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Note: This webpage was updated on 4 October 2024 to remove certain references to personal information.

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Topic: Is Exercise and Sports Science Australia (ESSA) Heading in the Right Direction?

Topics of Discussion

 The purpose is to speak to the specific challenges being faced by members on these topics, to discuss both my own lived experience, observations and opinions, and those of others, and to offer some recommendations.

With this document, my aim is to address the following:

  1. ESSA’s communication style, reactivity and speed with members

  2. What advocacy do ESSA members want and need in the personal injury and workers compensation space?

  3. What is your experience when it comes to diversity and inclusion as an ESSA member?

  4. Transparency with membership fees and accreditation fees

ESSA’s Communication Style, Reactivity and Speed with Members

ESSA fails to effectively recognise the different circumstances of members, and to allocate appropriate and relevant resources and opportunities. The final page of the ESSA 2021 Culture Report was on defining the ESSA Team Roles. The final paragraph reads:

 “Members provide input and feedback as required to ensure outcomes being achieved in a way that benefits members. Raise concerns or risks when they occur and work together in finding solutions that will help manage these risks or challenges. Support the creation of effective, fun, responsive and impactful solutions achieved in a collaborative and inclusive way.”

At the ESSA NSW Chapter meeting in November 2022, when discussing the survey participation rates, a member commented that ESSA should reach out to the larger organisations and companies who employ ESSA members. The reasoning given by this particular member was that the opinions of managers and executives of larger organisations were “more valuable” than other members’. Additionally, this member commented that, if the entire membership is asked for opinion, there would be “too much noise.” I gave my opinion that all members should be equally valued and when another member has a differing experience to ours, it is an opportunity to hold a safe space to listen, engage and discuss. It is not the quantity of opinions which needs to be addressed, rather the inability of ESSA to filter through, to listen and understand the opinions, and to then develop solutions.

Every voice matters.

ESSA entering the space of social media and using Facebook groups as a communication platform has resulted in a few things:

  • Enhanced connectivity amongst the members, ESSA Chapter and ESSA National.

  • Increased the “noise” level

  • Highlighted the need for efficient communication

As of November 2022, the ESSA NSW Chapter Facebook group had approximately, 1,500 members, moderated by seven administrators. Generally, the page is used to advertise job vacancies, advertise professional development, to refer patients onto others, and to ask members for advice and information. There is one topic, however, which evokes the greatest number of responses and interactions from the membership. That topic is that of workers compensation, specifically icare and SIRA NSW. I will take one example from 1 June 2022, which was a post by (name not disclosed). The post was this:

“Today has been not a great day to be an EP but I have some burning questions for Anita Hobson-Powell Essa and/or someone from ESSA. There are no clear guidelines in relation to the needs of the insurer for Category C. The fees makes reference to bringing us in line with Physio, Chiro and Osteo so does that now mean we don't have to pay GST (just like the other professions). The travel rate is 72c per km but our award wage (Health Professional and Support Services Award) stipulates that we pay travel reimbursements of 80c per km. The only good thing is that as a small business owner we have 2 months to restructure, but based on the comments I am not the only one that feels SIRA and ESSA have little understanding about how we provide rehabilitation services to clients in the WC system. A large portion of my clients have been in the system for greater than 6-12 months receiving passive treatment and it takes at least 15 - 20 mins per session to break down the negative barriers they have developed around pain and movement. I think if industry consultation was completed properly a 45 min option for services for EP would have been fairer. I've been in the WC and EP system for 21 years and haven't been approached or contacted yet in relation to my opinion from SIRA and I had to call ESSA to provide information. Unfortunately the fact that ESSA and EP's yet to have a representative on SIRA continues to be an issue and their (sic) must be something legally wrong with this. I wonder how other professions would react if it was up to us to decide their future and the way that they should treat. It all seems very unfair and very disempowering sitting from this perspective. So much for providing a safe workplace and support and guidance from administration. Just disappointing and I feel for the small businesses and EP's that will potentially lose their jobs as a result of cost cutting.”

