Our perspective of Exercise Physiology in the current health system
Exercise Physiology (EP) is carving out its place in both private and public healthcare. While awareness is growing, its purpose is still widely misunderstood, even by Primary and Allied Health Professionals. EPs complete the same, if not more, tertiary education compared to some physiotherapists, chiropractors, and osteopaths. In terms of study hours and practical experience, we’re right up there with dieticians and psychologists. Yet ironically, we’re one of the last professions people think to visit.
A Brief History of Exercise and Health
Bit of a history lesson: exercise and its impact on health aren’t new concepts. A Greek physician back in the 5th century BCE (who also happened to be an athlete) was one of the first to explore movement’s role in recovery. Greek, Asian, and Southeast Asian cultures have long embraced a holistic approach to health, emphasising diet, movement, and well-being. Fast forward to the 19th and 20th centuries, and humans became increasingly curious about optimising recovery, healing, and performance. With modern research, technology, and a good dose of curiosity, we’ve continued to uncover just how powerful exercise can be.
The Cost of Inaction: Non-Communicable Diseases in Australia
Non-communicable diseases (NCDs) put one of the biggest financial and resource burdens on Australia’s healthcare system. The kicker? Exercise alone can help manage and reduce the risk of almost all of them. But what’s the root of the problem? Well, it’s complicated. There’s no single solution to a multi-layered issue. A person’s ability to engage in exercise and take control of their health depends on countless factors. Breaking down these barriers is key to creating real, lasting change.
The Underutilisation of Exercise Physiology in Primary Care
For most people, General Practitioners (GPs) are their first touchpoint with the healthcare system, from a baby’s first vaccinations to adulthood. They’re meant to be the trusted professionals guiding us through health and medicine. Logically, GP referrals should be an easy, direct path to EP services, yet they remain one of the least utilised.
In 2016, only 1.44 out of every 1,000 GP appointments resulted in an EP referral. Less than 1% of people living with obesity and only 0.8% of those with Type 2 Diabetes have ever been referred to an Exercise Physiologist.
Why? A lack of awareness, on both sides. Many GPs don’t fully understand what EPs do, and many patients don’t even know we exist. But as a new generation of physicians enters the field and more people become proactive about their health, these numbers should increase.
Reactive vs. Proactive Healthcare: Where We Need to Be
When it comes to managing health, people generally fall into one of two categories: reactive or proactive.
Reactive behaviours kick in after a problem arises, such as receiving a diagnosis, finding out you’re pre-diabetic, or discovering your cholesterol is high. Basically, we wait for the bad news before taking action. This is how the current healthcare system operates.
Proactive behaviours, on the other hand, focus on prevention. They involve choosing actions that keep us healthy rather than reacting once things go sideways. This is where we need to shift.
A proactive healthcare system would ease the burden on both individuals and the economy. Investing in prevention reduces the need for expensive treatments and improves quality of life. It’s a win-win.
The Biggest Obstacle to Health Engagement? Money.
So, if prevention is the better option, why don’t more people do it? One word: money.
Cost is the final boss of adherence. Gym memberships, personal training, and regular EP sessions can feel like luxuries rather than necessities. With the rising cost of living, healthcare services are often the first thing people cut, even though they play a massive role in long-term health.
And let’s be real, it’s not just patients struggling financially. EPs themselves face rising costs for equipment, insurance, clinic space, and professional development. This limits the services we can provide, whether it’s investing in specialised equipment, accommodating bariatric patients, or furthering our education. We want to help people, but we also need the resources to do it properly.
A Call for Change: Education, Empathy, and Action
So, what’s my take? Takes a sip of my oat iced latte. The reality is, we need to be more open to learning, not just teaching.
Healthcare professionals can sometimes be quick to “punch down” on people who need to improve their health, without considering the external factors at play. The bigger the picture we look at, the more effective we can be in helping people.
If we start treating patients as whole people, not just as a collection of diagnoses, we’ll see better results. People say money doesn’t buy happiness, but it certainly buys access, security, and peace of mind. Expanding EP outreach through existing healthcare resources and making services more accessible is the key to long-term impact.