CREP: Advancing the Professionalization Effort in the Fitness Industry w/Francis Neric

This paradox , as I view it , is the trust , interaction and communication gap that exists between fitness professionals and our medical community . This podcast is all about closing off that gap by disseminating the latest , most evidence-based and most engaging information in the health sciences . And to do that , in episode 101 , i'm joined by Francis Narek .

Francis is the Associate Vice President for Certification and Credentialing at the American College of Sport Medicine , but in the context of this conversation we're going to be talking to Francis in his role as the President of CREP .

Crep is the Coalition for the Registry of Exercise Professionals , and this professional registry is one of the most important legs to the stool of the professionalization effort that's ongoing in our industry , essentially the professionalization effort to transition fitness professionals onto the healthcare continuum as qualified healthcare providers .

In this episode , we're going to unpack the different legs of that stool a little further , talk about the role that CREP plays and , most importantly , talk about where the profession is going in the next five , 10 , 15 years . This is an incredibly exciting time , as we sit here kind of on the doorstep of the professionalization effort in our industry .

Stakeholders are talking together , plans are being put in place and progress is being made , and that's really what this conversation with Francis is all about . Any additional information we'd like to share with you from today's episode can be found on the show notes page , that's by going to wellnessparadoxpodcom . Forward slash episode 101 .

Please enjoy this conversation with Francis Narek Today . I'm delighted to be joined by Francis Narek . Francis , thank you so much for joining us . Thanks . So this is going to be an exciting topic .

Francis and I have connected on this topic for the past couple of years and we were just talking before we came on the air about how exciting of a time period this is for the professionalization effort that's happening in our industry , which we're going to get into today with regard to the role CREP is playing and some of the other things that are happening .

But before we get into that , why don't you just give our audience a little bit of an idea of your background to provide some context for the discussion ?

I've been in this industry for about 15 , 16 years or so . I started my work at the National Strength and Conditioning Association , kind of worked my way from an exam preparation to exam development , kind of overseeing their education programs as an exam as an education project manager .

And then I transitioned over to the American College of Sports Medicine about six years ago .

I've been working on overseeing their certification portfolio and really kind of expanded it from just certifications to specialty credentials and kind of like specialized training and really expanding our online application portfolio , and I've been really involved with our organization and outreach efforts in conjunction with Monty Ward , who's our government relations person .

So really spending a lot of time and really kind of pushing the industry to kind of set the benchmark of what we consider mainly competent and doing a lot of that work . So super excited to continue this conversation here .

But I do want to keep this conversation so much focused around C rep because I think of C rep as one of the best kept secrets in our industry . That is so critically important and it needn't be a secret anymore , particularly going to move this in a positive direction .

So first tell everyone a little bit about C rep and then why its mission is so important to our professionalization effort .

I think that's one of the kind of the simple version of it But really for their unique qualities , that they have in their education , training , experience , to really kind of set the bar of like , how do you prepare for the workforce , how do you find the ?

how do you determine that they're competent , how did they continue to grow as a professional and also remain competent over time ? and then the last last part is where do you find them in terms of employers or other stakeholders ? where do you find those professionals ? I think that's the big thing that the C rep does .

The co , the C rep stands for the coalition for the registration of exercise professionals . A lot of folks really know us for our registration , the US registry of exercise professionals . So that's really kind of the product line that we offer at the coalition .

The intention is really to make it a one stock shop to identify who the lectures professionals are , where they're located and positively verify their certifications . So that's kind of like what the US registry does . The intention for the registration is really to kind of be consistent with the way healthcare professionals do things .

If you look at nurses , you look at physical therapy , you look at athletic trainers and you look at other just kind of licensed professions , they have the registration as a benchmark of like here's who's supposed to be in the industry And that's really the role that's there .

We do that with a number of NCCA accredited organizations but it's certainly open to ISO 17 oh two for accredited organizations as well The American Council on Exercise on there and American College of Sports medicines on there .

Now sort of the strength and conditioning association , the college strength conditioning coaches associations on there , nc , ncppt is on there And there's a number of other organizations , including the American College of Sports medicine are all in that organization that really believe that same mission of you .

