BooneThink

Behind the scenes of every academic program, there are faculty members who are responsible for teaching courses in the physical education major, others who teach courses in the athletic training major, and still others who teach courses in the exercise science major.

As an example, look at this list of department titles. Now, fast-forward through several decades and ask, “What has changed?” Nothing! The issue of diverse department titles and quality of education has seldom been addressed.

Most of these departments are stuck in a phase of growth that no longer serves the students. Keeping things as they have been serves the department and the academic institution rather well. 150 to 300 student-majors represent a significant income and security, but it does relatively little to benefit the students in the long run.

In fact, just this week I was reminded of why ASEP exists. While getting some grocery items at Super One, the guy at the cash registered said “You’re a teacher, right? I said ‘Yes.’ What do you teach? I’m an exercise physiologist. Oh, one of the other clerks just graduated as an exercise physiologist. I said, “That’s interesting. Where did he graduate? “From University of Wisconsin, in Superior”, he said. Then, I said, almost without thinking, “He isn’t an exercise physiologist.” He looked at me rather strange like, then, I said “He needs either an academic degree in exercise physiology or he must pass the EPC exam to earn the professional title, Exercise physiologist.” He just kept staring at me as I left the counter.

Transformative change is never easy. It takes time, resources, and the perseverance. Unfortunately, the entire exercise physiology community must be involved in solving their problems and, frankly, most academic EPs just don’t get it.
• They aren’t comfortable moving in the direction of the unknown on the promise that ASEP is the right course of action.
• And, it is clear that people like to remain connected to those they know, those who have taught them, those with who they are familiar, even at times of their own detriment. In other words, change is not a trivial process.

I am, after all, a product of years of failing to change. I performed academic functions entirely without knowing that I didn’t think differently because it was comfortable doing what others had done for years.

It wasn’t until I became a department chair that I realized neither more nor less academic titles, concentrations nor emphasis areas will help students from the inadequacies of the traditional ways of solving problems. There are simply too many false assumptions. For all intents and purposes, there is a lack of leadership today with respect “what is exercise physiology.”

Not surprisingly, exercise physiology is still defined as “acute and chronic adaptations to exercise training.” This thinking simply will not help us solve the challenges we now face. Instead, it requires radical rethinking of the most basic and foundational ways we view ourselves.

But, you may be thinking, “How can you say that?” First, there are essentially no other comparative academic departments with such in-house confusion about its purpose. For example, although most academic institutions graduate primarily physical educations majors, more often than not, they refer to the students as exercise science majors. My young friends, you are not living in ordinary times. The minds of many, if not most, academic exercise physiologists are closed to the fact that students majoring in academic programs that is essentially 90% a physical education major.

Calling it an exercise science major or even a concentration will not (cannot) make it an exercise physiology degree. That’s why students should not be encouraged to think of themselves as exercise physiologists when they graduate from an exercise science major or a kinesiology major. There are many other examples as well.

Second, what I’ve said is true despite the bursts of published papers by exercise physiologists in non-exercise physiology departments. Research by itself is not enough to bring about a change in awareness of the need for one’s own professional organization.

Academic exercise physiologists have lost sight of the distinction in professional titles that exist among other professions. They have also failed to appreciate that “exercise is medicine” and that exercise physiology at its core is a healthcare profession no different from PT, OT, or nursing.

There is no reason why exercise physiology should feed physical therapy programs, unless of course you already understand that exercise science is not a career-driven academic major.
Research is important and, in fact, it is an obvious requirement for being a profession.

There are other requirements, too. One that is critical to any profession is the support of its professional organization. Others include a code of ethics, accreditation, and standards of practice.

The glue that holds every profession together is the sense of common identity that is tied to a common purpose. None of this exists within departments that embrace a failed sports medicine rhetoric; one that is infectious but misleading.

Graduating exercise scientists with an undergraduate degree is make-believe! Understandably, I don’t say this lightly. I’m not interested in offending anyone. My brain tells me that unless we change the way we think and talk about exercise physiology, many of us will continue to stumble and fall about.

This is not acceptable, given the expense of going to college today. No student should graduate to a fitness gym-job without medical benefits and a salary to pay the bills.

Regardless of what some may think, I don’t believe being a “personal trainer” is the job most parents hope for when their son or daughter graduates from college.

Also, in my opinion, exercise science, either as a degree or a concentration, is not an academic program that is pulling us into the future. It represents no-change from past thinking or, worst yet, change in the wrong direction. At least physical educators have a concrete connection to job opportunities. Exercise science is on a collision course with failure.

Note the following statements taken directly from several popular department web pages:
• The Exercise Science major prepares for work in clinical exercise physiology in hospital/clinical settings, as well as graduate school allied health programs such as occupational or physical therapy, exercise science or biomedical sciences.
• Exercise Scientists study the relationships among exercise participation, physical activity and human health and focus on the development and delivery of preventive and rehabilitative physical activity programs that promote health and prevent disease.
• An undergraduate degree in exercise science can prepare you for a broad range of careers such as clinical testing, fitness, performance enhancement, physical therapy, and cardiac rehabilitation.

