As a personal trainer and Sports Therapist in the Uk, i can back up Tony's point. Because of our problems with the NHS and the waiting rooms getting larger and larger, it is almost unfair to waste the GP's time to simply get the go ahead to begin an exercise program. As a personal trainer, if i  have any doubt about the risks of training an individual i refer them to the GP. (i should refer everyone). Nine times out of ten, due to their shear workload, he will spend <5 mins with the patient and do exactly what i would have already done .
- Blood pressure
- Resting Heart Rate
-Medical History
- Peak flow
- Possibly lifestyle (eg are you stressed? - always a fav. with Gp's that one - if in doubt just say paitent is stressed!!!!!!
 
So what is the point in refering the patient to the GP  in the fist place? Quite frankly, due greater availabilty of time, i would have a much better idea about the risks exercise may pose by checking every aspect of health and lifestyle. Naturally, if the client complains of chest pains refering to the arms etc then a GP is obviously needed to recommend an ECG or such like.
The reason i do it, is to cover my butt! If in doubt "pass the buck" to the GP, if he clears the patient and he drops down dead during a power walk, i am covered!
  Very cynical i know, but it is the way it goes. In fact several times GP's have sent the patient back to me saying that i would have more of an idea about the possible risks. Maybe maybe not, but now he has passed the buck back!!!
It is a sad world we live in now that this"blame culture" has evolved, but i guess we just have to deal with it! I understand the problem is much worse in the US than here, but we'll catch up i am sure!
 
Graeme Hilditch
 
 
-----Original Message-----
From: - for physiotherapists in education and practice [mailto:[log in to unmask]]On Behalf Of [log in to unmask]
Sent: 22 January 2002 21:32
To: [log in to unmask]
Subject: Re: Consult Your Doctor?

Dear Mel
Maybe things are slightly different in the United States but, here in the United Kingdom, if I wanted to begin an exercise programme I would only consult a Doctor (General Practitioner) to ensure that I still had my heart and lungs in the correct place and in reasonable working order; that I did not have any gross pathology which might be aggravated by a sudden change in exercise habits and a reassuring pat on the back that I was doing the correct thing in trying to ensure a more healthy life style. As the average GP allows about 5 minutes per patient and has a pile of notes on his desk about patients who may be genuinely ill, anyone asking for a 'clean bill of health' is likely to receive fairly short shrift. I think it would be unreasonable to expect detailed advice about the correct performance of a particular exercise or activity: that is not his job. Ensuring that there is no bar to undertaking an exercise programme must be part of his job.
You just have to make sure that you do not fall into the hands of a philosophical detirminist: I had the misfortune to meet such a guy once who honestly believed that our hearts are programmed at birth to beat X times.... and then you died! Any effort to raise the pulse rate was, in his view, tantamount to suicide. I think he was serious; he would keep quoting Henry Ford who famously said "Exercise is bunk. If you are well you dont need it and if you are ill you shouldn't do it"
Mel: when do we get your next paradox? My Saturday nights with a Gin and Tonic and a Mellism are almost a distant memory! Keep asking awkward questions.
Regards, Tony Windsor