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POSITION PAPER

The American Society of Exercise Physiologists (ASEP) representing its membership and affiliate state associations strongly opposes the creation of the American College of Sports Medicines (ACSM) and Commission of the Accreditation of Allied Health Education Programs (CAAHEP) Committee on Accreditation for the Exercise Sciences (CoAES). ASEP believes that CoAES is not in the best interests of Exercise Physiologists and does nothing to help unify the profession or to protect the public safety.

The main reasons for ASEPs opposition to CoAES are listed below:

1. The public does not need more sports medicine certifications along with the 400 other fitness certifications (some not requiring a college or university degree). Accreditation and certification lead to credibility only within the established context of a profession. Less is more when it comes to the quality of the certification. ASEP believes that the creation of CoAES will create a situation that continues to dilute the exercise field by further opening the exercise profession to other disciplines at the expense of the professional Exercise Physiologist.

2. ACSM is a multi-disciplinary sports medicine organization. The purpose of the organization is to advance and integrate scientific research to provide educational and practical applications of exercise science and sports medicine. The membership of ACSM is made up of individuals from many professions who come together because of their interest in exercise, science, and sports medicine. ACSM has 46 distinct membership categories under its membership umbrella. Furthermore, Exercise Physiologists comprise only about 2,100 members (11%) of the entire ACSM membership (http://www.acsm.org/membership/mailinglist.htm). The question must be raised, how can a multidisciplinary organization accredit academic programs and attempt to regulate one small membership category within its vast, diverse organization? As a multi-disciplinary organization, ACSM cannot attend to the legal and legislative issues of any current or proposed profession. ACSM should not act to compromise the professions of its membership. Imagine the conflict created if ACSM or another multidisciplinary organization proposed a new allied health profession, physical medicine specialist, using the educational requirements, training, and scope of practice of the Physical Therapist, but allowed other professionals to enter this profession. Even further, currently there is a nursing shortage in the United States; why not develop a sport medicine nursing specialist profession to help minimize the effects of an insufficient number of trained nurses? By design, professions are exclusionary to assure quality through consistent educational, training, and certification standards.

3. ACSM is working with The Commission on Accreditation of Allied Health Education Programs (CAAHEP) to develop four tracks for the exercise professional: the bachelor prepared Exercise Specialist, both the clinical and practical Exercise Physiologist, and the Personal Trainer. They have focused their effort towards the clinical exercise physiologists. This in itself creates several issues. By focusing on the masters prepared exercise physiologist, they have devalued the significance in a bachelors degree. Meanwhile, many of our peers in healthcare require only a bachelors degree, or associates degree in the case of nursing. The ACSMs view is at the expense of well-prepared bachelors degreed exercise physiologists. After all, ASEP accredits undergraduate programs in exercise physiology. Additionally, by identifying the clinical role of exercise physiology as if it is separate from what exercise physiologists do, it tends to restrict the options of those in the field. Certainly the exercise physiologist is educated to work in the clinical realm, too. No other healthcare profession separates the clinical professionals from the rest of their field, so why would exercise physiologists?

There are nurses and physical therapists, not clinical nurses or clinical physical therapists. By creating separate tracks, not only is the confusion increased, but professional opportunities are restricted. Exercise physiologists should have as many choices (e.g., health, fitness, wellness, clinical, and athletics) as possible with the option to select a specialty that best suites their interest, skills, and desire.

4. ACSM has been in existence for 50 years, and according to their own website documenting their 40 most significant events (http://www.acsm.org/membership/top40.htm), they have done nothing to directly promote the profession of exercise physiology. ACSM is a great multi-disciplinary sports medicine organization. The leadership of ASEP has stated repeatedly that exercise physiologists should join ACSM since it is a good venue for research. But, for the profession to move forward, exercise physiologists must unite under an organization devoted exclusively to exercise physiologists.

5. ACSM does not have a history of protecting the rights and careers of exercise physiologists. For example, in 2004, ACSM did not oppose the Centers for Medicare and Medicaid Services (CMS) rule changes regarding “incident to physician.” The changes mandate that any “physical therapy” services provided incident to physician care be delivered by or under the direct supervision of a physical therapist.

This rule change has directly undermined exercise physiologists as healthcare providers. This is exactly why ASEP has rallied to fight for exercise physiologists across the country. The ASEP leadership worked with a dozen organizations to form the Coalition to Preserve Patient Access to Physical Medicine and Rehabilitation Services. Presently, ASEP is working with the American Kinesiotherapy Association (AKTA), National Athletic Trainers’ Association (NATA), and other organizations to support a coalition statement that opposes the CMS rule change. ACSM was not part of this coalition.

In 2004, SB360 was introduced in Indiana primarily to address direct access to physical therapy without a physician referral. But, there was a hidden provision that would have allowed physical therapists to provide fitness and wellness services to asymptomatic individuals in a non-medical setting without a physician referral. Since the fitness industry is unregulated, the bill essentially would have provided regulation by default. Upon passage of the provision, there is the concern that the American Physical Therapy Association would conclude that, by Indiana law, ONLY physical therapists could provide these services.

The Indiana Association of Exercise Physiologists, with help from ASEP, opposed the bill. SB 360 was defeated, but not because of the hidden provision. ACSM did not oppose the bill. If ACSM would not support exercise physiologists in these two very important professional issues, do you really believe that ACSM is interested in supporting the professional development of exercise physiology?

Would the APTA allow NATA to intervene in the development of their profession? Absolutely not, as that would be disastrous for APTA. Do you believe Jon M. VonderHaar, President of the AKTA, would ask ASEP for assistance on accrediting AKTA programs? Would Eve Becker, Executive Director, of the NATA, ask ASEP for assistance with the regulation of athletic trainers? Again, the answer is no. This is why ASEP opposes CoAES, and why it is not in the best interests of the exercise physiology profession.

This entry was posted on Monday, December 5th, 2005 at 8:36 pm and is filed under Exercise Physiology. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.