As long as this kind of thinking goes unchallenged, students of exercise physiology degree programs end up experiencing similar problems in locating jobs because neither the faculty (in general) nor the public knows the difference between exercise science and exercise physiology.

Learning to think differently is imperative. It must be learned and it can be learned – and this, of course, is part of what this presentation is about. We can already see how other healthcare professions have changed (and have do so for decades) and how they continue to create new ways of thinking and leading.

We need an entirely new vision of exercise physiology, and that is exactly why ASEP was founded. However, the process of transforming how we think is not an easy process. In short, it means getting rid of the old to make room for the new!

The newly emerging language of:
• professionalism – not another weekend certification
• code of ethics – not greed or opinions
• standards of practice – not just more research without focus or even meaning
• accreditation with a purpose, not an agenda item for competitive reasons, and
• board certification is very different.

Nine out of 10 academic exercise physiologists aren’t prepared to rebel against the established way of thinking. They operate within the boundaries of programs defined by very little to no change since PE became ES in the 70s and 80s.

Wouldn’t it be impressive for an exercise physiologist to say to a department chair the following? “The exercise science major needs to be updated to an exercise physiology major. This can be done in accordance with the ASEP Accreditation Guidelines. I know it will take work and dedication, but it is the right thing to do. Is it going to take time, of course it will.”

Although we may share fundamentally different views on what I’ve said and what I’m about to say, the objective is rather simple: That is, why not do what is best for our students? Exercise physiology today is not as it was 20 or 40 years ago. It is not just about research or calling oneself a “physiologist” or even a “scientist.”

There is little doubt that the academic exercise physiologist’s job should be an unshakable commitment to the student’s education, not to writing another grant or attending a meeting (even this one), even though both are important.

These things are all part of the job of a being a college teacher, just as service is. The name of the game is giving power to our students so that they may take the best of what we can give them to realize their true potential and happiness. This, it seems to me, is intuitively and morally the only course of action.

Therefore, it is only right that exercise physiologists, particularly, the Board Certified Exercise Physiologists should come together and agree that the institutional thinking of the past is obsolete and that new ways of thinking about the profession should be taught, crafted, and implemented. I know I’ve said it to myself 100s of times, “Tommy, be strong, stay the course, after all, my students should have the same rights to a future in healthcare as the students of PT, OT, nursing, and dietitics.”

Understandably, it isn’t easy to “stay the course” but it is possible. I’ve taken risks and done things that some of my friends are not willing to do. The bottom line is that the old paradigm is dead and it should be buried and put away!

It is time to clean away the old thinking, and replace it with a new way to think about who we are and what we do. I imagine the new way might look something like this and, if you will, a recipe for coming together:
1. Fill the cooking pot with fresh 21st century ideas, especially the ones that speak to healthcare, sports training, and professionalism.
2. Fill the pot with more discussion among colleagues, more papers on the exercise physiologist’s code of ethics and standards of practice.
3. Stir in equal parts of focus on students and the role of a college degree in their future and financial well-being.
4. Bring to a boil and blend a liberal portion of research by exercise physiologists at all levels of education.
5. Fold and slip in precisely the right amounts of credibility, accountability, and legal responsibilities to clients and patients.
6. Simmer until smooth, thick, and strong, stirred with a common purpose driven by a shared vision and leadership.
7. Season with a dash of business courses and a pinch of courage to commit to building one’s own financial athletic and healthcare enterprise.
8. Let cool, then garnish with a topping of specialized certifications that further supports the EPC’s professional status and recognition.
9. Serve by teaching “professionalism” and self-worth as a course of study as one would teach exercise physiology.

To make this recipe work, to embrace a vision of the future that is compelling and inclusive for all, we must have the courage to do and say what we believe is right, rather than what is convenient or popular. Also, we must find ways to build partnerships based on shared aspirations.

Notice the emphasis on the word “we” – which is another way of saying “Self-Leadership.” Students (and especially those of you here today) need to take stock of this point because “leaders of the future” come from YOU. You must be willing to engage in self-change, and to bring into being what never existed before and couldn’t have been predicted based on the past.

As I was thinking of this meeting, I thought about asking students in particular, “What are you going to do to make the most of your life?” I thought, “Please God, let me find that person who will transcend the normal everyday way of thinking, who is going to break through, inspire us, challenge us 24/7/365, and call forth from all academic EPs the spirit of imagination. Bill Moyers said it best: “You know the spirit of which I speak.” He, then, said, “Memorable ideas sprang from it: “life, liberty, and the pursuit of happiness”…”created equal”… “government of, by, and for the people”…”the only thing we have to fear is fear itself”…”I have a dream.”