On 10 November 2022, the team at The Intelligent Rebellion had counted, 123 comments. In reading all 123 comments, the most notable sentiment was, frustration. Members were frustrated at the lack of communication, the lack of transparency, and the lack of consultation. There were questions raised regarding ESSA’s direction, proactiveness and leadership.

There was the occasional response from an ESSA National staffer, an ESSA Chapter Committee member, or a key opinion leader (KOL) who had been consulting with ESSA defending their position and explaining the actions and steps which ESSA had taken to help minimise the damage. The annoyance from the members with whom I have spoken, was the apparent lack of proactivity by ESSA to be ahead of the issue. In speaking with some members, I had learnt it wasn’t until a member had brought the issue to ESSA’s attention, that ESSA started to make some moves, and by this stage, there was little which could be done. For ESSA to then peddle their efforts as a win, and citing that the situation could’ve been worse only threw gasoline on the already raging fire.

Responsible leaders are emotive and intuitive, and they show genuine humanity, humility and openness. The root of the frustration appeared to be in the response from both ESSA staffers, and the KOLs telling members that it was a job well done, when the perception and feeling from the majority of members was quite obviously the opposite.  

 

Volunteers vs Everyone else

For many reasons, members are unable, unwilling or simply do not want to volunteer. This should not and does not disqualify them from complaining or commenting, nor does it make their opinion or experience less valuable than those who do choose to volunteer. When there is criticism, a default response from volunteer members is to publicly announce that they are sacrificing their time, energy and resources for the greater good of the community. This sentiment is usuallly followed by a suggestion that anyone who is raising an opinion or criticism should volunteer for ESSA. This virtue signalling by some of the volunteer members, and the inference that they are making sacrifices for the greater good of our community is simultaneously exhausting and exasperating. Let’s be real, the main reasons why members volunteer is because, ultimately, it benefits them and their own interests. Additionally, members are not forced to volunteer, hence the very notion of volunteering. So, really, if it’s such a burden and sacrifice to volunteer, then – don’t. Additionally, when a member chooses to volunteer, they take on the responsibility of serving both their own interests and that of their fellow members. Being a member volunteer does not make their opinion any more valuable.

Once again, I will use an example from the ESSA NSW Chapter Facebook page. In 2022, there were attacks on KOLs from other members who felt that there was not enough being done to support members in the SIRA NSW system, and there was general anger regarding the change to the fee schedule. Members publicly expressed their frustration and outrage, me included. I announced my article "ESSA vs SIRA NSW c.2020-2022." on a post which is dated 2 June 2022. One of the comments in response to the post was from (name redacted), who I understand to be a KOL. The comment read,

“Just remember the people who’s (sic) efforts you’re all trashing whilst you take pot shots from the sidelines here”

This type of comment could be harmful to both the people whose efforts are being trashed, and to those taking the “pot shots”. I acknowledge that my article could also be harmful. I can appreciate it is frustrating when KOL volunteer their time, effort and resources into advocacy and others then “take pot shots from the sidelines.” Especially when it might appear that those accused of taking “pot shots” might not have an insight into the process. I can also appreciate when non-KOLs take “pot shots” because they have not been included nor been given insight into the process. What it boils down to is this, there is an expectation by fee paying members that ESSA National and State Chapters are on top of things. And, it does appear that ESSA was on top of the SIRA NSW Fees.

Personally, I took issue with this comment. Firstly, my criticisms were not random nor unfounded. Secondly because the reason I’m on the sidelines is because, up until most recently, I had not been invited to play on the field. This was despite many offers to assist ESSA National, ESSA State, and the SIRA KOL with advocacy. In my very specific situation, it has taken my publicly releasing my articles and commentary, several private discussions with ESSA, and hundreds (yes, hundreds) of conversations with members to be offered a seat at the table. I know of other members who have also offered their time and resources to support ESSA with advocacy only to be rejected or ignored.

