Amateur Clinicians, Faith Healers And Tao Of Dirty Harry

 In For Fitness Pros, Magazine, Uncategorized

In every Dirty Harry movie, the cynical Harry Callahan coins a phrase that he repeats throughout the entire film at key moments. In Magnum Force, he responds to a superior ‘ a good man always knows his limitations.’ Harry used that line a few more times, including the movie’s climax when his superior gets into a bomb-laden car and is shortly blown to Mars. I know some won’t take this very well, but the fitness industry may want to pay more attention to Harry Callahan.

Over the last decade more material, courses and certifications have been created and sold to individuals in the fitness industry empowering them to assess and treat dysfunction in their clients.

There’s just one problem; the majority of those fitness individuals, despite the “extensive” nature of a two or three-day event just aren’t qualified to diagnose or licensed to treat.

Most of us are not medical doctors and therefore don’t have the legal standing to diagnose disease or structural dysfunction. Furthermore, we lack the ability to structure a course of treatment or an escalation when there is a failure of conservative therapy. Most importantly, we don’t have the right.

If we, as members of the fitness and exercise industry, are going to grow our businesses, improve our craft, and end the cartoonish nature that is so pervasive, my opinion is that the very first step should be in knowing what we know and knowing what we don’t know. The next step is to appreciate how strategic relationships with those who specialize in knowing what we don’t are key to our growth.

Each day, more customers seek the assistance of a good mechanic or an experienced carpenter than a structural engineer or an architect. The lesson in this is that simple issues are a bigger market than the complex; there are more customers seeking the simple answer. As for exercise professionals, we should all have a working knowledge of anatomy and science, but that knowledge should be used as a basis for understanding more complex matters, not as a license to prescribe or treat.

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I’m fortunate to have the support of a group of medical professionals. They trust me and I them. My trust in them comes from their years of medical school, internship, residency, and fellowships, all backed up with board certifications and ample amounts of malpractice insurance. Their trust in me comes from my admission that I know what I don’t know and am happy to acknowledge that fact and ask the real professionals for help.

What’s my point here?

There is a way for you to become the point of expertise, to become a trusted source for your current customers and a pool of future clients without having to become something you shouldn’t be; an amateur clinician. How can you tell if you’ve started down the road of fake clinician/faith healer/charlatan?

Here’s a simple test: If you’ve ever used any of the following terms to describe a client’s issue:

“Slipped Disk”

“Rib Out”

“Locked Up”

“Reset”

And you are not licensed as a practitioner by a medical board and do not have access to imaging studies, you probably fall into one of the three categories above. Is this my opinion? No, it’s the law.

You’re receiving money for your services and by using one of those innocent terms, you just provided, for a fee, a non-evidence based diagnosis of the pathological cause of a presenting symptom.  Someone comes into your facility complaining about some pain in his or her ribcage. You ask if they recently engaged in an MMA bout or were involved in a downhill skiing mishap.They say no, they haven’t had any traumatic events involving their ribcage. How many of use have said/thought :

“You may have slept wrong on your side”? How many of us have nodded our heads in agreement with their statement, “I may just have a ‘rib out’”?

Let’s not get into the discussion of how someone can “sleep wrong”. That statement in itself is an example of intellectual laziness; no one “sleeps wrong”, we all just sleep and if someone actually had a dislocated rib, a “rib out”, they probably wouldn’t be talking to you with a flat affect; they would be slightly more animated, especially every time they took a breath.

Nope, the seven most common reasons for ribcage pain or discomfort not associated with traumatic contact to the ribcage itself are

• Costochondritis or chest pain that is related to inflammation of the cartilage in the rib cage. More specifically, often affects the cartilage where upper ribs attach to the sternum or the costosternal joint.

• Pleurisy when the tissues that line the lungs and chest wall become inflamed or infected the texture costochondritis then becomes gritty, causing extreme pain. Pleurisy is also sometimes referred to as pleuritis.

• Osteoporosis, or a bone disease, the name of which means “porous bones” in Latin. The inside of a normal bone has small spaces, like a honeycomb. Osteoporosis increases the size of these spaces so that the bones lose strength and density. At the same time, the outside of the bone also grows weaker and thinner.

• The auto-immune disease systemic lupus erythematosus.

• Lung Cancer

• Metastatic Lung Cancer

• CML or chronic myelogenous leukemia (source Healthline Networt, Inc., Dr. George Krucik, MD)

“Funny, I didn’t see “rib out” or “slept wrong” in that list”.

So, what’s a responsible knuckle-dragger to do? Where are the lines, how do you avoid crossing them? How can you attract business from medical professionals when your toolbox is limited?

[bctt tweet=”It isn’t easy; it takes time, patience and a servant’s heart.” username=””]
Mark Toomey
Mark Toomey is a fitness instructor from Reno , Nevada . He serves as a Subject Matter Expert (SME) in fitness and conditioning for the United States Navy and the United States Marine Corps.
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