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A Day In the Life of a Certified Athletic Trainer…

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1 A Day In the Life of a Certified Athletic Trainer…
Hospital / Clinic UW Health Sports Medicine

2 Physicians are learning that certified athletic trainers help
improve their productivity while improving patient outcomes and satisfaction. Certified athletic trainers are regularly employed in the orthopedic, family, pediatric, physiatry and sports medicine practices. Athletic trainers work effectively as physician extenders. Here is how: Increase Physician Productivity/Efficiency Time Savings Revenue Generation Patient Satisfaction Patient Education Certified athletic trainers help move patients faster through the appointment and treatment process. This helps to increase the physician’s productivity and efficiency, which ultimately aids the Bottom line. By treating more patients in the same period of time, physicians are able to increase billing, revenue and patient throughput. Learn how one athletic trainer is working as a physician extender in this Day In the Life Presentation. © 2008 National Athletic Trainers’ Association (800)TRY-NATA

3 I am an Athletic Trainer Working in a Hospital / Clinic
NAME: Nicole Lanza CREDENTIALS: MS, LAT JOB TITLE: Athletic Trainer EMPLOYED BY: UW Health Sports Medicine UW Hospital & Clinics specialty outpatient clinic JOB LOCATION: Madison, WI NATA NOTE: NATA has about 500 members whose titles are ‘Physician Extender.’ More work as physician extenders but with different titles. (October 2007)

4 Hospital / Clinic Athletic Trainer- Minimum Requirements
Graduation from an accredited four-year college or university with major course work in athletic training or related field Entry-level administrative and managerial skills Bachelor’s degree required Master’s degree preferred Experience working in a clinic setting preferred CPR certified AED certified

5 UW Health Sports Medicine A Historical Overview
1975 1984 1995 1999 2000 2007 1981 The Sports Medicine Clinic was started in the orthopedic clinic at UW Hospital by Bill Clancy, MD. The First Athletic Trainer, Brad Sherman was hired in the Sports Medicine Clinic. The Sports Medicine Clinic moved from UW Hospital to 3313 University Ave. The Sports Medicine Clinic moves again to our current location: 621 Science Dr. (10 exam rooms, 8 physicians – 11,309 visits annually) Licensure for Athletic Trainers was achieved in the state of Wisconsin! LAT’s started charging for their services at UW Health Sports Medicine. (10 exam rooms, 8 physicians – 19,200 visits annually) UW Health Sports Medicine is currently adding 9 new exam rooms and 1 new orthopedic surgeon in August. Our totals will be 19 exam rooms, 8 physicians.

6 UW Health Sports Medicine – History
UW Hospital was established by the Wisconsin Legislature in 1924 It was first referred to as Wisconsin General Hospital, located at 1300 University Avenue but moved to its current location (600 Highland Avenue) in 1979 UW Hospital was reorganized as a public authority on June 29, 1996 Bill Clancy, MD brought Sports Medicine to the Clinic In 1981, Brad Sherman was the first athletic trainer to work in this clinic In 1995, Sports Medicine moved to its current location. The space allowed for 10 exam rooms and 8 sports medicine fellowship-trained physicians. In total, these physicians saw an average of 11,309 visits annually In 1999, licensure for athletic trainers was achieved in Wisconsin By 2000, licensed athletic trainers (LATs) were billing for services at UW Health Sports Medicine From 1995 to 2006, patient volume increased from 11,309 to 19,200 with no change in the number of rooms or physicians

7 UW Health Sports Medicine – Staff
The number of certified athletic trainers: 33 Other health care providers employed in the Sport Medicine Clinic: Registered Nurses : 4 Medical Assistants: 2 Nurse Practitioners: 1 Physician’s Assistants: 2 Medical Doctors: 7 CA’s / Scheduling: 5

8 UW Health Sports Medicine – Patients
THE PEOPLE I TREAT: We see a wide-range of individuals with injuries related to athletics as well as injuries related to active lifestyles Most of our patients are in the athletic population PATIENT AGE RANGE 8 years old – 80 years old + MOST COMMON INJURIES Orthopedic injuries related to the shoulder and knee

9 A Day In The Life Of A Hospital / Clinic Athletic Trainer
TYPICAL SCHEDULE FOR MY JOB: ~ 40 hours per week Monday – Friday 8 a.m. – 5 p.m.