There is a lingering sense of resignation amongst members that, their voice does not matter. There is an ever-increasing group of members who feel they don’t have the experience or the knowledge, and who also believe that others are more qualified to make decisions and to provide opinion.

Simply put – there is a group of members who don’t feel they belong or that their opinion matters. Moreover, members simply do not trust ESSA.

Recommendation

  1. ESSA to employ a General Manager for the state chapters. Someone who is accessible and visible.

  2. ESSA to provide renumeration to State Chapter committee members and KOLs.

  3. ESSA to hold face to face open forums - town hall style.

  4. ESSA to employ outreach strategies. I have discussed with ESSA National a strategy to deploy ESSA members around the country to hold open, transparent, yet confidential discussions with other members, either one-on-one or in small groups. These members would then collate the information and send it back to ESSA National.

 

What advocacy do ESSA members want and need in the personal injury and workers compensation space?

A growing field of work for ESSA members is in the personal injury and compensable schemes (the schemes). This is the industry which I have spent most of my career within. For context, members who work in personal injury and compensation can be split into two distinct yet broad categories of,

  1. Treatment Providers

  2. Consultants

 Treatment Providers

These members predominantly work in private practice and provide services primarily guided by the Clinical Framework for the Delivery of Health Services [1]. In examining and monitoring the system, and in speaking with my peers, there are two main challenges faced by AEPs who provide treatments:

  1. Fees

  2. Independent Exercise Physiology Consults

 

Fees

Please refer to my discussion paper dated 23 February 2023 regarding EPC 009 – Consultation C in SIRA NSW.  An AEPs service provision is vastly different to those of other allied health professionals. AEPs believe their services are unique, and are best placed to assist with improving functional capacity through activity and exercise whilst also having the skills to address the psychosocial barriers which often present with patients in the compensable schemes. As such, treating AEPs believe they require,

  • Longer session durations

  • Equity in treatment provision to other AHP

 Treating AEPs are often faced with an internal battle between the margin of business and the mission of healthcare, particularly within the schemes. They struggle to work within the schemes because, often, they feel that they are being financially limited in their capacity to provide patients with the best care. As many AEPs have expressed to me, they find it difficult to provide evidence-based, quality services within a 30-minute session, particularly when patients present with significant psychosocial barriers. A common complaint is “by the time I get started, warm them up, time is up”, and “what am I supposed to get done in 30 minutes?”

Equity

Even with some similarities, every allied health discipline is different. Allied health disciplines do not need parity, they need equity and to be allocated the exact resources and opportunities needed to effectively support injured workers, to meet the principles of the framework, and to achieve the outcomes which the scheme so desperately desires.

The scheme must consider the role of each discipline, and at which stage of the recovery process the disciplines is referred. AHP providing services in the acute stage of recovery has vastly different needs to the one providing services in the sub-acute, and chronic stages.  Additionally, AHP employ various techniques and modalities in the delivery of services, again which require different resources.

 

Recommendation

  1. ESSA to advocate to the regulatory bodies.

  2. The topic of parity is paradoxical. It is not possible for AEPs provide longer session durations and then also ask for fee parity.

  3. ESSA to consider establishing fee standards and guidelines.

  4. Members to be open to discussing and sharing their fee structures with other members.

  5. ESSA to acknowledge that AEPs are unlike other treatment providers, and highlight the distinction of services.

  6. ESSA members to collaborate with other healthcare disciplines and create multi-disciplinary teams.

  7. Members require education on how patients could concurrently access multiple providers.

 

Independent Exercise Physiology Consultants

A long-standing concern by ESSA members is the lack of an independent exercise physiologist consultant. As the schemes stand, AEP treatments and treatment requests are peer reviewed by independent consultants with an allied health background as a physiotherapist, chiropractor, or osteopath [2]. Along with other members, I am increasingly frustrated by the apparent bias or perceived ignorance of the independent consultants in these peer-reviews. Comments I’ve often heard are “they don’t even know what we do,” and “how can physiotherapist assess my treatments as an exercise physiologist?”

