attainable through
ASEP, are guidelines that strengthen the transition from discipline to
profession. The first such criterion is the nationally recognized
“Exercise Physiology Certification”, the EPC exam for academically prepared
exercise physiologists. The exam holds the person with it accountable
for his/her actions or the lack of appropriate actions. The second
such specification is accreditation. Here, the idea is rather simple.
Exercise physiologists cannot be accountable for what they have no authority
over if their academic programs are not accredited. Accountability,
self-determination, and authority over, for example, cardiovascular stress
test protocols, are all based on the fundamental understandings that come
from accreditation. This particular point is especially true.
Titles, degrees, certifications, and accreditations create expectations
of professional rank and responsibility.
For these reasons, the next
several decades are going to be times of major change. It is necessary
for the spirit of exercise physiology as well as its vision. We need
a serious commitment to professionalism. We simply cannot continue
to bankrupt our history with the obvious lack of continuity in programmatic
issues. Even with good leadership, if the direction we are headed
doesn’t change, the threat to managing the little autonomy we have will
be seriously threatened. We need less misdirection, more self-control
and performance standards, and a new philosophic way of thinking.
Indeed, it serves no purpose to continue using the rhetoric of yesterday,
except to confuse and embitter graduates.
Copyright
©1997-2001 American Society of Exercise Physiologists. All Rights
Reserved.
ASEP
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