10 Educational Background
BACHELOR OF ARTS Exercise & Sport Science Emphasis in Athletic Training (Carthage College, Kenosha, WI) MASTER OF SCIENCE Athletic Training (Indiana State University, Terre Haute, IN) * Most of the athletic trainers employed at UW have acquired a Master’s Degree

11 A Day In The Life Of A Hospital / Clinic Athletic Trainer
SALARY RANGE: $44,000 - $57,000 EMPLOYEE BENEFITS: Health Insurance Dental Insurance Disability Insurance Life Insurance Paid holidays Retirement Paid time off Tuition reimbursement ESTIMATED WORTH OF BENEFITS Budgeted at 40% of base salary EXAMPLE: If you make $44,000 the actual cost to UW Hospital is $17,600 for benefits NATA NOTE: The average salary for an NATA member working in the clinic setting, according to the 2005 salary survey: Clinic - Hospital-based Clinic $43,341 Clinic - Outpatient/Ambulatory/Rehab $43,223 Clinic - Physician-owned Clinic $42,688 Clinic - Secondary School/Clinic$35,227 Clinic – Other $42,782

12 My Career Path I began working in this setting after graduate school ( ) I began working as an Athletic Trainer for the USOC (United States Olympic Committee) in Chula Vista, CA After this one-year position, I relocated closer to my family in Madison, WI While waiting for a position to open at the UW Health Sports Medicine Clinic, I was employed by The Princeton Club as a Personal Trainer ( ) I then traveled throughout the U.S. with NPF (National Pro Fast Pitch), a Women’s Profession All-Star Softball Team, for a summer promotional tour for the initiation of the WPSL I started working for UW Health Sports Medicine (2003- current) as a half-time employee with clinic/outreach responsibilities Over the last few years I have increased my appointment time to a full-time physician extender. My current responsibilities include clinic and administrative duties

13 Why I Like Working In The Hospital / Clinic
The Hospital/ Clinic offers athletic trainers an opportunity to utilize skills to help a much wider and diverse patient group Hospital/Clinic allows athletic trainers to practice beyond high school and collegiate athletes There are many ‘active’ people – whether professional or recreational – who deserve great care It is within these settings that athletic trainers can be a force that drives improved care, while simultaneously establishing heightened awareness for our profession I have the opportunity to work directly with several physicians on a daily basis I feel challenged and continue to learn new things daily I have had the opportunity to view/interpret different diagnostic tests (X-ray, MRI, CT, EMG, etc..) I have regular hours throughout the week I don’t work weekends

14 Employer Testimonial Why Athletic Trainers are a Good Fit as Physician Extenders
“The athletic trainer is a very skilled and versatile healthcare provider that is capable of assisting with nearly the entire spectrum of care within an orthopedic clinic setting. The orthopedic training that an athletic trainer receives prepares them exceptionally well for this role.” “Athletic trainers are beneficial from a financial standpoint as they help us increase our throughput and are able to generate revenue. This is in addition to the very positive role they play in patient education and in improving overall patient satisfaction. We plan to continue to expand their role in the future as they have proven their worth time and time again.” Joe Greene, Supervisor of Athletic Training Services UW Health Sports Medicine

15 Daily Duties- Morning MORNING DUTIES: Administrative duties
Working on details such as constructing the department newsletter Triaging patients into appropriate clinics Creating continuing education documents for our sports medicine clinic staff Improving overall clinic function & efficiency

16 Working with Physicians
Typically each physician has patients scheduled in one half day of clinic 8 to 10 of these patients are typically new patients, whom have never before been seen by that particular provider In addition, our physician assistants and nurse practitioners are responsible for patients seen for pre-operative workups With 3 athletic trainers scheduled to work each physician clinic, 1 individual may see an average of 8 patients in one afternoon

17 Daily Duties of a Physician Extender
Responsibilities associated with this physician extender role include, but are not limited to: History taking Physical examinations Ordering diagnostic testing Case presentation of clinical findings and impression to the physician Suture removal Brace fitting Exercise instruction Clinical documentation and / or referrals Dictation of medical record clinic notes

18 Daily Duties- Outreach
Clinic and outreach athletic trainers are contracted for 15 hours per week at their respective high schools Athletic training facility hours are generally from 2:30 p.m. - 5:30 p.m. Outreach athletic trainers are responsible for a high school’s extra event coverage during the week and on weekends (extra pay for extra work) A select few of our outreach athletic trainers also work with area semi-professional teams

19 Other Duties As Assigned
Our organization hosts an annual Sports Medicine Symposium in Madison and typically our staff volunteer where help is needed Continuing education meetings are held every Friday morning for our athletic trainers, sports medicine fellows, physical therapy interns, orthopedic and primary care physicians Information is presented each week by one of the above individuals, and time is allowed for discussion on current research Development of athletic training employer-based education (aka fellowships) and mentorship programs continues