Know you have to be from , have an accredited certification to be at least minimally competent . You have to have an organization that supports those professionals and believe in the vision that there is a continuum of professionals that will support the industry .

And moving head and really professionalism is really underscoring professionalism is is kind of where , when we think about US reps and kind of C rep , that that's what we're really focused on . Is you know if we wanted to be , to be a part of healthcare .

If you want to be a strength conditioning , you're wanting to have those professionals as uniquely qualified on the team that support athletes .

You have to professionalize the industry , and so those are the things that , when we're thinking about kind of our role , that's what we're trying to push ahead , especially when you're trying to meet with lawmakers and healthcare etc . You have to set the benchmark of . We are professionals in the industry And this is not a hobby .

This is , this is , these are careers and it's where we're focused on towards the horizon .

Certainly , the registry is a very important part of it , but , from your perspective , what are some of the other legs to that stool of the professionalization effort ?

I think that's really kind of the leg of the stool . So , on one hand , you know , when we're talking about education , certainly you can get anybody can get the education that you want .

But I think there's , especially when you're working with advanced training or if you're working in the clinical populations , the education that you learn at the university needs to tie directly to that profession , right , so that's not broad education at really has .

When you think , when you think about the education that you're getting in school , the way you're learning from a didactic perspective , just like you know you're learning in your lectures , but the practical application of it also has to happen to .

You have to have that hands on training in addition to what you're learning , the knowledge that you're learning in the classroom . Tying those together to a specific job is really important . So from our perspective , i think that's a really key , that's a really key component . It's all switching hats in the miracle sports medicine .

That's why our board moved that direction . When we're looking at for setting the bar at 2027 , you have to come from an accredited program . That program and exercise science programs pairing you specifically for the job as an exercise physiologist or clinical access physiologist and they also have include the practical experiences .

There It's funny is just like it's when you have , when you , when it's not accredited , exercise science can go multiple , multiple , multiple , different ways And so at the end of the day the employer isn't really sure exactly that person is when they graduate , because there's not a consistent way person trains .

So when we thinking about that from an exercise science side , or you apply that , to say it , like the healthcare industry , if every nursing school thought completely differently , it would be , it would be chaotic .

Yeah , if I'm a physician trying to hire a nurse , every nursing school did it , whatever they wanted and whatever they researched and whatever the how they prepared .

And then you're like I'm trying to hire a registered nurse , you would have no idea what you're getting , yeah , and so for us it's like , well , if you're , if there's a clinical exercise physiologist job , what are those ? what are you learning in the classroom .

What are the experiences you get then to get to the point where you are hireable and you're in an , in an integral member of a healthcare team . You have to line those up together . So I think that's one .

And so we work with the committee and accreditation for exercise science , who's a committee under under k , have , k , have to just kind of those like healthcare education and tying those pieces together . How did you prepare in school ?

tying it to a certification which is independent , which for our exams at ACSM , it's a , it's an independent , independent assessment of competency , like regardless of what institution you went to , how do you know this person's competent ? and tying those pieces together .

And then the other part of like , for when talking about like certifications , really the , the component is just like , it's the how do I remain competent over time ? because now that you're out of school , how do I , how do I ensure that they still keep up with the standards ? And then the registration components , like where do you find them ?

all those pieces need to link together in order to kind of support to support the industry , and I think that's one is just like knowing who we are and be able to explain that very simply . And registration combines all of them .

Yeah , so when we talk about , it's hard to say , i gosh , when I'm thinking about 15 years ago , we would always say in CC , in CC , accredited certifications , that's the benchmark . But when we start talking to lawmakers or we start talking to healthcare , explaining each one of those takes like , oh gosh , 10 , 15 , 20 minutes and it's just like you lose them .

Yeah , so talking about registered professionals , which includes these four components , they're like , okay , i get that Because that's similar to healthcare or that's similar to something else . So they're really being able to , especially for the industry , kind of set the bar like reduced amount of anxiety . That's there Understanding .

Like , okay , i'm not sure what I'm getting . So , oh , we're a professional industry , okay , let's talk .

