1. A Day in the Life of a Certified Athletic Trainer…
Pediatric Physician Extender & Performance Enhancement Program

2. Joe Schmitz, ATC, is working as a pediatric physician extender at St
Joe Schmitz, ATC, is working as a pediatric physician extender at St. John’s Sports Medicine in Missouri. As a pediatric physician extender, Schmitz helps improve the physician's efficiency. Athletic trainers working as physician extenders assist in physicians offices by:
Saving time : Certified athletic trainers help move patients faster through the evaluation and treatment process, decreasing patient wait time.
Increasing Patient Satisfaction: Patients like the personal care and attention that athletic trainers provide.
Generating Revenue: Athletic training services are reimbursable by many insurance companies, and services are either directly billed or billed incident to physician services.
Increasing Physician Productivity and Efficiency: A 1998 Time on Task study showed athletic trainers working as physician extenders increased clinic production by 12 patients per day.
Educating Patients: Understanding their path to recovery helps put patients minds at ease.
© 2008 National Athletic Trainers’ Association
(800)TRY-NATA

3. Athletic Trainers as Physician Extenders
ATHLETIC TRAINERS WORKING IN PRIMARY CARE
The skills of the AT can be substantially utilized not only in the orthopedic setting but even more so in the primary care setting.
Athletic trainers are useful because they can assist physicians with patients seeking help with orthopedic issues. This enables the physician to see upwards of seven other non-orthopedic cases in a day.
FUNCTIONS OF THE ATHLETIC TRAINER IN PRIMARY CARE
Orthopedic evaluation
Triage
Home exercise prescription
Treatment
Sports physicals
Brace fitting
Lumbopelvic and foot biomechanical exams
Patient education
Follow-up care

4. I am an athletic trainer working as a Pediatric Physician Extender
NAME:
Joe Schmitz
Credentials
ATC
JOB TITLE:
Manager
EMPLOYED BY:
St. John’s Sports Medicine-Health Tracks
JOB LOCATION:
Springfield, MO

5. St. John’s Sports Medicine Health Tracks: HISTORY (THEN)
HISTORY OF PHYSICIAN EXTENDER MODEL
AT ST. JOHN’S SPORTS MEDICINE
The physician extender model was started in 1996 by a pediatrician who teamed with an athletic trainer.
Initial team was composed of:
Pediatrician
Nurse Practitioner
Two Registered Nurses
One Certified Athletic Trainer

6. St. John’s Sports Medicine Health Tracks: PRESENT
CURRENT PHYSICIAN EXTENDER MODEL
Four Athletic Trainers
Three Strength and Conditioning Specialists
12,000 Square Foot Facility
Sports Medicine Rehabilitation
Nine-table treatment room
Sports Enhancement Program

7. Pediatric Physician Extender Job Description
Provide services that identify, prevent, remediate and rehabilitate acute or prolonged physical dysfunction or pain which arise from sports related activities
Such treatment encompasses evaluation and analysis of patients and therapeutic application of physical and chemical agents, exercise and other procedures to maximize safe return to activities.
Ensure professional and technical operation of business unit and that all policies and procedures are followed on a day-to-day basis
Responsible for the overall management of the business unit in accordance with system initiatives: communication, customer service, quality assurance and community health care

8. Pediatric Physician Extender: FUNCTIONS
FUNCTIONS OF THE ATHLETIC TRAINER
Provide the highest level of quality cost effective care in conjunction with the medical team
Quality care + customer satisfaction = SUCCESS
How do you measure success?
Reimbursement rates
Increased patient flow
Decreased patient wait times
Increased patient satisfaction

9. Pediatric Physician Extender: FUNCTIONS CONTINUED
ENSURING QUALITY AND CUSTOMER SATISFACTION THROUGH:
Comprehensive evaluation (obtaining patient histories, exam, etc.)
Communication
Education
Case Management
Triage
Follow-up
Exercise Prescription

10. Common CPT Codes used by AT Physician Extenders
Athletic Training Evaluation / Re-Evaluation
97005 / (or up-code physician visit)
Therapeutic Exercise
97110
Therapeutic Activities
97530
Orthotics/Brace Fitting
97760
Treatment Modalities
97010 / / 97035
Iontophoresis
Electric Stimulation
Neuromuscular Re-education
Manual Therapy
Home Care

11. Pediatric Physician Extender – Patients
Age range is years old
3,400 injury evaluations/ rehabilitation visits per year
11,000 Sports Performance program visits per year
Most common injuries: 1. Ankle Sprain
2. Knee Sprain/Strain
3. Back Pain

12. A Day in the Life of a Pediatric Physician Extender
TYPICAL SCHEDULE FOR MY JOB:
Monday through Friday
11 a.m. to 7:30 p.m.
Occasional event coverage on weekends