20 Essential Skill Sets Personable with diverse population of individuals, including patients and other health care providers Clear and constant communication Ability to multi-task Grace under pressure of fast-paced environment Professionalism Strong educational foundation Evaluative skills

21 Helpful Continuing Education:
WHAT: Orthopedic Tech Certification This is by no means a requirement, but it enhances the abilities and versatility of the athletic trainer in this setting OBTAINED FROM: National Association of Orthopedic Technologists (NAOT) PURPOSE: Allows athletic trainers to help with casting, splinting and bracing. Increases the potential to grow professionally when working in a clinic/outreach facility LEARN MORE:

22 Learning Curve As with most positions, there is a major learning curve in the initial few months. The difference between a sports venue and a clinic is significant We currently have re-developed the orientation process. The athletic trainer now has at least four separate shadowing opportunities in the clinic, while progressing his/her role each time A mentorship program has been developed for all new employees that allows for both professional and personal growth. Even with these two programs in place, the learning curve is very high initially

23 Issues and Opportunities:
Our facility does not have major issues. However: Issue: Individual state practice acts can be limiting Opportunity: Get involved to change your state practice act and lobby for Medicare legislation at the federal level Issue: Not all insurance companies reimburse for athletic training services Opportunity: Help your hospital/clinic administration and state athletic training association educate third-party payers Issue: Athletic trainers and their physician currently cannot be reimbursed for services provided to Medicare patients Opportunity: Contact your members of Congress and ask them to co-sponsor the Medicare Access to Physical Medicine and Rehabilitation Services Improvement Act (H.R. 1846) Issue: Physician understanding of and compliance with an athletic trainer’s knowledge and abilities Opportunity: Educate physicians on the entry-level and advanced educational qualifications Issue: Lack of athletic trainers in the sports rehabilitation realm Opportunity: Encourage more people to work in this setting so we have improved networking opportunities and broader learning communities

24 Quality of Life “Overall, there is good quality of living because of the regular hours. A balance of administrative time & actual clinic time is essential to quality of work life.”

25 Helpful Continuing Education:
Interpreting radiographic images Surgical procedures © 2008 National Athletic Trainers’ Association

A strong educational foundation will include not only the hands-on and basic concepts of physical examination skills and critical thinking skills, but it will also include exposure to the clinic environment Special attention should be paid to knowledge of radiological testing and clinical documentation High quality hospital/clinic rotations are essential

27 Key Resources to Learn More!
COMMON WEB SITES I VISIT ARE: ASSOCIATIONS/ORGANIZATIONS I AM INVOLVED WITH INCLUDE: Wisconsin Athletic Trainers’ Association Great Lakes Athletic Trainers’ Association National Athletic Trainers’ Association

28 Key Resources to Learn More!
CONFERENCES AND SYMPOSIUMS RELATING TO MY JOB: UW Health Sports Medicine Symposium NATA Convention BOOKS I HAVE FOUND HELPFUL ARE: Arnheim DD, Prentice WE: Principles of Athletic Training, 10th ed., 2000, McGraw-Hill McKinnis LN: Fundamentals of Musculoskeletal Imaging, 2nd ed., 2005, F.A. Davis Company Konin JG, Wiksten DL, Isear JA: Special Tests for Orthopedic Examination, 1997, SLACK incorporated OTHER REFERENCES I USE INCLUDE: Other UW Health, health care professionals that work at Research Park including, physical therapists, radiologists, physicians and exercise physiologists

29 Learn more at
Visit CAN-WORC on NATA Web site and find: - Videos - Brochures - PowerPoint Presentations - Studies - Marketing Materials - Advisors to assist with your specific questions *NATA members only Visit CAN-WORC TODAY (800)TRY-NATA © 2007 National Athletic Trainers’ Association

30 Still Need More Information about Athletic Trainers as Physician Extenders:
Contact the NATA National Office Staff: Kathryn Ayres, External Marketing, | ext. 138 Write to Nicole Lanza, UW Health Sports Medicine: Write to Joe Greene, Supervisor of Athletic Training Services, UW Health Sports Medicine:

LOOKING FOR A JOB? WANT TO HIRE AN ATHLETIC TRAINER? Visit the NATA Career Center today and find resources to help you find a job or hire an athletic trainer. (800)TRY-NATA © 2008 National Athletic Trainers’ Association

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