Never have we been more in need of transformational changes to create and anticipate the future; changes that are profound both in behaviors and new competencies. Of course this will require massive amounts of collaboration with all the stakeholders involved so that there is broad-based acceptance and support of the ASEP vision and mission.

The logic is clear: It simply isn’t right that out of 865 “exercise science” academic institutions that “194″ departments have different names. Whatever your politics or academic background, my friends, we cannot go on under false pretenses that of these programs have merit. It simply is immoral to ask students to go on paying hard earned tuition money for the wrong reasons.

And, frankly, we cannot win the battle as quickly as we should when our leaders don’t have the will or courage to ask everyone to sacrifice. Exercise science and whatever else it may be called needs fixing, because it is badly broken. Think it over: Those who graduate without a degree in exercise physiology aren’t sharing in the profits. Their incomes cannot keep up with costs and, therefore, because it’s harder and harder to figure out how to make ends meet, they go on to other fields of study. I believe this is the reason ASEP exists.
Please appreciate that challenging yourself to get out of your comfort zone is not easy. In fact, most can’t or will not do it. There are many kinds of risks in life: emotional, intellectual, and physical. The important ones are those that help you grow and express your values, especially in the service of others.

So, in summary, challenge the old assumptions, question the status quo, and develop new solutions, knowing there is no straight line to some future point. There is only learning along the way, adapting, and trusting your instincts.

When you do these things, you will be different, and your example will provide hope for others. After all, what you do defines who you are, what you stand for, and what you are willing to do to get what you want.

Thank you.

Have you notice that academic exercise physiologists seldom ever talk about the academic majors that make little sense to professionals? I think there are two reasons for this. The reason has to do with the historical aspects of the problem. Secondly, there is little to no leadership in exercise physiology outside of the American Society of Exercise Physiologists (ASEP). As a matter of act, if exercise physiologists aren’t members of ASEP, as disturbing as it is, they are likely to support most academic majors. Please appreciate this is not a little thing, especially since no one is analyzing the influence of mismanagement and, at times, disastrous problems that have resulted from questionable academic degrees.

Herein lies the problem. Exercise physiologists must own up to the simple truth that the term “fitness professional” is actually little more than jargon and gibberish. For a variety of reasons, the wit and insight invested in education are often viewed as anything other than necessary. This may be considered harsh, but the reality is it’s true. If academic exercise physiologists were to celebrate the importance of quality academic degree programs, there would be less propaganda woven throughout the faculty logic and dubious undergraduate degree programs. Above all, the strongest criticism is that the tuition dollars are simply too high for spending meaningless time engaged in non-career driven degree programs.

Does this sound offensive? I hope not. I mean no disrespect, although I can see how others may think my views represent a truncated version of their reality. The fact remains that the degree in exercise science or sports sciences isn’t equitable or even fair to undergraduate students. To the astute parent, both degree programs are devoid of significant scientific course work and hardly any comparable degree programs have a measure of authenticity. While Alfred North Whitehead, who once observed “There are no whole truths; all truths are half-truths. It is trying to treat them as whole truths that plays the devil….” may be right, my side of the half-truths says: There are more career opportunities for students who major in a credible degree program.

What kind of thinking is this? Well, the real objection is this: The cost of attending college today continues to increase year-after-year. Shouldn’t the degree program be equally transformed in its return value? Students aren’t students just to fill classrooms. In fact such thinking would be stupid. Yet it seems that some if not many college teachers think students attend college at the teacher’s pleasure. The teachers neither get the reason for parents spending their savings on an education for their children nor care! Then, what good does a college degree do for a student? Even when students yell after graduation, “Why didn’t you tell me that the exercise science degree was worthless years ago?”

Nothing is free or hardly anything is that has value. Paying tuition dollars for a sports science degree may provide time for curling up and getting plenty of sleep before the next sporting event, and it may be the next best thing to the commercialization of sports, it has done very little to market equality at graduation. Like the person who doesn’t go to college, the exercise science graduate is mesmerized by lack of work. Matters like a salary, credibility, respect, and health benefits are not discussed, written about, or even researched by academic exercise physiologists. After all, it is true that however lacking the degree program may be, they are investing their time in research opportunities. That is the way of life of college teachers, although their responsibility is to teach, do research, and engage in service. The true is 80% of their time is allotted to research and publishing.

To college teachers, it is foolish to teach a lot of courses when their reputation is defined not by teaching but by publications and presentations at national meetings. Yes, they have a choice but, here again the cultural understanding within the academic setting is that more research is better than more teaching. This kind of thinking has become an obsession leading some teachers to avoid teaching altogether. This raises the question; a dangerous one at that. Few academics are willing to tackle the notion that college teachers are suppose to teach! Most of my colleagues would consider it unwise if not imprudent to even raise the question. But, one only has to see the consequences of the failed rhetoric to understand the reality of the graduate’s stress and disappointment.

