This bill is the beginning of a national movement toward licensure in the US for persons in the exercise world. It will start with state-by-state bills for exercise physiologists, but will also encompass other members of the exercise profession within a short period of time. It will mean that the government will take a more pro-active role in the development of the profession.

What will this mean for those who call themselves exercise professionals? With the current push for HMO contracts, and the inclusion of exercise in certain types of health care plans, this may mean more marketing power for those who already work in the rehab and clinical areas of exercise instruction. Sadly, it may exclude competent fitness professionals who do not possess the academic background necessary to have this advanced certification. With the information provided in this article, it may spur these professionals to inquire about continuing education and future opportunities within the upcoming fitness/health care world.

It is up to the profession with its many types of practitioners, and the general public to mandate the direction of fitness. Positive changes will happen when fitness professionals read and recognize the current health care system, and trends affecting their professional status. They must establish relationships with medical and allied health professionals and insurers. Most importantly, they must have a universal outcomes-managed health promotion program that can assure long-term success of participants (2, 4, 8, 21). Health care providers are most likely to value the need for individualized exercise programs and the variety of prevention services that are provided. Organizations can foster this growth by providing education and certification programs that fill this need. They can go a step further to insure this recognition by performing their own form of regulation by: a) establishing a basic competency and code of ethics (1); b) providing a form of registry that all certified personnel can be listed under and give the public one view of a fitness professional is (28), and; c) certify health and fitness facilities that hire those personnel who are certified and registered. If these steps can be achieved within the near future, the profession will position itself as a viable productive part of the "health" care system.

Table I : Future Health Promotion Programs

• Exercise Rehabilitation/Therapeutic Exercise (3, 6)
  (Cancer, Osteoporosis, Hypertension, Diabetes, Metabolism, HIV/AIDS, End Stage Renal Disease, Lipid Disorders, COPD, PVD, Post-Rehab Orthopedic)
• Pre Natal, Post Partum Exercise (16)
• Cardiac Rehabilitation (phase III and IV) (14, 15)
• Low Back Prevention and Safety classes
• Water Exercise Therapy
• Smoking Cessation Programs
• Weight Management Programs
• Body Composition Assessment
• Fitness Assessment
• Nutritional Programming
• Stress Management Programming
• Senior Fitness Programming
• Youth Fitness Programming