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Guest Column - September 2006

Standards and Guidelines for Fitness Facilities: Sword or Shield?

Fitness

By David l. Herbert, J.D.


H
ealth and fitness facility operations in the United States and Canada have become big business. Reportedly, membership in such facilities continues to rise, now encompassing more than 41 million members in the United States alone. Industry revenues exceed $14 billion a year, while chain facilities have been marketed and sold for billions of dollars.

The growth of the fitness industry, however, has not come without some problems and its share of ups and downs. Some of those problems have been related to public and media perceptions as to the qualifications of some of those employed in the industry; others have dealt with so-called "certification mills" for fitness professionals, which in many instances have churned out unqualified fitness instructors and personal trainers to interact with consumers; still others have dealt with claims and litigation against exercise professionals and fitness facility operations related to negligence allegations in personal injury and wrongful-death cases.

The fitness industry responded with various remedial and even pro-active measures to deal with these matters. For example, the International Health, Racquet and Sportsclub Association (IHRSA) has adopted a formal corporate resolution recommending to its member facilities (IHRSA represents about 6,500 club member facilities in nearly 70 countries) that they employ personal trainers certified by certain educational entities who are in turn are accredited by another agency, such as the NCCA (National Commission for Certifying Agencies). At about the same time and for the same general purposes, others in the industry also acted to form the National Board of Fitness Examiners (NBFE) to provide a comprehensive, standards-based, national examination to test the qualifications of personal fitness training candidates. The process will include both a psychometrically sound written and practical examination, which will make the offerings of the NBFE somewhat unique in the industry at the present time. Those who successfully complete the examination process will then be registered on an NBFE-maintained list of trainers.

Aside from these efforts, the industry also responded to the foregoing problems with the development and publication of standards and guidelines so as to set benchmark behaviors for service delivery by those in the industry. It was hoped that the development of such standards and guidelines—or as some would call them, parameters of practice—would lead to a national standardization of service practices that in turn would improve the delivery of fitness services while reducing the number of untoward events occurring within facilities and related claims and lawsuits. While the jury is still out on the issue of whether or not the intended impact of these statements has achieved their contemplated goal, it is necessary that the impact of the effort be examined and analyzed so that those in the profession might realize and appreciate what is at stake.

Medical history lesson

In the 1970s and 1980s, the medical profession undertook a series of steps to create benchmarks of expected health-care service delivery that could be used as standards for providers to deliver minimum or optimal care and thereby avoid what was often individualized criticism of that care from experts in potential malpractice claims and negligence litigation. In this regard the medical profession expected to use these statements when service delivery was provided in accordance with the statements as a shield against lawsuits.

Interestingly enough, however, investigators at Harvard determined that more often than not such standards were used to attack the care that was rendered. Consequently, statements were thus used as a sword to attack care when untoward results occurred. The use of these standards in this manner was somewhat unexpected by many since this use was not the intended purpose for the development of the statements. A variety of explanations for the use of these standards in this manner were offered. It appeared on an examination of the issue that some physicians were resistant to practicing medicine by some "cookbook" type recipe for service delivery, while still others simply were not familiar with the standards and therefore did not follow them. Moreover, due to the sheer number of standards, some of which were inconsistent at least in part, it was somewhat difficult for practitioners to decide upon which ones to follow in their individual patient practices. Based upon certain research findings in the fitness industry, it appears that the same problems may have arisen with fitness parameters of practice just as similar issues arose in the medical profession with medical standards of practice.

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