I want to know what organizations are advocating the most for our profession. I work with Physical Therapists and they have APTA. Here is their leadership: http://www.apta.org/BOD/
In contrast, I look at the ACSM leadership and see: http://www.acsm.org/about-acsm/who-we-are/leadership
Am I the only one that sees a difference here? Am I wrong in assuming that very few people in the ACSM organization are, or were, practicing exercise physiologists or fitness professionals? What I am really getting at is what organization(s) are helping out our field when it comes to legislation and advocacy? With all these certifying bodies, it isn’t like we can get them all to work together like APTA.
I think that these questions bring up implications with who we become certified by. Do you want your money going to an organization that may or may not have your best interests in mind? What are your thoughts on this and what good are different organizations doing for our profession?
In my opinion, the problem with reimbursement for personal training is as follows:
1. Personal training doesn’t guarantee the outcomes that the insurance companies are looking for. The education base of personal trainers is very diverse and some trainers simply do not have good outcomes. In addition, the plans of action that are outlined by different certifying bodies can range, and many trainers ignore them because they are often behind the times. If a weight loss client walks into a gym, the plan that will be provided simply varies too greatly to be able to predict outcomes. Additionally, there would have to be proof that personal training leads to good long-term outcomes. If a client loses 25 pounds initially, but regains 30 pounds within a year or two (not out of the norm in many case or scientific studies), then that doesn’t really help the client or save insurance companies any money.
2. Personal training (1 on 1) is not an efficient delivery of services. This is realistically a luxury service for those who can afford it. If weight loss is the goal, I can easily train 3-5 clients at the same time and deliver very close to the same service as 1 on 1 training. When considering health care costs, if I can get 80-90% of the results, for 35-50% of the cost, that is efficient delivery of services.
3. Reimbursement for services always opens up the potential for fraud. To combat this fraud, it seems that insurance companies and Medicare bombard you with paperwork. If personal training ever gained any form of compensation, I would not be surprised to see paperwork akin to that found in a physical therapy settings. Assessments, discharges, having to fight with insurance companies over how many sessions are necessary, etc. If it went this route, you would not even want to bother.
In my opinion, our best bet would be to fight for small compensation from employers, or insurance companies, for small to moderate size group sessions. If it would normally cost the client $15/session, perhaps they could get $5 reimbursed per session. This is considerably less than a $15-30+ dollar copay for physical therapy.
I appreciate your participation in this discussion. Regardless of our opinions differing, it would be nice if we had an outlet to discuss these with an organization that was ready to back us. As mentioned earlier in the discussion, APTA fights for legislation for their professionals. Who is fighting for us?
Hi Steve (and Karin). I love this discussion and wanted to weigh-in on your last two comments (dealing with insurance reimbursements etc.). In my opinion, when and if health insurance reimbursement becomes widely available to clients, I do NOT believe it will (or should) be relegated to group exercise. Cost for personal training (I’m talking ‘individual’ training) should hardly be an issue once this coverage becomes available, for many reasons. Perhaps first and foremost is that whatever the cost of a session of personal training, or even a series of packages, that cost pales in comparison for how much is spent in ‘curing’ or ‘correcting’ a health issue (such as obesity and ALL of the attendant co-morbidities) later. I don’t see it as a matter of cost, because honestly the cost for your average (or even above-average trainer) is still substantially less than for a doctor’s visit, or worse yet, and ER visit. Cost is less of an issue than ‘regulation,’ and acceptance of our credentialing process in the fitness industry. In my opinion, until those two HUGE issues are addressed in our industry, we will be fighting a losing battle in receiving total acceptance in the medical and insurance worlds.
My two cents 🙂
I could not agree more with you. Cost is just such a factor. Everybody agrees that exercise can do great things, and there is a need for qualified supervision because many people to not know where to start. But only a few a willing to pay for such services, and the masses cannot be reached.
On the flip side, free services are notoriously under-appreciated. Physical therapists had to introduce draconian threats to prevent people from canceling gratuitously, and non-compliance with the prescribed exercises are a frustrating reality for them.
People are also getting conflicting messages. It appears that many are holding out hope that a pill for their problems will be found thus making it unnecessary to exercise. After all, we have pills for just about everything.
I have no solution. I do my thing and try to reach as many people as possible by also teaching a few group classes in addition to the one-on-one training.
Thank you for your response, Karin. The objectives of APTA and ACSM are certainly different, yet the ACSM is considered the “gold standard” by many, when it comes to personal training certifications. I would prefer that the certifying body that I am involved with has my best interests in mind because they are currently, or were previously involved in my field.
I’ve heard mention of people hoping for reimbursement from insurance companies for fitness services, specifically personal training. Anyone with a basic understanding of business realizes that this is not sustainable. The high cost of personal training would increase the costs incurred by insurance companies, which ultimately pass the bill to the rest of us. I do believe that there is potential for reimbursement in group exercise settings, for populations that are at a high risk of future health complications as a result of deconditioning.
I feel as if nobody is really fighting for the increasing, maintaining, or even defining, our scope of practice. Our field is hardly mentioned in the statutes of the State of Massachusetts, where my business is located. This field really has a great opportunity for expansion to to efficiently serve a large number of people.
I have been thinking about your question for some time. You bring up an excellent point when you ask who represents fitness professionals.
Comparing APTA and ACSM is not a fair comparison, though, because those organization have different objectives.
Here is the ACSM mission statement: “The American College of Sports Medicine advances and integrates scientific research to provide educational and practical applications of exercise science and sports medicine.”
Contrast that to APTA: “The American Physical Therapy Association (APTA) is an individual membership professional organization representing more than 85,000 member physical therapists (PTs), physical therapist assistants (PTAs), and students of physical therapy. APTA seeks to improve the health and quality of life of individuals in society by advancing physical therapist practice, education, and research, and by increasing the awareness and understanding of physical therapy’s role in the nation’s health care system.”
APTA also has a Political Action Committee (PAC) which wants to influence legislation pertaining to issues involving physical therapy. ACSM, on the other hand, provides guidelines in the exercise field and does not talk for the fitness industry because they are not representing it.
IDEA is probably the closest thing to APTA but at present there is a different need compared to PTs. The fitness industry is not regulated – for better or worse. On the other hand, many regulations start like a patchwork of different state legislation, sometimes even on the level of municipalities.
For all I can see, quite a few fitness organizations are in for the money. Just look at the proliferation of certifications and specialties. At least some are recognized by NCCA as a standard for certifications. That is a step in the right direction.
I guess, after a lot of rambling and looking at the issue from different sides, I still don’t have an answer. But thanks for opening the discussion on that.