Since we put up our podcast conversation with Dr. Carol Garber this past Friday, I've had couple of interesting email conversations, and one in particular with my friend Kevin, has struck a chord that needs to be amplified a bit. I think if you listen to Dr. Garber, you may get the sense that Exercise Scientists are only interested in state licensure and are a bit elitist to boot. I think it is critical that we drop back a couple of steps to look at some context for this conversation that adds another dimension to the discussion....
The purpose of state licensure laws is 'to exclude from activities which may adversely affect the health and safety of the public those entrepreneurs who will not or cannot conform to desirable standards' (Public Law Health Manual - Washington, DC, pg. 58-59) - in other words - to protect citizens from practitioners that have no knowledge in a particular area. That's why our physicians, nurses, surgeons, etc. are all licensed. That's the way we know that these professionals have some sort of basic training and foundational knowledge for what they do. But how do you know the same thing for personal trainers? Distressingly, there are no states that have licensure for personal trainers, which is strange considering that exercise may be one of the most physiologically stressful activities you can do. (Louisiana does require licensure for Clinical Exercise Physiologists - those folks in cardiac and pulmonary rehabilitation programs - but they are the only state to require such a license). So, I pose the question - which is liable to result in more harm - a misguided and uneducated personal trainer exercising a client or taking your dog to an unlicensed dog groomer?
Dr. Garber was right on the mark when she noted that we've been missing educational standards in exercise science and that is the key to state licensure. Until a few years ago, there was not a formalized set of curricula so that we could all be sure that every degreed personal trainer knew how to do all of the stuff they should do to exercise their clients safely (e.g. intake surveys, blood pressure screenings, sub-max and max test procedures, etc.). While I'm pretty sure that all my former students that work with the public do everything the way they are supposed to, I can't vouch for all of the self-educated trainers that are out there. So, yes, there is a need for some credential(s) or even licensure to help people know that the exercise professional that they are trusting to help them reach their fitness goals, whether it is to lose weight or run faster, actually knows what they are doing. In the end, the best chance currently for an individual to get the right exercise treatment is to work with someone who has foundational education in the area. There is no dobut that someone who has a college degree in Exercise Science or Kinesiology is your best bet.
Unfortunately, the field of Exercise Science is behind other allied health fields like physical therapy and athletic training in establishing professionals standards and the requisite licensures. In the past, the governing bodies for Exercise Science in the United States decided to concentrate on developing the scientific base of exercise therapies and did not pursue professional credentialling like other professions did. As a result, the scientific literature backing most exercise therapies is deep and broad and well established while many other allied health professions - even though they have state licensure - are struggling to develop 'evidence-based' theories to underpin their therapies. As a result, even though Exercise Scientists have a deep and broad scientific literature basis for their practice of exercise science, the credentialling efforts in the field have been behind other professions. It is dedicated professionals like Dr. Garber and many others that are working hard to rectify that situation.
So, if you are concerned about protection of the public when it comes to exercise training - which we are - licensure is the way to go, especially if most of the other allied health fields are licensed as well. And yep, it is extremely elitist. But after all, I want the best-educated and best-experienced (but not necessarily self-taught) professional to treat me - I bet you want the same for yourself. No system of credentialing is fool-proof, but if you look for particular professional development hallmarks in your personal trainer - like a degree and a certification from ACSM or NSCA - your chances of having a satisfying personal training experience go up considerably.
Until next week, stay active and healthy!