Vol 2 No 2
February, 1998
ISSN 1097-9743
ASEPNewsletter is devoted to informative articles and news items about exercise physiology. It is a monthly magazine of news, opinions, exercise physiology professionals, and events that shape exercise physiology. While it contains views and opinions of the Editor who oversees the ASEP Internet Websites, visitors can have a voice as well. We welcome interested practitioners, researchers, and academicians to e-mail the Publisher their thoughts and ideas or to respond directly via the ASEP Public Forum.
March, 1998
Exercise Physiology and Health Care: A Field Perspective
Eric P. Durak, MSc
Director, Medical Health and Fitness
Santa Barbara, CA 
"The most reliable way to anticipate the future is by understanding the present" -John Naisbitt

I am sincerely happy to be a new member of the American Society of Exercise Physiologists. I believe that this organization, via the Internet, will serve a vital function that was not realized by working in segregated groups through ACSM, NSCA, and other fitness organizations.

I have been involved with the licensure movement in California for about four years. I have been on the consortium for the California Coalition of Health Promotion that programmed Senate Bill 891 into the state legislature in January of 1998. Unfortunately, the bill was killed by the California Physical Therapy Association before it ever reached the Business and Professions Section. The power of allied health groups in the current health care system is mind boggling.

The reason the bill was killed was due, in part, to the perception by physical therapists that the upper level of fitness licensure (the Physio-Technologist) was in direct competition with their professional status. The author of the bill, Mr. Wogbe Ofori, was disappointed because, as he told them, the current health care system is not divided into a pie, whereby new allied health professionals (such as massage therapists, acupuncturists, Rollers, etc.) are not "taking away" a piece of the pie - as most health care workers see it now. Wogbe believes (and I concur), that the future health care system is more akin to a raging river, and if we don't have additional health care workers (alternative and allopathic) to work with the ever-increasing senior population, health problems will manifest, and health care costs will cripple our economy.

Exercise stands alone as the most efficacious complimentary treatment for many types of diseases because of the vast amount of research published in the medical literature (thanks in part to the work of many exercise physiologists!). Licensure may take quite a long time based on two points of importance. First, legislatures may only grant licensure status when they feel first and foremost that public health is at jeopardy - and that NOT having that professional at hand would be detrimental. The statistics don't really point to that yet - depending on how you look at it. Second, other allied health care professions must "accept" the incoming profession in terms of not directly competing with their job description.

Since exercise physiology is a blend of many professions, it may be compared to physical therapy and occupational therapy in a sense, even though it is not either one of them. My experience with exercise physiology from a field perspective is that physicians (our greatest allies) already have an interest in exercise physiology, and are willing to work with EPs in certain areas as long as it makes them money. That is the crux of this entire argument! In order to compete successfully in the changing health care market, exercise physiologists MUST have a rudimentary knowledge of managed care, insurance reimbursement, and health care trends. This knowledge will supersede the perceived value of licensure status as a means to an end to be a true allied health professional.

We need only to look at Louisiana as a state of licensed professionals who still are not accepted in the health care system. Why? Because they are still looking at the system from a classic standpoint - that of an outsider trying to get in. One view of the future of exercise physiology and health promotion will be to facilitate growth within managed care via the following: First, an understanding of the basics of a managed care contract and using that information to market exercise and health services to physician practices, clinics, and hospital based wellness programs is imperative. Second, forming networks with existing organizations that will promote the cause and abilities of exercise physiology is equally imperative. Groups that come to mind include: (1) Medical Fitness Association (located in Evanston, IL, formally known at the Hospital Health and Fitness Association); (2) National Fitness Therapy Association (located in Denver, CO, the NFTA promotes standards of care in health clubs and is expanding its reach nationwide in 1998 - they have secured managed care contracts for many of their regional affiliates); and (3) IHRSA - the International Health Club Association has had a health care provider task force for over eight years. They were the first to secure insurance reimbursement for club memberships in 1989. They would welcome the input of clinical professionals on how to upgrade the professionalism and increase the exposure of their clubs to the post rehab and health promotion sectors.

The future looks only as bright as where we are looking. The changes in health care today will not have any effect on exercise services if contacts are not made at local and regional levels. In keeping with the format of the ASEP, exercise professionals should think about health care relationships as one of their #1 goals for 1998 and beyond. They will achieve recognition and increased job opportunities through networking as well as building upon their membership in ASEP. I welcome feedback from members and look forward to a rewarding experience with ASEP.

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About the author: Eric Durak is an exercise physiologist and health educator in Santa Barbara, CA. He is Director of Medical Health and Fitness, a consulting firm, and serves as Director of the Fitness Therapist CEU course through the International Sports Sciences Association. He is involved with exercise and health care issues, and is currently researching the effects of chronic exercise on patients with cancer. His email address is

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