Fitness Professionals: are you giving medical advice?

Fitness Professionals: are you giving medical advice?
When we ask “where is the line?” when it comes to fitness professionals giving medical advice what we are really asking is what is the scope of practice for a fitness professional? While it is fundamental, we often need to state the obvious clearly: Fitness professionals should not provide medical advice to other individuals, unless you are legally permitted and qualified to do so. The rules for who can give what type of advice (medical, fitness, nutrition) vary by state, which means you need to be familiar with what is allowed by law in your state. Some states have very strict rules about nutritional advice in addition to medical advice, which can include a prohibition on recommending dietary plans and advice on supplements. In general terms, diagnosing health-related conditions, recommending treatment for health conditions, and dispensing nutritional advice are governed by established scope-of-practice guidelines and regulations that are state specific. What are the risks associated with giving medical advice as a fitness professional? If you, as a fitness professional, give advice about a medical condition or medication, or any situation where you go outside your areas of training and expertise you may be risking your business (or potentially your freedom) if a client suffers illness or injury as a result of relying on your advice. One of the reasons why the fall out can be so catastrophic for your professional and personal life is that insurance providers often exempt themselves from liability if you have acted outside the bounds of your knowledge and authority – because they consider this to be reckless or intentional negligence.  In short, insurance may not help you if you are accused of offering medical advice. Here’s the thing: If you give “medical” advice that your client follows, which results in injury, or illness, you can be held legally liable. This is serious! If you hold yourself out to hold qualifications that you do not have then you can also be subject to criminal charges as well as civil (if you assert that you are a medical professional). So, what’s the solution? To ensure that you avoid giving medical advice or giving any advice outside of your scope of practice, be very clear about your ethical boundaries and your responsibility to make sure your clients understand that you are not a medical professional. As a best practice: If you aren’t a doctor, be careful giving medical advice or advising in relation to medication or medical testing. If you aren't a registered dietitian, be careful recommending, supplying or prescribing nutritional supplements. Some of the professional associations provide specific ethical guidelines. For example, the guidelines for how to think about your scope of practice for fitness professionals is based on the IDEA guidelines. Scope of Practice for Fitness Professionals Guidelines
  • Fitness Professionals do not have patients, they have clients. Fitness professionals are not managing the care of the patient, they are providing a service within the limits of their training and experience. They use exercise to help improve overall health.
  • Fitness Professionals do not diagnose injury, disease or illness in a client, rather they receive guidelines from a Doctor, physical therapist or dietician and follow national guidelines on exercise prescription based on an individual’s health history. Fitness professionals screen for exercise limitations and design exercise programs.
  • If, during a screening, a fitness professional or personal trainer believes a client has a medical issue, then they should refer the client to an appropriate medical professional for diagnosis. Fitness Professionals do not prescribe medication or recommend specific supplements, but they do provide general information on healthy eating and refer clients to a dietician or nutritionist for a specific diet plan. They also help clients follow a physician's or therapist's advice.
  • Fitness Professionals do not rehabilitate but work with a client following release from rehabilitation. They don’t counsel about medical options, but rather provide general information about fitness. Fitness professionals don’t treat injuries, rather they refer their client to a medical professional.
  • Fitness professionals coach and provide general information, they do not provide counseling. Where a client is in need, a fitness professional will refer client to a qualified counselor or therapist.
  • Fitness Professionals do not monitor progress for medically referred clients, rather they document progress and report progress to the medical practitioner in the format requested.
Finally, Fitness Professionals are more likely to avoid giving medical advice if they understand their scope of practice and, as a consequence, their ethical boundaries. It is important for fitness professionals to also understand the additional limitations that local and state laws may place on their professional practice as a fitness professional (including as a personal trainer). As mentioned above, one of the key concerns in situations where a fitness professional has provided medical advice is the unauthorized practice of medicine or other licensed healthcare disciplines. Unless you're well-trained and certified, this can give rise to liability and the risk of both criminal charges and civil litigation. There are other ways to help you understand your ethical limitations and the scope of practice that applies to fitness professionals. By continuing to engage in professional development activities, you are more likely to grow in your understanding of your professional responsibilities and your limitations. By interacting (and perhaps joining) with professional associations that have a written ethical code of conduct and provides training on their ethical code you may gain a greater understanding of industry standards and deepen your knowledge of your scope of practice as a fitness professional.  
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