ESSA members, particularly in NSW have been vocal about the need for an independent exercise physiology consultant (I-EPC). Depending on who you ask, the explanations for not having an I-EPC include, limitations to the AEP scope of practice; AEP not being regulated by AHPRA and as such, not meeting the medico-legal requirements of an independent consultant; and limitations in the current legislation which prevent an AEP from being appointed as independent consultant.

 

Recommendation

  1. ESSA to be forthright to membership regarding this issue, and to engage in transparent communication with members to,

  • End or park the discussion, and/or

  • Clearly and strategically define the pathway for ESSA members to be appointed as I-EPC.

Consultants

Within this category are three main categories:Workplace Rehabilitation Consultants whose services predominantly guided by The Nationally Consistent Approval Framework Workplace Rehabilitation Providers[3]

  1. Employer-based Injury Management Advisors who conduct services guided by internal organisation policy, and employer guidelines specific to Commonwealth and/or State and Territory based schemes.

  2. Claims Managers & Injury Management Specialists who are employed by the regulatory body, nominal insurers and/or claims and injury management service providers (also known as scheme agents, and more colloquially, “insurers”), and whose services are guided by guidelines and framework specific Commonwealth and/or State and Territory based schemes.

For the purposes of this section, the term “consultants” will be used to collectively refer to all three categories mentioned above. In examining and monitoring the system, there are two main challenges faced by AEPs who are consultants in the schemes..

  1. Acknowledgement by ESSA of these members

  2. Lack of professional development opportunities in this space

Acknowledgement by ESSA

According to the 2021/2022 ESSA National Workforce Profile Report[1] prepared by Miss Jessica Ballamy, the top three workplace sectors for ESSA accredited members are:

  • 26.6% of ESSA accredited members worked within a private allied health clinic.

  • 18.4% ESSA accredited members worked within a private exercise physiology clinic.

  • 9.7% of accredited members worked in the consultancy sector (primarily within workplace rehabilitation)

This data indicates consultancy primarily within workplace rehabilitation as being the the third largest workforce sector for ESSA accredited members. And yet, my ongoing personal experience of feeling treated like a second-class member is echoed by other consultants. ESSA has focused resources and advocacy towards members who prescribe exercise in clinical settings, to the general population, and to elite / high performance populations. The advocacy and marketing towards high performance and elite sports does, however, make some sense given the Brisbane 2032 Summer Olympic Games. Though, with so few members working in this space (sports club/team 2.5%; sports institute/academy 1.5%, according to the workforce report there appears to be many resources allocated a for a smaller portion of the membership. Now, I’m not suggesting that they should not have access to advocacy and ESSA resources, what I’m highlighting is, there is a disparity.

The workforce data indicates an increasing number of ESSA members are moving into consultancy roles. For this, there are many reasons, though, in monitoring the trends, it appears there is greater opportunity for career progression, higher salary and renumeration, and more flexible working options. Consultancy is trending towards the traditional corporate career pathway, particularly within the personal injury schemes and workplace rehabilitation industry. The salary for a new graduate and early career professional in consultancy could start from $70K, and injury management and claims manager roles upwards of $150K. Comparatively, according to the Pay Guide - Health Professionals and Support Services Award [MA000027][2], the salary for a Health professional employee level 4 - pay point 4 is approximately $118K per annum.

As it stands, accreditation with ESSA is only required if you are; a) providing treatmentss; b) prescribing exercises; and c) are providing workplace rehabilitation services. ESSA members who take on the other types of consultancy roles are realising the redundancy of their accreditation and membership. Over the years, I have spoken with a number of ex-members who chose not to renew their membership or accreditation for two main reasons, 1) they do not require membership or accreditation for their job role, and/or 2) they do not see the value in accreditation or membership. The challenge to ESSA is, how do you retain these people as members, and, once they’re gone, how do you get them back?

In the ecosystem of the personal injury and workers compensation, exercise physiologists who are working as claims management professionals are powerful partners for treating AEPs. Their intimate understanding and appreciation for the AEP scope of practice, and of the role an AEP could play in recovery combined with their decision-making powers, these claims management professionals are a group which ESSA has consistently overlooked.