I’m told that when Abraham Lincoln was elected to Congress, he was given a form requiring him to describe his education. He wrote one word, “Defective.” Sounds familiar? Well, that is very simply the point of this editorial. Exercise science and similar academic degree programs are used metaphorically for physical education, since both have the element of sports and activities. Yet physical educators can usually locate high school jobs; exercise science students cannot. When one looks at the various department web pages on the Internet, it appears that too many statements are closer to inventing stories about jobs than is the actual truth. In fact, the ordinary person can easily conclude that of the 100s of students graduating at any one time a particular college or university, only a select, small number of graduates actually find a job. Most graduates must go back to school and major in a completely different major to find work.

Then what is it about the false picture of the exercise science major that excites students? Above all they envy the thought that the content is sports related. It is the new order of having fun even though it is not unprecedented in college offerings. Part of the problem is the department’s willingness to attract the attention of students. Another part is the obvious failure to justify the academic majors and the continuity thereof after graduation. The academic majors appear to have grown on the edge of what was health and physical education decades ago. There are obviously a number of reasons or causes for this. However, plainly it is the case that the faculty has lost contact with their purpose and/or audiences, especially given the sense of being cut off from career opportunities available to the healthcare professionals.

The word exercise derives from a Latin root meaning “to maintain, to keep, to ward off.” To exercise means to practice, put into action, train, perform, use, improve.

Most of us know that physical exercise is good for our general health, but did you know that physical exercise is also good for your brain? If you think you’re going to get smarter sitting in front of your computer or watching television, think again. Here scientists present the evidence that a healthy human being is a human doing.

Nearly half of young people ages 12 to 21 do not participate in vigorous physical activity on a regular basis. Fewer than one-in-four children report getting at least half an hour of any type of daily physical activity and do not attend any school physical education classes.

In June 2001, ABC News reported that school children spend 4.8 hours per day on the computer, watching TV, or playing video games.

The impact of computers, video games, school funding cuts, and public apathy have combined to leave Illinois as the only state that still requires daily physical education in first through 12th grades. This is a far cry from the 1960s, when President John F. Kennedy made physical fitness a priority for Americans of all ages.

These sedentary tendencies respresent a real health crisis. And, not just for couch-potatoes. Deep vein thrombosis (DVT) occurs when blood circulation slows, allowing clots to form and then, eventually, break free, causing death. DVT has been nicknamed “economy class syndrome,” because airplane passengers who sit throughout a long flight in the close quarters of economy class have become victims of DVT.

Exercise is a natural part of life, although these days we have to consciously include it in our daily routine. Biologically, it was part of survival, in the form of hunting and gathering or raising livestock and growing food. Historically, it was built into daily life, as regular hours of physical work or soldiering. What is now considered a form of exercise – walking –was originally a form of transportation.

Walking is especially good for your brain, because it increases blood circulation and the oxygen and glucose that reach your brain. Walking is not strenuous, so your leg muscles don’t take up extra oxygen and glucose like they do during other forms of exercise. As you walk, you effectively oxygenate your brain. Maybe this is why walking can “clear your head” and help you to think better.

Movement and exercise increase breathing and heart rate so that more blood flows to the brain, enhancing energy production and waste removal. Studies show that in response to exercise, cerebral blood vessels can grow, even in middle-aged sedentary animals.

Studies of senior citizens who walk regularly showed significant improvement in memory skills compared to sedentary elderly people. Walking also improved their learning ability, concentration, and abstract reasoning. Stroke risk was cut by 57% in people who walked as little as 20 minutes a day.

A decade ago, when neuroscientist Fred Gage of the Salk Institute made the discovery that the adult brain continues to regenerate, the brains in question belonged to mice. Some of the mice had been sedentary, others had been exercising, and the ones that logged the most miles on their wheels produced many more new neurons than did the sedentary ones.

Now it turns out that the same appears to be true for humans. In a paper published last spring, a team led by Gage, Small and Richard Sloan, a psychologist at Columbia University, revealed that after pounding the treadmill four times a week for an hour for 12 weeks, a group of previously inactive men and women, ages 21 to 45, showed substantial increases in cerebral blood volume (CBV)–a proxy for neurogenesis because where there are more cells, there are more blood vessels.

Not only did the CBV profile of the human exercisers mirror that of the mice, but the people who exercised more did better on a slew of memory tests. Other evidence backs this up. In a study of “previously sedentary” older subjects by psychologist Arthur Kramer at the University of Illinois and others at Israel’s Bar-Ilan University, investigators found that those who engaged in aerobic exercise did better cognitively than those who stretched and toned but never got their heart rates pumping. What’s more, subsequent imaging showed that aerobic exercise “increased brain volume in regions associated with age-related decline in both structure and cognition.”

