I’m Anne, a Clinical Exercise Physiologist, and I have been with Michigan Medicine since November 2018.  My colleagues and I are educated and highly trained professionals.  At Michigan Medicine, we are required to:

• Have a bachelor’s degree (though a master’s is preferred).
• Maintain basic life support (BLS) and advanced cardiac life support (ACLS) certifications. 
• Accumulate 1200 clinical internship hours to sit for the Clinical Exercise Physiologist certification which is required by one year of employment.

Our job involves complex clinical decision making to care for our patients.  We are involved in many areas of preventive and diagnostic cardiology.  Our skills are invaluable yet our wages are not equivalent to those with similar responsibilities and requirements.

We ask to be fairly compensated for the care that we provide and to allow growth in this profession to retain staff long term. Our current pay grade is not competitive or inline with other allied healthcare professionals  with comparable duties and education requirements such as registered dietitians, cardiac sonographers, or cardiac cath lab technicians.

“Clinical exercise physiologists (CEPs) possess a unique range of skills and knowledge regarding exercise testing, programming, and supervision for individuals with chronic health conditions as a result of their comprehensive education and clinical experience. Clinical exercise physiologists are formally trained in the physiological effects, and benefits, of both acute and chronic exercise in healthy and diseased populations.”  ~ ACSM Health and Fitness Journal 27 (2):p 20-26, 3/4 2023.

The Perpetual Training Mill

I have been essential in training new staff. There is a high turnover rate amongst new exercise physiologists. There have been 18 exercise physiologists hired over the past six years and only 8 of those have remained on staff in our department. Much of our time and resources have been spent training new staff quickly.  Major reasons are:

• Our role in providing high quality patient care is marginalized.
• Staffing shortages that lead to increased workloads and added duties.
• Low wages and low merit raises that do not keep up with the cost of living. 
• Lack of growth opportunities in our field.

Due to high turnover of staff, the new norm is constantly training new hires.  This places a heavy burden on more senior and experienced staff. Many of my colleagues have left to pursue careers with better pay and work/life balance.

“Personnel shortages of all types are the single greatest problem facing healthcare organizations. Numerous anecdotal experiences from cardiopulmonary rehabilitation programs have reported facing workforce departures, particularly by Clinical Exercise Physiologists (CEPs), as well as having difficulty filling subsequent vacancies. The exit of CEPs from the healthcare workforce, in combination with the looming healthcare staffing shortage, will pose significant challenges for both employers and patients unless meaningful changes can be made to satisfy the contributing causes of these departures. 

The challenge of inadequate, and at times, inequitable compensation has emerged as the leading issue for most CEP. Formerly elusive, CEPs now seem to have constructive tools at their disposal to move forward and advance reimbursement opportunities.” ~ Clinical Exercise Physiology Association (ACSM-CEPA)

No Acknowledgement for High Performance

We used to receive incentive pay for taking on extra tasks and small bonuses for high levels of patient satisfaction.  In 2020, the University of Michigan Medical Group (UMMG) took both of those incentives away.  While they were only a modest amount, they demonstrated our employer’s appreciation to us for going above and beyond.  

Despite this, we continue to go above and beyond because we deeply care about the patients we serve. Our patients know and appreciate the high level of care we provide. Earlier this year, our cardiac rehabilitation department received recognition as achieving top quartile performance in the 99th percentile for the Press Ganey Outpatient Services patient experience survey metric: “Overall Rating of Care”.

These are the challenges we are facing as Clinical Exercise Physiologists. My coworkers and I deserve fair compensation and improved workloads from our employer, Michigan Medicine.  

I have no doubt that adequate staffing and compensation would improve our workplace culture.  It would improve employee satisfaction and retention at Michigan Medicine.

~ Anne Dobek, Michigan Medicine Clinical Exercise Physiologist