13. Educational Background
MY ATHLETIC TRAINING
EXPERIENCE LEVEL IS:
Bachelors of Science in Sports Medicine & Athletic Training from Missouri State University
Approved Clinical Instructor
Functional Movement Screen Evaluator
Certified Club Coach by USA Weightlifting
8 years in the health system

14. A Day in the life of a Pediatric Physician Extender
SALARY RANGE:
$40,000 – $60,000
EMPLOYEE BENEFITS:
Health, dental and eye insurance
Retirement investment health system matching plan
Health System Personal Pension Plan
Continuing education/job development training
Sick time
Paid vacation
Flex spending account

15. My Company Hired Me Because…
“I hired an athletic trainer because I needed someone with the same knowledge as myself in sports medicine, but who also had a comprehensive skill set.
“With the size of my patient practice, the
health care of my patient encompasses a
team approach. Athletic trainers are an essential part of that team.
“This team approach is the most efficient
method to administer care in any healthcare
practice.”
-Bernard Griesemer, M.D.
Pediatrician
Board Certified in Sports Medicine
American Academy of Pediatrics
Council on Sports Medicine and
Fitness

16. A Day at the Office MONDAY, FEBRUARY 12, 2007 84 pediatric visits
53 for physician
31 for nurse practitioner
18 rehab patients
Divided four athletic trainers
50 strength and conditioning patients
Divided among two strength & conditioning specialists
152 total patients
The AT saves the physician time by helping increase patient load through the day.
It takes 42 minutes for a full orthopedic exam.
When an athletic trainer assists,
the physician can see approximately seven other patients. This is because the AT provides a comprehensive orthopedic exam with exercise prescription.

17. Daily Duties- Morning Chart notes documentation Supply ordering
Managers meetings
System meetings
follow-ups
Joint Commission compliance tasks
Chart audits
Marketing projects
Financial review
Patient evaluation/rehabilitation

18. Daily Duties: Afternoon/Evening
Patient evaluation and rehabilitation
Consultation with physicians
Nutrition counseling (supplements)
Monitoring floor for strength & conditioning program
Pediatric patient evaluation
Lumbopelvic Biomechanical evaluations
Foot Biomechanical evaluations
Orthotics fabrication
Functional movement screen evaluations
Brace/splint fitting

19. Other Duties Outreach Coverage of Events Strength & Speed Camps
Community Education Programs
Advertising Programs

20. Every AT must have a skill set that separates them from the field:
Essential Skill Sets
Every AT must have a skill set that
separates them from the field:
Lumbopelvic Biomechanical Assessment
Foot Biomechanical Assessment
Orthotic Fabrication
Splint/Cast Fabrication & Application
Throwing Mechanics Assessment
Pre-participation Sports Physicals
Triage
Nutritional Supplement Knowledge
Strength & Conditioning Programming

21. The Major Issues Justification of your salary How you produce revenue
Billing at your clinic
How you benefit the physician .

22. Making it in a Managed Care Environment
Chasing the healthcare dollar has become more and more difficult. The idea is to justify our existence by continuing to produce revenue.
The Team Medicine is the most efficient and profitable approach to medicine.
Who makes up the team?
Physician(s)
Certified Athletic Trainers
Certified Strength & Conditioning Specialists
Nurse Practitioners, Physician Assistants
Registered Dietitians
Registered Nurses, Licensed Practical Nurses, & Medical Assistants
Front Office

23. Performance Enhancement Program Integration <a quick side note>
Our performance enhancement program initially began not only to improve sports performance but primarily as an injury prevention program.
The program is set up to start at age 11 through college age.
In order to be successful, your program must diversify to include relationships with many already established organizations.
Our success story include relationships with:
Public Schools
Area Universities
Parks Department
Club Teams
Community Olympic Development Program

24. WHAT I wish I knew before this job:
I wish I knew more about the daily operations of a pediatric clinic prior to being hired. If I had this knowledge prior to my hiring, I would have had a smaller learning curve and could have been more efficient.
© 2008 National Athletic Trainers’ Association
(800)TRY-NATA

25. Key Resources to Learn More!
First and foremost is - seeking advice from colleagues is a MUST.
I utilize the NATA for most professional improvements but have found the NSCA and NASM as great organizations to aid in my personal and professional improvement.
Finally, I have a great group of co-workers that also push me to think outside the box.

26. Learn more at www.nata.org
Visit Career Development Resources on NATA Web site and find:
- Videos
- Brochures
- PowerPoint Presentations
- Studies
- Marketing Materials
- Advisors to assist with your specific questions
*NATA members only section
Visit Career Development Resources TODAY
(800)TRY-NATA
© 2008 National Athletic Trainers’ Association

27. Still need more information about Athletic Trainers as Physician Extenders?
Contact the NATA National Office Staff: Kathryn Ayres, PR and Marketing Coordinator | ext. 138
Write to Joe Schmitz:
(417)

28. Want to hire an athletic trainer?
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.
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© 2008 National Athletic Trainers’ Association