Meanwhile, researchers from the Karolinska Institute in Stockholm who have been following over 1,500 people for more than 35 years found a significantly lower rate of dementia, including Alzheimer’s, in those who exercised. Another study, this one of 2,000 elderly men living in Hawaii, showed that those who walked two miles or more a day were half as likely to develop dementia as those who walked a quarter-mile or less.

Cerebral blood volume is not the only thing responsible for this brain-boosting. Also at work is the fact that exercise increases what’s known as brain-derived neurotrophic factor (BDNF), a protein that stimulates the birth of new brain cells and then helps them differentiate and connect. BDNF also enhances neural plasticity, the process by which the brain changes in response to learning. In diseases like Alzheimer’s, depression, Parkinson’s and dementia, BDNF levels are low. In people who exercise, BDNF levels rise.

Blumenthal and a team of researchers at Duke University Medical Center found that an aerobic exercise program decreased depression and improved the cognitive abilities of middle-aged and elderly men and women.

They followed 156 patients between the ages of 50 and 77 who had been diagnosed with major depressive disorder. They were randomly assigned to one of three groups: exercise, medication, or a combination of medication and exercise. The exercise group spent 30 minutes either riding a stationary bicycle or walking, or jogging three times a week.

To the surprise of the researchers, after 16 weeks, all three groups showed statistically significant and identical improvement in standard measurements of depression, implying that exercise was just as effective as medication in treating major depression.

Note: I didn’t write the above information, although I agree with it. I read these comments on different web pages today and thought it would be helpful to share it with those who read www.boonethink.com

A wise man can learn from the experience of other men, but a fool cannot learn even from his own. — Will Durant

What I have to say today is directly a function of what I know after 10 years as a co-founder of the American Society of Exercise Physiologists. You may think that I should have been aware of these things early on rather than later, but please believe me that such thinking is naïve.

1. Just because something makes sense doesn’t mean it will be adopted by intelligent people.
2. New ideas need unbelievable decades of time for change to occur.
3. You can create something special and under no circumstances does that mean they will come running.
4. Friends…please, you are lucky to have one friend who is willing to go down with you.
5. Nothing will prepare you for indifference from colleagues.
6. Anyone comfortable with what he or she is doing isn’t likely to join up with you.
7. Inertia is exactly what it means, especially among the academic types.
8. “This is the way we have done it” prevails even among the dead.
9. Politics and power are real competitors, often viewed as beyond the average person.
10. Professionalism requires serious work and commitment, even attitude.
11. Thinking critical and becoming your own leader are not easy.
12. Maintaining a positive outlook with a daring personality to believe in possibilities is a huge mindset.
13. Organizations are a dime a dozen, but the right culture and philosophy are rare as a diamond in your backyard.
14. The 21st century isn’t about exercise physiologists as healthcare professionals, although it should be!
15. Entrepreneurship and business opportunities are exciting topics for a few.
16. Concepts, issues, and challenges are seldom interesting headings for exercise physiologists.
17. Excellence…forget it, the sense of “what is success” is built on the path of least resistance.
18. Topics like hope, despair, and “where are the jobs” versus one more research publication on the same subject seldom raise heart rate.
19. Academic exercise physiologists aren’t aware that exercise science is a waste of time and tuition dollars.
20. Traditional mental models are more powerful than anyone could have imagined.
21. People don’t like to change what they think they know.
22. Educators need to unlearn existing mental models that are dysfunctional or just plain wrong.
23. Leadership is more about persistence and “staying the course” than position or charisma.

1. If you don’t know where you are going, no road will get you there.
2. If you fear separation, meaninglessness, and death, then unite.
3. The price of community is your own individualism.
4. There is no daddy or mommy, but if there were a daddy or mommy, he or she would be you. (Martin Shubik).
5. Share power — one person, one vote.
6. Might doesn’t make right.
7. There’s no substitute for commitment and hard work.
8. Small is beautiful.
9. Keep it simple — always make molehills out of mountains.
10.Cooperate and communicate, if you want to survive.
11.Reduce tension; don’t escalate conflict.
12.Grow spiritually, intellectually, and emotionally or die.

THE ECONOMIST

This is an interesting question. The energy cost of sex is vastly exaggerated. There are reports of aggressive love-making costing 250 calories an hour (also kilocalories in this case) or 4 calories per minute. Think about it.  The average person may make love for only five minutes and burn fewer than 25 calories.  By making love, I mean actual sexual intercourse non-stop to orgasm.

Interestingly, one of the most common myths is that sex often brings on a heart attack or sudden death in post-myocardial infarction patients. To the contrary, however. According to the American Heart Association, the risk is very low. The physical demands of sex are mild and comparable to a brisk walk up two flights of stairs.

