This post from LinkedIn was written by Phillip Godfrey, MES, who has granted permission to share it here. Phillip is a long time advocate for enhanced standards for fitness professionals. He has done a lot of work to advance our profession and is extremely informed on the issues related to standardization and licensure/registration. This article is very much in alignment with the American Exercise and Fitness Professionals Inc.’s position and goals. Enjoy and please remember, we welcome your comments at the bottom of the article.
In 2014, Washington, DC became the first United States Jurisdiction to regulate fitness professionals through the Health Occupations Revision Act (HORA) since Louisiana began to regulate exercise physiologists in 1996 . Recently, the White House released a publication entitled Occupational Licensing: A Framework for Policy Makers in July, 2015 to provide a strategy for future and existing occupational licensing practices. This framework highlighted the protections for public health and wage increases that can be achieved through licensing but, warned of the economic consequences of unfounded over-regulation. Taking the ideas put forth from the White House framework and considering the diversity of the fitness professionals it seems clear occupational standards for the fitness industry are needed.
The Intent of the HORA
According to some D.C. lawmakers, there is a need for legal distinctions of the scope and practice for the “athletic trainers”, “personal fitness trainers”, and “physical therapists.” Additionally, these lawmakers wanted standards to be developed to provide some protections from injuries and sexual misconduct caused by personal fitness trainers. The District of Columbia Board of Physical Therapy (DCBPT) was given the task in D.C. of creating regulations for “athletic trainers” and “personal fitness trainers”, and then a system of registration within the Office of the Mayor for those professionals who meet the standards.
The Fitness Profession at a Glance
The fitness industry is full of designations similar to that of the “personal fitness trainers.” According to IDEA health and fitness association Chief Development Officer Mike Bannon at the 2012 Club Industry Personal Trainer Summit, data collected from the IDEA Fitness Connect e-verify system reported that fitness professionals on average have 2-3 different titled credentials e.g., health coach, wellness coach, medical exercise specialist, etc. Bannon also went on to say that 45% of the fitness professionals on Fitness Connect did not have the credentials they claimed to have or let the credentials laps in renewal. Regulations may be needed to address these concerns.
Injury and Sexual Harassment Claims
Currently, no data exist to prove substantial public health concerns related to injury or sexual harassment in the fitness industry due to “personal fitness training” malpractice or other inappropriate activity. One major study Epidemiology of Weight Training-Related Injuries Presenting to United States Emergency Departments, 1990 to 2007, collected data on 970,801 injuries. Of the data, none correlated to injuries related to fitness professional instruction. However, the report did say “Based on our findings, prior to beginning a weight training program, persons should receive proper instruction in how to use weight lifting equipment, as well as the proper technique for lifts, and should consult health professionals.” Therefore, instruction from fitness professionals should help to reduce injuries in exercise activities.
Contradiction of the HORA
When explaining the intent of the HORA, DC Board of Physical Therapy chair Senora Simpson said, “One was to ensure that the public knew the difference (between a physical therapist and personal trainer) and that ‘PT’ was not going to be the acronym (for a personal trainer).” “In most cases, the public has no idea (how to tell the difference) between personal fitness trainers, PT or athletic trainers.” Why would legislators allow physical therapists to write standards for “athletic trainers” and “personal fitness trainers?” To implement the intent of the applicable designations, legislators must create separate boards of “athletic trainers” and “personal fitness trainers” from “physical therapists.”
Registration for “You Are Who You Say You Are”
Fitness professionals are a broad group in some ways more like “physicians” with different types of practitioners instead of a singularity such as “athletic trainers” and “physical therapists” which warranted the need for the “similar designations” language in the HORA. Therefore, one standard regulation will kill jobs and grossly decrease market choice. The one real glaring problem in the fitness industry which regulation might address is misrepresentation and lack of credentials.