I think that's one of the key components of tying those pieces together And just using I think for us it's being able to use the like to like terms is really simplified , and simplifying the language is really been helpful Education , certification , continuing competence , registration is really you're starting hearing us talking about .

Like that really is kind of like we're moving towards is registered professionals . For that minimum bar of you know , if you want to be a professional , you're registered as professional And registration that we have at US Reps is the same is similar to the registrations already established in adjacent health occupations .

No one for a second thinks that it would be appropriate from a healthcare perspective for every nursing school in the country to have a different curriculum , But that's right now how it is structured in exercise science , and so it's a very that in and of itself makes this an exciting time .

So you're comparing I don't know University of Michigan to I don't know Mike's school , mike's University of fitness , right . So when we're saying , oh , that's a non-accredited program , that's not unworthy , what you're really saying is the accredited .

When you talk about accredited universities , that's regionally accredited , which means for the public , if I send my child to a university and that my child goes there , you say University of Michigan . If they change their mind 15 times 15 different majors , the university can still support them . They're adequately supported financially .

They can switch majors whenever they want . It is as a parent I can go . Okay , they're not going to just fold up , fold up , shop , my money's gone . It is saying that this institution can adequately prepare my child and support my child . The version that we're talking about is programmatic accreditation .

So when we're talking about that exercise science program , if my child goes into an exercise science program , there's a job that we're preparing them for The student when they come in is just like okay , so you're going to teach me and I'm going to provide me experiences that I need in order to be adequately prepared for this particular job .

So , as you're transitioning in that position , you're given those knowledge , experiences , that tools in your toolbox to go look , i am prepared , i'm ready to hit the ground running as an exercise physiologist , strength coach , line of box exercise physiologist , a trainer , i'm able to do the job And that's really a key differentiator .

Like , oh , we were talking about accreditation for the whole time It's like yes and no . Accreditation means something different for everything that you do , and that's really a third-party verification tool Is one . It's just like are you doing what you're supposed to be doing ?

But for us , when we think about professionalized industry , it's like you're protecting the public . That's the intention when you talk about accreditation and registration , why that's what ? you're protecting the public first and foremost , and that's really a key component too . So we went a little sideways , a little bit No that's great , but that's going to tie that .

Framework . Talk a little bit about that , and that's something we'll link up to on the show notes page , because everyone needs to look at this document . But educate us a little bit on what is called the NERF not the football , yeah , not the football , that's right , that's right .

But we understand that when we're thinking about all the diseases and the conditions that are out there , there's a lot of risk involved . So there are parts of it where there's nuance part of it where there's a lot of risk involved , where there's nuance parts like where , if I have cancer , exercise and college exercise helps cancer survivorship . That's an example .

If I have obesity , there's certain things . Diabetes , there's certain things you have to understand . I think two things . One of them what is the risk that they have , the coromabidities that they have ? What is the risk for this person in getting active ? And then the reward of okay , can I reduce the liability of this person ?

Can I reduce the cost of those things ? Now , the higher the risk the person , the more education , training , experience that they would need to have . So there are parts of it where , when we think about the national exercise control framework , when you think about economic impairment , the higher you go , the more that you're considered quote unquote safe .

Now , for example , having a master's degree in clinical exercise physiology puts you kind of towards the top of that pyramid within the exercise science space . But here's the problem If there's 14 million people and you only have 300 people that can deliver the service , now you run into a major problem .

So while the framework really made sense of like , look , the more education you have , the better , and then you have lots of people that need your help , now you're going to have a skill problem .

So the framework that they did in Ireland was absolutely wonderful Understanding , like you know , how education , how physical activity , really can help benefit people on a mass scale . I think that's one . How do you unify the exercise professionals and get the work I'm sorry , the healthcare to the exercise professionals ? I think that's another thing .

That's component is just like I'm then cycling back to healthcare . So this is preventative model versus like a reaction to a model . Right , so healthcare comes in . They screen the person . How can you bet Are you , are you any disease or condition state that could benefit from exercise , yes or no ? And then get them to the right program .