Also, from a slightly different perspective, the literature generally agrees that resting metabolism is equal to 1 MET. One MET is equal 3.5 ml/kg/min (i.e., a resting oxygen consumption of .25 l/min or 250 ml/min divided by 70 kg of body weight equals 3.5 ml/kg/min). By multiplying .25 l/min times 5 kilocalories, one can calculate the total energy expended at rest, during exercise, or during sex.

For example, .25 l/min x 5 kilocalories equal 1.25 kilocalories per min. So, if sexual intercourse is equal to an energy expenditure of 3 to 5 METs (as most scientific papers  indicate), that would equal 1.25 kilocalories times 3 METs, which equals 3.75 kilocalories per min or 1.25 kilocalories times 5 METs, which equals 6.25 kilocalories per min.

Therefore, the bottom line is that 5 minutes of sex equals a range of 18.75 kilocalories to 31.25 kilocalories. Note that the “25 calories” mentioned in the first paragraph falls within this range.

Anyone can (or should) appreciate that the energy cost of sex is indeed vastly exaggerated. To burn 250 calories, one would have to engage in sexual intercourse non-stop for at least 40 minutes (i.e., 250 divided by 31.25 times 5, 5-minute periods) to 67 minutes. Please appreciate again that “Sex” in this posting is defined as actual sexual intercourse, not kissing and in general engaging in love-making, such as before and after orgasm.

Hence, the question is obvious: How many people engage in non-stop sex for essential an hour? And, if one were to do so, that person would burn only 250 calories. That amount is equal to walking two miles that would on average require 30 to 40 minutes of exercise.

In sum, burning 250 calories is much more likely to happen when exercising than when engaged in sexual intercourse. The research is limited, but it is reasonable to conclude that this is true regardless of gender, age, and sexual positions.

AS EXERCISE PHYSIOLOGISTS gain authority, autonomy, and accountability, they will have to assume responsibility and liability for their own practice. Responsibility and thinking of this kind is uncommon in exercise physiology. Yet, with the development of the Board of Certification, exercise physiologists can now sit for the “Exercise Physiologist Certified” (i.e., EPC) exam [1]. As a result of passing the EPC exam, the candidate earns the title “Exercise Physiologist.” Then, the exercise physiologist is held responsible for adhering to a scope (standards) of practice, which adds another consideration to doing one’s job. Given the added “liability” factor and, therefore, the increased likelihood of liability suits, exercise physiologists should carry individual malpractice insurance.

In malpractice or professional negligence cases (i.e., the failure of a professional to act in a reasonable and prudent manner), there is a plaintiff (the injured party) and a defendant (the professional who is alleged to have caused the injury). In short, then, negligence is a breach of an objective standard of medical practice [2]. When judged by a reasonably prudent person, as in a jury, if the exercise physiologist’s conduct falls below this standard set by the profession to protect the public from unreasonable risk of harm, a breach of duty is said to have occurred.

Five elements of liability must be present for a professional to be held liable for malpractice [3]. First, a standard of care must be established that defines the quality of care believed of a professional group. The exercise physiologist’s standard of care is defined by the Standards of Practice [4]. The point here is that the exercise physiologist is responsible to a client for adhering to the profession’s standards of care. When the quality of care is questioned by the plaintiff (the client), the defendant must show that the care given is consistent with what the reasonably prudent EPC exercise physiologist would have done in accordance with the profession’s standards.

Second, a breach of duty occurs when the exercise physiologist violates the standards of care. The plaintiff must prove that the exercise physiologist’s actions were substandard and that the substandard action caused an unfavorable outcome that would not have occurred in the absence of negligence. For example, failure of the exercise physiologist’s to properly acknowledge the client’s disease condition, either by not using the proper treadmill test or not monitoring the client properly, failure to properly administer an exercise prescription, or failure to gain a proper informed consent from a client before proceeding with a metabolic test or other such procedure for fitness assessment and/or rehabilitation.

Third, the exercise physiologist understands that the professional practice is written with the expectation that if the standards are followed they will avoid harm to the client. This foreseeability of harm argues that the exercise physiologist has reasonable knowledge to foresee the likelihood of injury to the client. Fourth, the failure to uphold the professional standards increases the likelihood of injury to the client. Fifth, failure to adhere to the standards resulted in an injury that would not have occurred had the exercise physiologist not failed to perform his or her duties in accordance with the standards. That is, the alleged deviation from the exercise physiologist’s standards of care directly or indirectly caused the injury or unfavorable outcome. Of course, the plaintiff must prove that the exercise physiologist’s actions were substandard and that the substandard action caused the injury that would not have occurred in the absence of negligence.

References

1. American Society of Exercise Physiologists. (2007). Board Certification for Exercise Physiologists. [Online]. http://www.asep.org/services/EPCexam

2. Franklin, C., Marutzky, E.M., and Sandberg, C.M. (2007). Medical Professional Liability. Physicians’ Guide to Professional Negligence Claims. Resident & Staff Physician. July/August, 53:7 [Online]. http://www.residentandstaff.com/issues/articles/2007-07_03.asp

3. Marquis, B.L. and Huston, C.J. (2003). Leadership Roles and Management Functions in Nursing. Philadelphia, PA: Lippincott Williams & Wilkins.