Then, there are the members who maintain their accreditation solely because it is a requirement to perform their job. I have listened to my peers’ comments of,“if I didn’t need to be accredited to do my job, I wouldn’t be”, and “if there was any other option to ESSA, I’d probably take it”

Recommendation

  1. ESSA needs to actively acknowledge and engage with consultants.

  2. Maintaining accreditation and membership must be more attractive.

 

Professional development opportunities

ESSA has limited professional development opportunities for members working as consultants in the schemes. In recent years, there has been an increase in external providers offering courses, including my own company, Threesticks Training & Development, David Parkinson, and David Riley. For consultants to meet their continuing education requirements, ESSA members are attending workshops and courses which have little to no relevance to their day-to-day work. Therefore, attending courses has become a dull exercise in collecting points, and not in the spirit of lifelong learning and professional development. Some of the comments made by my peers, “This course has no relevance to what I do, I just need the points” and “I don’t really want to do another course on rehabbing the knee” and “this course is a waste of my time”

Most of the ESSA CPD offerings are aimed at treatment providers, usually around topics of exercise prescription for specific populations or conditions. Although, one could argue that knowledge of evidence-based research is valuable when working as a consultant, it does not satisfy the appetite for education in the very specific skills and knowledge needed by consultants. Consultants are relying on internal employer training, external providers, and other associations to access relevant professional development, rather than looking to ESSA for these CPD opportunities. With the data reporting nearly 10% of ESSA accredited members are working in consultancy, ESSA CPD opportunities need to increase, or at the very least offer CPD points parity.

Although universities are now offering subjects in workplace rehabilitation as a response to ESSA’s accreditation requirements, it is still in its infancy. Students and new graduates should have the same understanding of the potential career pathway as a consultant, as they do of the clinical career pathway.

Recommendation

  1. University courses to increase the exposure of students to consultancy work, and consider consultant placements as part of the curriculum.

  2. ESSA to maintain personal injury / workplace rehab / injury management as a part of the accreditation criteria.

  3. Increase ESSA CPD opportunities for consultants.

  4. Equal points value for ESSA vs non-ESSA accredited professional development.

What is your experience when it comes to diversity and inclusion as an ESSA member?

ESSA has witnessed an exponential growth in our profession. Members are now working in roles across almost every industry, from healthcare, education, retail, academia, biotech and healthtech, engineering and in the media. Though ESSA members continue to work in the more traditional clinical fields of Exercise Science & Research, amateur and elite sports, and with the general population, a growing work sector is within the personal injury, and compensable injury schemes. With the exponential growth of our profession, naturally comes a growth in the diversity of our members. As evident in the 2022 ESSA Culture Review, volunteers and members indicated that there is a “required culture” of inclusivity and diversity. Diversity comes in many forms, cultural and ethnic diversity, age, race, gender and gender identify, sexual orientation, disability, religious diversity, and personal and professional skills.

I will provide to very specific examples. The first was during the ESSA National AGM in/around May 2022. I asked a question regarding the direction and strategy for cultural diversity and inclusion. Anita Hobson-Powell, Chief Executive Officer of ESSA responded, and provided two examples. The first was ESSA had commissioned an artwork by an Indigenous artist which was used as her Zoom background, and the artwork was also incorporated across ESSA marketing and branding. The second example provided by Anita Hobson-Powell was that ESSA staffers were including their gender pronouns as part of their email signatures. Notwithstanding the importance of these two examples, they are low level, obvious, tokenistic and simplistic. What was most striking, and offensive to me, however, was Anita Hobson-Powell’s following comments. These comments were the effect of, we do these things to help, and I quote, “external groups” feel included. The use of the phrase “external groups” by the CEO of my professional association was simultaneously distressing and offensive. Kirsty Rawlings, ESSA President provided a response to my question following Anita Hobson-Powell. I cannot recall Kirsty Rawlings’ exact words, though recall feeling that her response acknowledged the challenges faced by ESSA, and a commitment to working towards a more inclusive and diverse organisation. 