Right , so , an exercise program delivered by qualified people . And then the last part is just like , as soon as that program is done , cycling them back into healthcare , because you know how do we work together as an efficient team .

The problem that happened there was just like there was enough people to be in within that kind of in that framework There was , the idea was phenomenal , the execution was a little , it was a little tough . So that's really kind of driving .

Crep now is taking that framework that they did in Ireland and we'll link it to , i guess , in your podcast , the national exercise for performer , and then kind of Americanifying it . So , when we're thinking about the millions of people in the United States , do you have enough professionals to do it ? In the backdrop of that is the American Medical Association .

They have a call to triple name . So it's cost , quality and access Right , so can you do this ? Is there is the impact of this activity ? Is it cost effective ?

I think , just like reducing in reducing costs in , the professionals are delivering those as a cost effective , using the top of their , of their certification , right , so I think that's that's one Quality .

How can you , how can you ensure these professionals for delivering programs , effective programs can be done consistently , right , so wherever you go , a program is being delivered , it's consistently done . And then the access is do you have enough people ? How do you ? how do you have , how do you have that ?

And that really is just like looking at healthcare or access professionals as a continuum . So you have to . I think that's the big key difference that we have in . What we're looking for is just like look at the highest level of supervision where the physician has to be present .

You're going to have to work with somebody at the master's degree , clinical access physiology , with advanced certifications , etc . Etc . And lots and experience to be able to work at the highest level of your credential , at a moderate level where it's physician recommended .

When we're thinking about that component , it's really like OK , so if I go through a health screening , athletics right , so I have to . If I'm going to be working in a high , at a very high level with physically , my doctor screening is am I safe enough to do that ? Or , like you , look , you're not active enough .

You need to work with a professional And so to make sure that they have enough education . That's there . If you're broadly healthy and you have lower risk , or you're just just getting started and you have lower risk , then you can work with those with less education , right So , but they're certainly qualified because they've passed the standardized exam .

So it allows you to stepwise into the numbers of professionals that we have . And so within the US registry right now is a little over a hundred and it's right around 168,000 professionals .

So when we think about those 168,000 professionals that are supporting our health care or our folks that are out there , there's a lot of professionals that are out there that can help And so , depending on the need of the health care or the public , you have enough professionals to support the industry . So I think there's certainly there .

If it is , i think that's the big . The big component And that's really driving us now is just like it's time goes , time goes together .

One of the major wins from the physical activity alliance and really the physical activity alliance and US reps type work together a lot Physical activity alliance has a lot of folks that work on that , including some of the exercise exercise . Professional registrations are on there , and so the societies are on there .

The biggest one you have payers and then you also have technology folks and then you also have it is how occupations all working together . One of the major wins they had is adding physical activity as a vital sign or physical activity as a health measure , and so , with the PA into each else seven don't need to kind of go into that , each else seven .

What that does is it is a framework with a , it's a way to have databases interacting together in health care . Now , what's phenomenal ? by adding physical activity as a health measure , it really goes back to okay . So if I'm going to refer them , who am I referring them to ? US reps ?

the US Registry Act as professionals is the intermediary of like okay , if you're in health care and this person can benefit from physical activity , i'm referring them to somebody who is on the registration . Yeah , that is a huge step Because the referral never happened before .

So what we're thinking about US reps and , i'm sorry , the coalition and the nerve , that's how we're tying those pieces together . The coalition is really focused on who are the qualified professionals .

Hl7 is just like in health care And the work that we're doing with the physical activity alliance and the health care is just like here's if you can benefit from exercise , who are we sending you to ?

Yeah , and that's the merge , the merging together , or to me , that's the so exciting to see Because that's never happened before And you have to work together in order to do that . It's not any one single organization can do what's all .

You have to work as a coalition , you have to work in and handle the health care And you know and recognize that we are uniquely qualified as exercise professionals . In health care is like look , yes , you have the training and experience to help somebody you know stay healthy , but we work together as an efficient team .

That's the part that's just so exciting to see And that here's the thing You have to trust each other And that , i will say , is when we're thinking about the next few years three to five years one was we're focused on do you understand who we are ? The next three to five years , we've got to prove you can trust us .