4. American Society of Exercise Physiologists. (2007). Standards of Professional Practice. [Online]. http://www.asep.org/services/standards

5. Allied Healthcare Professionals Insurance Center. (2007). Why Do I Need Professional Liability Insurance. [Online]. http://www.ahc.lockton-ins.com/pl/understandingPLI_3.html

It is certain that the future of exercise physiology will be different. It may not be so obvious today, but with the founding of ASEP exercise physiology is finally on the track to professionalism. Clearly this has been a long time in coming. Now, exercise physiologists can distance themselves from exercise science. Imagine exercise physiologists as healthcare professionals, not trainers. A person’s career can be built on such thinking. It is uplifting, and it is the right thing to do. Accreditation and Board Certification will help gain control over the practice of exercise as medicine. This is exactly why exercise physiologists must become agents of change.

“The entrepreneur is our visionary, the creator in each of us. We’re born with that quality and it defines our lives as we respond to what we see, hear, feel, and experience.” — Michael Gerber

YESTERDAY, I was talking to several students and the subject – entrepreneurship — came up. The word entrepreneur originates from the French word, entreprendre, which means “to undertake.” Frankly, I was surprised because not too many students are poised to think about the entrepreneurship of exercise physiology. While entrepreneurship has many meanings, the practice of starting a new business is often the most common meaning of entrepreneurship.

As the conversation permitted, I told the students that I had just read an article entitled “Clinical Nurse Specialist Entrepreneurship” [1]. It seems that nurses and just about every other established healthcare professional is thinking about or engaged in entrepreneurship. As an example, think about the following article titles by nurses:

· Vogel, G. and Doleysh, N. (1994). Entrepreneuring: A Nurse’s Guide to Starting a Business. New York: National League for Nursing Press.

· Kowal, N. (1998). Specialty Practice Entrepreneur: The Advanced Practice Nurse. Nursing Economics. 16:277-278.

· Roggenkamp, S.D. and White, K.R. (1998). Four Nurse Entrepreneurs: What Motivated Them to Start Their Own Businesses. Health Care Management Review. 23:67-75.

· Dayhoff, N.E. and Moore, P.S. (2003). Entrepreneurship: Start-Up Questions. Clinical Nurse Specialists. 17:86-87.

· Andrica, D.C. (1998). Entrepreneurship: Is It For You? Nursing Economics. 16:330.

· Vollman, K.M. (2004). Nurse Entrepreneurship: Taking an Invention From Birth to the Marketplace. Clinical Nurse Specialists. 18:68-71.

· Palmer, J.W. (1996). Thoughts on Becoming a Nurse Entrepreneur. Emergency Nursing. 22:534-535.

Obviously, just from this short list of titles, entrepreneurship is important to nursing and other professions. I think it should be an important topic of discussion among exercise physiologists, too. Why? There are many reasons. One, in particular, is the stifling negative effect of the sports medicine influence on exercise physiology. In short, the idea of “exercise science” resulting in viable careers opportunities is an illusion of considerable tragedy [2]. For an engaging analysis of this point, refer to the October PEPonline article entitled “The Tragic Illusion of Exercise Science.”

Board certified exercise physiologists (BCEPs) represent a new breed of exercise physiologists in the United States, if not the world. They want control over their work, and they want to practice exercise physiology without restraints placed on them by association with exercise science and/or sports medicine. Entrepreneurship is all about transforming what is presently a gym and/or corporate fitness mentality that most often associates with exercise physiology (i.e., aside from cardiac rehab) into a completely new business-way to think about exercise physiology.

This is clearly consistent with the definition of entrepreneurship. That is, the “emphasis on innovation” [3]. From this viewpoint, one can define the actions of the ASEP leaders in the development of the exercise physiology professional infrastructure as the innovation that gives exercise physiologists the competitive advantage in the use of exercise as medicine. This thinking is in agreement with Schumpeter [4] who concludes the following: “The entrepreneur is someone who carries out “new combinations” by such things as introducing new products or processes, identifying new export markets or sources of supply, or creating new types of organization.” ASEP is such an organization plus the BCEP is the new product that markets both a new and improved career for exercise physiologists and a new healthcare professional.

It is not enough to simply get a college degree. Instead, academic exercise physiologists must nurture a new vision and perspective of exercise physiology. They must help with key areas, particularly new thinking and innovative ideas along with the entrepreneurial mindset. Building the next generation of leaders is critical to the future of exercise physiologists with the desire to promote a strong sense of professional accountability. Clearly, it is important that exercise physiologists do as nurses have done. Why not the following book titles or articles titles?

