Physical therapists are uniquely positioned through their knowledge and skills to help people become more physically active, which may reduce the consequences of physical inactivity for health-related quality of life and the global economy. The “Exercise is Medicine” (EIM) campaign was introduced in 2007. It holds that exercise may be prescribed like a medicine. Although this analogy doubtlessly has promoted innumerable life-changing conversations between clinicians and patients, there are important shortcomings to considering physical activity and exercise as medicine. In the United States, many of these shortcomings relate to how medical services are provided and remunerated. Medical care is provided in the context of exclusive groups, which are established by insurance, preferred service populations, or other characteristics that determine a basis for providing care. Exclusivity means that medical care is frequently provided in a type of club. The club structure of medical care jeopardizes the ability of nonmembers to benefit. Medical care clubs based on payment create an environment in which nonpaying customers may not benefit in the same manner as paying customers from approaches that consider exercise prescribed as medicine. This clinical perspective reviews the characteristics of exercise as a good, focusing on how it is prescribed by physical therapists, and discusses how physical therapists may become involved in the process of making exercise a public good by reducing its exclusivity. Multiple levels of involvement are recommended at the societal, community, and individual levels. These involvements may be guided by an existing construct proposed by the World Health Organization (WHO), which would bring the global physical therapy profession into a common alignment. This Perspective concludes with a discussion that anticipates the shortcomings of conceptualizing exercise as a public good to be addressed in future service delivery models.

中文翻译：

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超越物理治疗中的“作为医学的运动”：向促进运动作为公共产品的方向发展

物理治疗师通过他们的知识和技能具有独特的定位，可以帮助人们变得更加活跃，这可能会减少身体不活动对与健康相关的生活质量和全球经济的影响。“运动就是药物”（EIM）运动于 2007 年推出。它认为运动可以像药物一样被开出处方。尽管这种类比无疑促进了临床医生和患者之间无数次改变生活的对话，但将身体活动和锻炼视为医学存在重要缺陷。在美国，许多这些缺点与医疗服务的提供和报酬方式有关。医疗服务是在由保险、首选服务人群、或其他决定提供护理基础的特征。排他性意味着经常在某种俱乐部中提供医疗服务。医疗保健的俱乐部结构危及非会员受益的能力。基于付费的医疗保健俱乐部创造了一种环境，在这种环境中，非付费客户可能无法像付费客户那样从将运动视为药物的方法中受益。这种临床观点回顾了运动作为一种商品的特征，重点关注物理治疗师如何规定它，并讨论物理治疗师如何通过减少运动的排他性来参与使运动成为公共产品的过程。建议在社会、社区和个人层面进行多层次的参与。这些参与可能以世界卫生组织 (WHO) 提出的现有结构为指导，这将使全球物理治疗专业成为一个共同的联盟。本展望以讨论结束，该讨论预测了将锻炼概念化为公共物品的缺点，以在未来的服务交付模型中解决。