I think that is going to be the toughest part , because as soon as you lose , cross is game over . And how do you , how do you build that sense across ? I think that's going to be , i think , the component that just being able to stay like professionalism is one and got to stay tight with the messaging and kind of what we are , what we do .

How are you uniquely qualified ? And you have to go look the state or does here . If you're not meeting it , i'm sorry you're not going to be a part of this model Right , and so work together in order to get us to where we need to go , and we cannot break that sense across the healthcare . If we do break it , it's game over .

Sometimes It gets so technical Before you know . Before we kind of bring this to a close , c-rap just released its 2023 impact report here in the beginning of summer . Can you hit on some of the wins that C-Rap has had recently that were mentioned in this report ?

We worked with the NCAA and then our association worked together to really put the recommendations of what are the at a minimum , what do you need to be able to be a safe strengthened conditioning coach ? Because this is not a backdrop of some really unfortunate deaths that have happened at strengthening conditioning profession in the university .

I think there's been 80 deaths per year of athletes who are considered kind of the healthiest individuals And when we think about that is just like what are those recommendations ?

in order to stay , keep those professionals safe , and so we provide a number of recommendations , which includes the education that has to be an exercise science I think it's one you have to have the right certification , you have to have continued education , you have to have a specific training and athlete safety , et cetera .

There is about eight recommendations sorry , seven recommendations that we pushed out And they accepted it because the key component of it is just like because we work as a coalition , it's not one organization , it's multiple organizations .

Nsea , ncsap was on there and CSCCA worked together under the coalition banner to put these recommendations together in collaboration with other organizations , and that's key is that we work together to come up with those recommendations , and those were accepted by the NCAA In July . Those are going to be implemented .

So in order to continue to be a strength coach , you have to be able to do that and meet those requirements . Otherwise you're not going to be able to work in that industry .

It's just like , as we're continuing to push the industry , professionalism , we're recognized by HHS . It's huge .

The third one is the physical activity as a health measure , which we just talked about , and then the National Office of Health , which says we're a framework , is driving us now is tying those pieces together and actually writing out technically how this would actually work is really what we're working on now and actually working on it .

Looking ahead in the impact report and we'll link it to here to Mike , it's high school athlete safety is a big component . So , building on the wind that we have with NCAA , how can we then go to high schools ? because there are more deaths . I think there's three times as many deaths that are happening in high schools than they are at universities . You know .

So when you're running kids through a Conditioning program , how do you know that they had the right training ? Do parents know about there ? There's , there's things that you know . If I'm running really high level of strength conditioning programs . It could be run by a janitor , yeah right . So these good people are just like they look fit , safe enough .

If I knew that , if I was like knowing what I know now and my , my oldest daughters , and track and field and They're running through conditioning programs with little to no training and you're having them left heavy barbells over their head With little to no training and not understand , like how like safe and safety works , i Feel very uncomfortable .

Yeah , you know what I mean , when I worked as a lifeguard back in the day , there was trainings that we would do all the time in emergency sex procedures . How do you work effectively as a team , like there's trainings that you need to be able to do to work effectively to get there .

For us , high schools that are just like a wild west When it comes to conditioning conditioning folks We are sitting there , going like that is a aid , is a huge opportunity for us to make an impactful , to be impactful there too , of like getting qualified professionals Into those facilities , and whether it's the training up of the staff .

You already have to go through the same process to be considered Through a registration . How can you do that ? But then also , those who are strength-additioning professionals There's a job opportunity That's there too . Well , you're gonna hire somebody to oversee these programs or run the programs .

There are folks that that are certified as strength coaches , that are they're qualified to do this . So those are components that are there and , at the last part , being able to continue to underscore collaboration , you have to work together And I think that's that's the building .

Collaborations is one , and that's within our own industry , but really collaboration across industries , like interdisciplinary collaboration , is going to be huge and the big one is after that . It's like really kind of establishing and maintaining trust . I think , between all those things , i think that's really big things for us And it's just .