· Entrepreneuring: An Exercise Physiologist’s Guide to Starting a Business

· Board Certified Entrepreneurship: The Next Generation of Leaders

· Four Exercise Physiology Entrepreneurs: What Motivated Them to Start Their Own Businesses

· Exercise Physiology Entrepreneurship: Taking an Invention From Birth to the Marketplace

· Thoughts on Becoming a Board Certified Exercise Physiology Entrepreneur

It is just a matter of time and the world will see that exercise physiology has changed, and ASEP is just the beginning of the change process. But, exercise physiologists must put forth a sustainable effort towards professional development. The ability to manage their own profession is directly related to their own career opportunities. Such thinking requires mental flexibility and an aptitude for seeing beyond the sports medicine influence. Entrepreneurship equals new jobs, more revenue, and improved professional image. It is vital to the growth of the profession. Promoting entrepreneurship in academic courses, workshops, seminars, and national meetings is in the best interest of all exercise physiologists.

In the end, it will be clear that the BCEP entrepreneurial is innovative when it comes to the exercise prescription, self-confident when overseeing musculoskeletal and cardiovascular profiles, fiercely competitive about exercise as medicine, and intensely obsessed as a professional. They are interested in creating a credible healthcare practice that is founded on mind-body interconnectedness. In fact, as Howard Marguleas said:  “Never cease to pursue the opportunity to seek something different.  Don’t be satisfied with what you’re doing.  Always try to seek a way and a method to improve upon what you’re doing, even if it’s considered contrary to the traditions of an industry.”  

Hence, as I wrote in an article published in PEPonline, year 2000 [5], “In the not too distance future, Ph.D. academic exercise physiologists, who probably know little to nothing about entrepreneural ventures as an emerging trend in our economy, will be expected to offer entrepreneurship courses for undergraduates and master level prepared exercise physiologists. The question is whether they will find the time to leave the laboratory to address the new opportunities in the public (service) sector. Another question is whether they will help their students form the necessary, strategic alliances with other entrepreneurs, locally and otherwise. Students who develop entrepreneurial, negotiation, and legal skills will be prepared for the 21st century.”

Reference

1. Leong, S.L. (2005). Clinical Nurse Specialist Entrepreneurship. The Internet Journal of Advanced Nursing Practice. 7:1:1-8.
2. Boone, T. (2007). The Tragic Illusion of Exercise Science. Professionalization of Exercise Physiologyonline. 10:10 [Online]. http://faculty.css.edu/tboone2/asep/Tragic_Illusion_Exercise_Science.html
3. QuickMBA. (2007). A Definition of Entrepreneurship. QuickMBA.com/ [Online]. http://www.quickmba.com/entre/definition/
4. Schumpeter, J.A. (2002). Biography of Joseph Alois Schumpeter (1883-1950). The Concise of Encyclopedia of Economics. [Online]. http://www.econlib.org/Library/Enc/bios/Schumpeter.html
5. Boone, T. (2000). The Exercise Physiologist as an Entrepreneur. Professionalization of Exercise Physiologyonline. 3:1 [Online]. http://faculty.css.edu/tboone2/asep/jan2.html
6. Boone, T. (2003). The Entrepreneurship of Exercise Physiology. Professionalization of Exercise Physiologyonline. 6:3 [Online]. http://faculty.css.edu/tboone2/asep/EntrepreneurshipOfExercisePhysiology.html

Athletes, coaches, trainers, parents, society, and researchers know that performance enhancers are used to do more work than possible without them. There are many reasons why athletes use ergogenic aids. Just a few include fame, fortune, and scholarship from winning the gold. No wonder athletes are willing to ingest or inject almost anything to win. And, the CEOs of companies that market supplements and illegal drugs know it. The idea of helping athletes to cheat makes no sense to them. The spirit of competition is a meaningless subject, as is their unethical behavior. Promoting drugs to teenagers is their business. They are “The Cheat Pushers.” They are in the business of promoting the “win at all cost” mentality. After all, their only concern is making big bucks. Forget about the side effects. The CEOs, consultants, and sports nutritionists who promote and commercialize performance enhancers are no different from individuals who sell crack on the street corner. They don’t care about possible long-term adverse effects and/or complications. The “win at all cost” attitude permeates many sports nutritionists. The idea that their research justifies promoting supplements is wrong. Athletes should win based on who is naturally the best athlete at that point in time. Using sports supplements to level the playing field is unfair. It is also unethical. It should not be tolerated, and those who promote sports supplements should not be rewarded. And, sports nutritionists, in particular, who consult (and therefore essentially work for the CEOs of sports supplement companies) are engaged in unethical professional behavior that should not be tolerated. For an excellent read on “Steroids and Other Performance Enhancers” by Robert J. Dimeff, M.D., refer to Chapter 21 of Clinical Preventive Medicine by Richard N. Matzen, M.D. and Richard S. Lang, M.D, M.P.H.