Lawmakers should simply create a verification system (preferably e-verification) of credentials to limit misrepresentation in the fitness industry and preserve jobs. Each individual claiming to be a “personal fitness trainer” or “similar designation” would register all their credentials relating to their “title”. An example would be an individual who claimed to be a “clinical exercise physiologist”, “corrective spinal instructor”, and a “CrossFit coach” but didn’t have the credentials to prove their “titles” then they could not register or use the titles. Consumers could then use this system to simply choose a professional based upon the fitness professional’s background and credentials as verified by the municipality such as D.C. or state.
Case law decisions such as the Capati vs Crunch Fitness in 1999 demonstrate that courts may find “gross negligence” in the absence of credentials of a fitness professional when an injury or even a death might occur in the fitness industry. Similarly, sexual harassment laws are on the books pertaining to all workplaces and fitness professionals could answer for those claims through legal proceedings. Verification of credentials, continuing education, and requirements for professional liability insurance would assist the public and streamline applicable court decisions while ensuring potential damages incurred by consumers could be paid for through insurance claims.
In Louisiana, for 20 years, the standards have been increased for “exercise physiologists” to the point of requiring a masters degree and an American College of Sports Medicine (ACSM) certification which has not improved practices or the job market. The ACSM-Clinical Exercise Physiology Association reported, “While Louisiana CEP licensure efforts faced few barriers, changes in the originally proposed bill’s narrative were made following discussion with special interest groups. Louisiana CEPs have not observed much change in their practice patterns or employment opportunities since the bill was enacted. Some employers in Louisiana require licensed CEPs within their allied health programs, while others do not. Louisiana CEPs are constantly exploring ways to increase opportunities and demand for their services. LAEP continues to provide continuing education in an effort to increase the quality of care provided to member client.” Increasing occupational requirements do not guarantee the desired outcomes or insurance reimbursement for services.
Fitness Certification and Education Companies
Fitness certification companies and education providers have spent too long operating on a “read a book and take a test” basis and lack any requirements to teach and test hands-on fitness competence. Fitness professional practitioners are underrepresented in the fitness industry and must have more influence on standards and practice in these organizations. Re-structuring fitness certification companies to help protect fitness professionals through appropriate fitness education and certification services may be essential to progressing the profession.
Each certification company must have a board composed of representatives of their certified population which would separate from the management of the company. This provides a check and balance on how the company delivers and enforces standards. Education and certification departments should also be separated in their operations.
The fitness continuing education system is broken. Mike Bannon reported about IDEA’s CEC Connect which collects data on CECs, “When we do the math… the numbers don’t add up.” Fitness professionals too often choose continuing education based off their certification company’s policies of not matching credits/units to other companies. A streamlined system of 1 hour = 1 unit/credit would help to fix the fitness continuing education conundrum.
Licensing and copyright of every certification title and educational program should be encouraged. This helps protect titles and services provided by the fitness professionals and their businesses. Market confusion must be limited and preferably, eliminated.
Accreditation can be optional given that current providers in the US do not have subject matter experts fact checking each certification. Municipalities must provide a list of approved providers of certification and education so that the framework above is met by each company. A board of fitness professionals in each state would operate the approval process with heavy checks and balances from regulators to help prevent what may be tantamount to anti-trust activities.
Conclusion
“Protecting the public” with occupational licensing means that evidence of that need must be proven, not acquired through anecdotal means. Protecting the professional’s ability to gain employment or stay employed must be taken into account since professionals are the public too and must be protected for their health and well-being. Outcomes should reflect appropriate standards set forth or be replaced.
Lawmakers must create separate boards of professionals to prevent conflicts of interest between professions. Likewise, private sector groups in the fitness industry pushing for regulations with intent to severely limit market choice through a singular business entity should not be allowed to take control of the market through legislation. Lawmakers must balance protections to the public while stimulating, not limiting the free market place. A system for just simple verification of credentials should achieve that balance.
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https://www.linkedin.com/pulse/framework-fitness-occupational-standards-industry-godfrey-mes