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Professional Library: The Blurring of the Health Professions

Correspondence to:
Eric P. Durak, MSc
Medical Health and Fitness
1074 Miramonte Dr. #1
Santa Barbara, CA 93109
(805) 966-1299

Enter the Exercise Physiologist
The recent growing pains of clinical exercise physiologists trying to get established in therapeutic settings has brought to light a very interesting phenomenon within the health care industry today. It seems that the professionals who work in different areas of health care are in fact, performing similar types of duties in the care of their patients and/or clients.

The profession of clinical exercise physiology was born from physical education curriculums that branched out into cardiac rehabilitation, and general fitness programming. Some worked in other areas of exercise with different types of patients. Today, clinical exercise physiologists specialize in diabetes, cancer, metabolism and weight loss, rheumatic diseases, and pulmonary dysfunction rehab, to name a few.

A Natural Crossover
Many exercise professionals have found employment in diabetes treatment centers, using fitness as one of the three primary modes of treatment for the disease, along with diet and insulin. Again, the clinical exercise specialist is also required to know, in addition to exercise programming, information about insulin regimens, and their administration, effects of food, and exercise on their disposal, timing of injections, knowledge of complications, medical and laboratory diagnostics and assays, patient scheduling and billing procedures, and literature reviews, which encompass a variety of historical, clinical, pathological, and philosophical topics. In this instance, the exercise physiologist performs basic resting measures, once thought to be the sole domain of the nurse, performs patient education, just as the nurse or diabetes educator performs, and helps with some nutritional information, along with the dietitian. It has become clear that the exercise physiologist must become a Jack-of-all-trades, and become well versed in each of them.

However, physical therapists have performed clinical services with many of these types of patients also, from rehabilitative services to office procedures to medical liaisons. The once-clear line that delineated the physical therapist from the exercise physiologist has become blurred in the clinical care that is performed by each professional, and the other responsibilities they are expected to perform.

Another case is the chiropractor, who by virtue of being business owner as well as clinician, performs, in addition to spinal manipulation, soft tissue manipulation, some therapeutic exercises, nutritional consultation, and injury rehabilitation, again blurring the distinction between themselves, and physical therapists, massage therapists, exercise physiologists, and dietitians.

Many allied health professionals are performing different health care procedures. Some MPH graduates in public health are becoming certified in exercise testing and prescription, registered as dietitians, or performing counseling duties and behavior modification with patients with eating disorders, much like clinical psychologists and marriage and family counselors.

Part of the dietitian's counseling practice is to perform and interpret body composition analysis, once reserved for the laboratory, and program entire wellness packages for their patients and clients.

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 About The Author
Eric Durak received his Master of Science degree from the University of Michigan in 1986. His research experience is in the application of exercise for special population groups, such as diabetes, high risk pregnancy,......more
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