As the U.S. and other countries search for new ways to reduce healthcare costs, the need to improve disease prevention and management strategies grows stronger.

A report by the American Heart Association (AHA) and the American College of Sports Medicine (ACSM) clearly shows that health and fitness facilities must be ready to meet the future needs of low-risk clients with disease by being prepared to safely monitor and implement exercise programs outside of traditional rehabilitation programs (AHA– ACSM 1998). To realize this scenario, strong relationships must develop between health and fitness facilities and healthcare providers. In most cases, these relationships are specifically coordinated between a personal fitness trainer (PFT) and the client’s physician. If PFTs are
to fill this role, it is crucial that they
must adhere to a professional scope-of-practice standard that inspires medical professionals to feel confident about referring patients (IDEA 2001).

What Can PFTs Do?

In addition to empirical and experiential knowledge of exercise and program design, successful PFTs require an understanding of the legal aspects associated with the training profession; these include ethics, negligence, malpractice and scope of practice.

A scope of practice provides specific boundaries within which a professional may work, based on the knowledge and skill competencies required in that area. When professionals work outside of their scope, they not only expose themselves
to legal risk but also may risk the safety
of their clients. Some legal claims against trainers stem from their failure to work within the boundaries of practice. These claims usually involve giving advice construed to be medical in nature or failing to refer clients to a physician or other healthcare provider when warranted.

IDEA has developed scope-of-practice guidelines that PFTs can follow to help keep them within the boundaries of their professional duties, responsibilities and competencies. When in doubt, PFTs should always refer clients back to their personal healthcare providers, especially for medically based issues.

Table 1 summarizes IDEA’s recommendations for PFTs’ scope of practice. Recommendations to assist PFTs in making referral decisions can be found in Table 2. (For a complete copy of the IDEA Opinion Statement on the “Benefits of a Working Relationship Between Medical and Allied Health Practitioners and Personal Fitness Trainers,” see the June 2002 issue of IDEA Personal Trainer, pp. 26–31, or log onto the member section of