The second example I will provide is from October 2021. ESSA released some marketing material in the form of social media tiles for the upcoming Allied Health Professional Day. We were informed via Facebook by a post by an ESSA staff member (*name has been removed) and as I downloaded the social media tiles, I noticed the lack of diversity in the people used on the tiles. I responded on the Facebook post, “Thanks (*name has been removed) . In the spirit of celebrating our whole community, does ESSA have media tiles for AHP Day which show the diversity of our members? I appreciate there are limitations to this, though having a few additional options would be great.”

To ESSA and the ESSA staff member (*name has been removed) credit, the response was swift and the ESSA staff member (*name has been removed) responded, “Hi Rhea, we have just added a few more options to that folder for AEPs to choose from.”

As someone who identifies as Asian-Australian, I feel there is an under-representation in ESSA of the CALD community. I don’t know what are the solutions.

In 2022, I wrote two articles, the first titled “ESSA We Have a Problem” and the second, ESSA vs SIRA NSW c.2020-2022” which shares more about my experience when it comes to diversity and inclusion as an ESSA member.

Transparency with membership fees and accreditation fees 

In February 2023, I posted the following on Linkedin (view original post)

“Exercise & Sports Science Australia (ESSA) is both the accreditation body and membership body for exercise physiologists and exercise scientists. Last year, as renewal fees went out, there were many questions both publicly and privately about our fees. As such, I suggested #ESSA National itemise the invoice to reflect these two options. It's disappointing that this has not happened for 2023 (at least not on my invoice). As a member, I expect transparency from ESSA and for the options to be clear. As a part of the industry roundtable for AEPs in December 2022, I had the opportunity to raise the issues of lack of transparency, and the growing distrust and discontent of a portion of the membership towards the association. I am not engaging in discussions about the actual fee nor am I engaging in discussions about what value membership and/or accreditation means to a person and their circumstances. My point is for there to be some transparency and clarity between what is the actual #accreditation fee and what is the actual #membership fee. So, once again, I am requesting #ESSA to itemise the fees on our invoice, and be clear about the choice people have in choosing to be, or not to be a member. (That is the question). When comes to accreditation, this is a requirement for exercise physiologists to be able to work in healthcare, workplace rehabilitation and other sectors, so there isn't much of a choice.”

 Each year, at the time of renewal, the membership engages in the same discussion. I have only two immediate requests:

  1. Could ESSA itemise invoices? (Accreditation Fee and Membership Fee)

  2. Could ESSA be transparent about the fees?

When, I have asked these questions previously, the response from ESSA has been, either the payment system is limited, or a member should call ESSA directly to discuss their options. Frankly, online purchasing technology is quite advanced. Surely, ESSA could invest in technology to make the process of renewal simpler and more transparent.

  

Always end with optimism

As is always, let’s end with optimism. The diversity of the ESSA membership is its strength. The association needs a new leader. A responsible leader who can properly and justly meet  role, normative, ethical, and moral obligations they have to the association. A responsible leader who is willing to be held accountable for the consequences of their actions and behaviours. And a responsible leader who will unlock the immense potential of our members and our profession by genuinely focusing on equity, belonging and inclusion.

Cheers for now, -Rhea ✌🏽

My opinions are strong and lightly held. Let’s have a discussion.

4 April 2023


 Footnotes:

[1] https://www.essa.org.au/Public/Advocacy/National_Workforce_Profile_Report.aspx

[2] https://www.fairwork.gov.au/employment-conditions/awards/awards-summary/ma000027-summary

[1] https://www.tac.vic.gov.au/providers/type/content/clinical-framework

[2] https://www.sira.nsw.gov.au/for-service-providers/A-Z-of-service-providers/independent-consultants

 [3] https://www.hwca.asn.au/nationally-consistent-approval-framework-workplace-rehabilitation-providers/