Components of Professionalism for Exercise Physiologists
Larry Birnbaum, PhD, FASEP, EPC
Department of Exercise Physiology
The College of St. Scholastica
Duluth, MN  55811

The American Board of Pediatrics (ABP) published components of professionalism in July, 2000 [1]. They state that professionalism “comprises those attributes and behaviors that serve to maintain patient interests above physician self-interest,” and that in addition to interactions with patients and their families, “professionalism also involves the relationships between physicians and other health professionals and the interactions between specialties and between professional organizations.” [1]  Subsequently, they list eight components of professionalism:   1) honesty/integrity, 2) reliability/responsibility, 3) respect for others, 4) compassion/empathy,  5) self-improvement, 6) self-awareness/knowledge of limits, 7) communication/collaboration, and 8) altruism/advocacy.  These concepts are worthy of consideration for exercise physiologists.

Surely, honesty and integrity are essential for any profession, for that matter, for all persons.  The ABP states that these attributes “imply being fair, being truthful, keeping one's word, meeting commitments, and being forthright in interactions with patients, peers, and in all professional work.  They require awareness of situations that may result in conflict of interest or that result in personal gain at the expense of the best interest of the patient.” [1]  Exercise physiologists in any professional environment, be it cardiac rehabilitation, fitness, training athletes, or wellness, have an obligation to be honest and meet their commitments.  Perhaps the most striking issue associated with this component of professionalism for exercise physiologists is nutritional supplements.  It is common practice for some fitness industry businesses to push supplements, and their trainers get a percentage of the profit by facilitating sales.  If any such product has not been established by sound scientific research to be beneficial as claimed and not harmful, then it would be unprofessional to sell that product.  This issue has been thoroughly addressed [2]. 

The reliability/responsibility component means being accountable to clients, society, and one’s profession [1].  In other words, exercise physiologists are responsible for their own decisions and actions and consequences thereof.  If an error is made in serving a client, corrective action must be taken as soon as the error is discovered.  Of course, that means being forthright in disclosing the error.  This component supports continuing education so that exercise physiologists can best serve clients and society.  It also requires membership in a professional organization that advances the profession (e.g., ASEP).

Respect for all others includes patients, colleagues, members of other professions, literally everyone.  This does not just pertain to gender, race, ethnicity, religion, and sexual orientation, but also physical appearance.  Physical appearance is mentioned because some clients/patients of exercise physiologists may be substantially overweight.  Interaction with obese persons must be maintained on the same professional level as will all others.  In a similar manner, physical attraction cannot interfere with client interaction either.  Sexual innuendos, improper touching, ogling and the like are always unacceptable.  To label such behavior as unprofessional is an understatement.  Finally, patient confidentiality is not only a matter of respect, it is also the law.

Compassion and empathy go a long way in helping a client feel more at ease in what could be an uncomfortable environment.  Put simply, empathy could be defined as understanding the feelings of another.  Whether working with a cardiac patient undergoing stress testing or an overweight person exercising as part of a weight loss program, understanding the unique challenges of the client will enhance the professional relationship and the probability of success markedly.  Bear in mind that empathy is not sympathy.  Feeling sorry for someone is generally counterproductive. 

Self-improvement could be considered part of the responsibility component.  Providing the best health care possible requires lifelong learning via continuing education.  One must also learn from his own mistakes, through periodic self-evaluation, and from the constructive criticism of others.

The exercise physiologist must also be aware of her professional boundaries.  She must recognize when a situation calls for expertise beyond her capacity and respond accordingly.  In such a situation, the appropriate level of intervention by a supervisor or a practitioner from another profession will assure quality care and safety.  Put simply, ask for help when over your head.

Good listening skills and the ability to express oneself clearly and accurately are essential for success in any field.  Most, if not all, of the other components require effective communication.  Collaboration is also essential in today’s health care arena.  Exercise physiologists must be able to work cooperatively with nurses, cardiologists, physical therapists, occupational therapists, dieticians, and other health care providers as members of a health care team.  The team approach to health care has become commonplace and has improved the quality of care.

The ABP describes altruism/advocacy as the “unselfish regard for and devotion to the welfare of others.  Self-interest or the interests of other parties should not interfere with the care of one's patients.” [1]  A good question for exercise physiologists to ask themselves when working with any client is, “Am I serving the best interests of my client?”  An obvious issue associated with this component of professionalism for exercise physiologists is nutritional supplements.  If an exercise physiologist is selling any nutritional supplement to clients, he must be convinced that his clients are benefiting from that supplement.  If benefits are not evident, continuing to sell the supplement would be unethical, and, of course, unprofessional.

These components of professionalism should serve exercise physiologists well, provided they are aware of them.  It is a good idea for academic programs to include an educational component on professionalism in the curriculum.  In addition to classroom instruction, professional behavior should be expected of students.  Most importantly, educators must model professional behavior for students in their interactions with colleagues and with the students themselves.  Academicians should frequently contemplate the above components of professionalism in light of this responsibility.

References

1.  https://www.abp.org/resident/profguid.htm

2.  Boone, W.T.  (2006)  Is Sports Nutrition for Sale?: Ethical Issues And Professional Concerns for Exercise Physiologists.  Nova Science Publishers, Inc.