It is such an exciting time because you could just feel the momentum building .

See the work that we're doing . We are kind of like you do a lot of the organizational outreach for multiple organizations , so that's keeping your ears to the street .

I was kind of where the industry is going and our goal really for me as the president of the Coalition now is taking those things and then communicating it out , and I think that's the big thing for me is just being able to go . there's a lot of things about there . It's super complex .

My goal as president now is , now we've kind of established helping people understand what those components are and then in being that , the voice and champion for our professionals out there . So us reps or is one place that we're going to be able to do that There ? so us reps or is one place you can find us ?

on Twitter and LinkedIn and really join the conversation ? We we push out a lot of this stuff and we have on webinars , you know also take a lot of the panel discussions and really kind of make the less like I think , less formal and some people Need to stick talk more freely . I think it's just been very helpful too , so you can put a face behind .

It is really kind of understandable people are coming from and It really kind of making folks helping , help you folks understand where our industry is going , what we're doing this for them .

Well , francis , before we bring this to a close , this is actually a question that I've been interested to ask you for a long time , but I just haven't had you on the podcast . So it's the question I always had the podcast on And I think , i think I think we've hit . I think we've hit on so many things today .

I'm curious how you , how you , land the plane on this one . But you know , i consider this wellness paradox to be the Trust , interaction and communication gap that has existed between fitness professionals and our medical communities is literally our entire Conversation today .

No , if you can distill all of this down into you know One piece of advice to give the fitness professionals that are listening as to how to close off that gap , what would it be ? Oh , man .

If I think it's is that gap , because I think that's the , when I first got here in 2017 , the , i think there's , there's a couple things that Kind of led me to kind of registrations really kind of the key a Lot of us , because it distills a lot of of the way , the way I would consider Prepared to do it . So I think it's just like it .

Then , using like to like terms , i think that that's kind of like I guess a simple version of it , but I will say that I guess it's like , if you're , if you're gonna press me on how to and how to answer it , it's I think it's programs over people .

That When I think we did a survey at ACSM of our physicians and I think it's just like and there was like really kind of three survey questions , it was it's a really elegant survey , but it's really kind of like captured , i think , a lot of what we see in the industry . What is , what is your level of cross as a physician ?

to refer to specifically an actual , an exercise professional who has education , training experience About 50% , mm-hmm , which is kind of scary . We're going Oh my gosh , what the heck ? Yeah , and then it's what is your level of trust that you have of Referring to a facility that has run by qualified professionals , which I kind of describe About 50% ?

The third one was what is your trust to send them to a program that has Measurable outcomes , key performance indicators of improving health , wellness , etc . Nearly 100% , mm-hmm , i .

So I think that to me , if we're going to bridge the gap between both , it's the effective programs to set the level across between the program that you're delivering and connecting it to healthcare .

Because if you can adjust that and go , okay , well we're running a cardiac rehab program , a pulmonary rehab program , didibees Prevention Program , exercise Ecology Program , the program that is shown to have efficacy in the research and is improving health and well-being and reducing costs . That program is really the key .

Now , in order to run an efficacious program that reduces risk , it has to be delivered by qualified people . That , to me , if you're going to connect the two , is what needs to happen .

So it's working with this really ties in the research that we see at the universities that are happening , working with the employer sector and healthcare and being able to connect them all together . So this is the education , the training , the experience , everything else effective programs .

That , i think is our priority , and so I think that to me there are a number of tentacles that come out of it , of those effective programs .

But for the coalition for the registration of Actualized Professionals , it's you have to be minimally qualified , you have to be registered , in order to be a part of that , because we cannot break that trust And therefore you have to use other components that deliver these types of programs that can show those KPIs , the healthcare needs and the weighting .

I think that's our way ahead . I know that was kind of like it started off as just the registration , but really to me I think if you're bridging that gap , it's effective programs .

Any information we'd like to share with you from today's episode can be found on the show notes page by going to wellnessparadoxpodcom . forward slash episode 101 . Please be on the lookout for our next episode when it drops in two weeks , and don't forget to subscribe on your favorite podcast platform Until we chat again next . please be well .