Hi Jo. This is a great question because it’s one that I’m sure faces us all at some point in our careers. In my opinion, since you (or I) are the exercise expert in that relationship, you must take charge of the situation and do what you are comfortable with, and what is in the best interest and safety of the client. The answer to your question all comes down to a couple of factors (the severity of the medical condition, and its effect on your client’s ability to safely and effectively exercise). First and foremost should be the seriousness/severity of the medical condition. While in my own practice if a client has any condition that will effect their ability to safely or correctly exercise, I would insist that they see their physician, I recognize that not all medical conditions are ‘created equal.’ Quite frankly, there are some conditions (especially chronic ones) that our clients and doctor’s patients simply have to learn to live with. That being said, if I as the trainer have ANY doubts or hesitation about the client’s medical condition I would INSIST that they obtain medical clearance before training with me, and would make it a prerequisite to our working together. “No clearance, no training” is my rule. While some clients may initially be taken aback by my insistence, in the long run they quickly recognize that here is a trainer who considers their clients health first and foremost, above training dollars. It also helps establish that in the trainer-client relationship you are being hired for your expertise and knowledge and that you have certain guidelines that must be followed in order for your client to safely navigate the road to health and fitness.
I hope that this helps.
If an individual has a diagnosed disease and refuses to get a clearance from his or her doctor, I am of the opinion that you must then look at your scope of practice.
The reason we as fitness professionals request that our clients get clearance from their physicians is to determine whether their condition is medically stable. Only the physician can determine that.
If the client is on any medications, only the doctor would know whether he/she takes his/her medication according to “doctor’s orders” or if they feel they can self treat or are just negligent about taking their medication.
Professionally, I would not do it because I have no clue whether the individual is medically stable as far as their disease is concerned.
Hope this helps.
I was once in a situation where a person had purchased a package with me as part of a silent auction for a charity. The information had indicated that a physician’s approval may be required.
When she called me to set up the appointments, it turned out that she had a medical condition for which I require a physician’s approval. She did not have health insurance and therefore did not want to go to a doctor. She knew that she needed to exercise and had hoped that I could get her on the right path.
I still feel bad about it many years ago, I did not train her because of the physician’s approval issue. I know that it was the correct and professional thing to do. Let something happen, and people will quite rightly say that you should have known better.
But it is not easy saying ‘no’.
Thank you all very much for sharing your thoughts. As all of you said, there are clients who wants to start training but are somehow uncomfortable or scared to ask their physician for advice. I firmly believe that as much as we want to help people take a path for a healthier and active lifestyle, we should always think of their safety first.
As hard as it is, I will have to make my client understand that.