Professional Behavior in Exercise Physiology
Larry Birnbaum, PhD, FASEP, EPC
Department of Exercise Physiology
The College of St. Scholastica
Duluth, MN  55811

Much has been written about professionalism and professional behavior from a variety of perspectives and fields.  The fields of medicine and law have been particularly prolific in writing and teaching about professional conduct, professional standards, and so forth.  The business world has also contributed substantially to the topic.  Exercise physiologists do not need to reinvent the wheel with respect to professionalism.  Instead we can learn from those who have paved the way before us, and it is important that we do learn if we expect to be regarded as a profession and as professionals. 

A common definition or description of professionalism would be a good place to start.  Although descriptions vary across fields, common elements are readily identifiable.  Not surprisingly, the Accreditation Council for Graduate Medical Education (ACGME) focuses on the physician-patient relationship [1].  Elements include respect, compassion, integrity, competence, ethics, accountability, responsiveness to the needs of others supercedes self-interest, confidentiality, sensitivity, and commitment to excellence and lifelong professional development.  The Georgia lawyer’s creed [2] incorporates faithfulness, competence, diligence, good judgment, fairness, integrity, civility, respect, candor, and courtesy.  All of these are important features of professionalism and exercise physiologists should integrate all of them into their practice.

Toupin [3] considers professionalism from a business perspective and asserts that the intent of professionalism is to provide a foundation for effective communication and efficient performance.  Effective communication is absolutely essential for exercise physiologists but providing quality care should never take a back seat to efficiency, that is if efficiency means getting the job done with minimal expenditure of resources.  Time is a resource and exercise physiologists must spend enough time with each client to establish a trusting relationship.  Anything less would ultimately be ineffective.  It can be argued that if an exercise physiologist’s performance is ineffective, it is also inefficient.  Thus, efficient performance could be described as satisfactorily meeting the client’s needs with the appropriate expenditure of resources. 

Attire is another aspect of professionalism that is commonly addressed.  What is the proper attire for exercise physiologists?  That depends on the work environment.  In other words, the work environment dictates the norm for attire.  Work settings vary and the exercise physiologist must dress for the situation at hand.  A business meeting may require a suit or at least a coat and tie, while more casual wear may be acceptable for performing a graded exercise test.  Blue jeans and a T-shirt are never acceptable.  Bear in mind that appearance, including attire, is a reflection upon the individual.  A common element of professionalism is respect for patients/clients.  It is also important that clients respect their exercise physiologists if the exercise physiologists are going to work effectively with their clients.  The manner in which they dress may encourage or discourage respect from their clients, peers, and superiors.

Another important point that Toupin [3] emphasizes is working in professional settings without emotion.  That does not mean without compassion.  As mentioned above, compassion is an important element of professionalism, but emotional responses generally adversely affect professional relationships.  Anger may destroy the relationship.  A client in tears should not evoke tears from the exercise physiologist.  Demonstrating compassion for the client is necessary in such a situation; however the exercise physiologist must also help the client work through the issue and continue to make progress toward the client’s goal(s).  Humor can be part of some professional interactions, but it has to be used carefully.  It must always be respectful.  As Toupin [3] states, a business (professional) situation has a purpose and a goal, and emotional responses may detract from that goal. 

A final point about professional relationships is patient satisfaction.  According to Hall, Zheng, Dugan, Camacho, Kidd, Mishra, et al [4] and Hauck, Zyzanski, Alemagno, and Medalie [5], professionalism is related to patient satisfaction.  Patients are more likely to be satisfied with physicians (think exercise physiologists) who behave professionally.  Furthermore, they are more likely to follow through with treatment recommendations (e.g., exercise prescriptions) when they trust their care provider.  They are more likely to stay with physicians (exercise physiologists) they perceive as professional and recommend them to others.  Most complaints about physicians involve physicians’ unprofessional behavior, and patients are more likely to sue physicians they perceive as behaving unprofessionally [6].

The importance of professionalism cannot be overemphasized.  Exercise physiologists must embrace professionalism and must practice it all the time.  By doing so, exercise physiology will be recognized as a health care profession by the general public and by our professional counterparts.  Keep this in mind as you prepare for work each day, and as you interact with clients, colleagues, and superiors.

References

1.  Accreditation Council for Graduate Medical Education.  (2004)  Advancing Education in Medical Professionalism.  Retrieved September 26, 2008, from http://www.acgme.org/outcome/implement/profm_resource.pdf

2.  State Bar of Georgia.  (2008)  Lawyer's Creed and Aspirational Statement on Professionalism.  Retrieved September 26, 2008, from http://www.gabar.org/related_organizations/chief_justices_commission_on_professionalism/lawyers_creed/

3.  Toupin, E.  (2002)  Professionalism … How do I get one?  Retrieved September 26, 2008, from http://www.selfgrowth.com/articles/Toupin14.html

4. Hall MA, Zheng B, Dugan E, Camacho F, Kidd KE, Mishra A, et al. Measuring patients; trust in their primary care providers. Med Care Res Review 2002; 59:293-318.

5. Hauck FR, Zyzanski SJ, Alemagno SA, Medalie JH. Patient perceptions of humanism in physicians: effects on positive health behaviors. Fam Med 1990;22:447-52.

6.  Hickson GB, Federspiel CF, Pichert JW, et al. Patient complaints and malpractice risk. JAMA 2002;287:2951-7.