3 Athletic Trainers as Physician Extenders ATHLETIC TRAINERS WORKING IN PRIMARY CAREThe 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 CAREOrthopedic evaluationTriageHome exercise prescriptionTreatmentSports physicalsBrace fittingLumbopelvic and foot biomechanical examsPatient educationFollow-up care
4 I am an athletic trainer working as a Pediatric Physician Extender NAME:Joe SchmitzCredentialsATCJOB TITLE:ManagerEMPLOYED BY:St. John’s Sports Medicine-Health TracksJOB LOCATION:Springfield, MO
5 St. John’s Sports Medicine Health Tracks: HISTORY (THEN) HISTORY OF PHYSICIAN EXTENDER MODELAT ST. JOHN’S SPORTS MEDICINEThe physician extender model was started in 1996 by a pediatrician who teamed with an athletic trainer.Initial team was composed of:PediatricianNurse PractitionerTwo Registered NursesOne Certified Athletic Trainer
6 St. John’s Sports Medicine Health Tracks: PRESENT CURRENT PHYSICIAN EXTENDER MODELFour Athletic TrainersThree Strength and Conditioning Specialists12,000 Square Foot FacilitySports Medicine RehabilitationNine-table treatment roomSports 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 activitiesSuch 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 basisResponsible 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 TRAINERProvide the highest level of quality cost effective care in conjunction with the medical teamQuality care + customer satisfaction = SUCCESSHow do you measure success?Reimbursement ratesIncreased patient flowDecreased patient wait timesIncreased patient satisfaction
9 Pediatric Physician Extender: FUNCTIONS CONTINUED ENSURING QUALITY AND CUSTOMER SATISFACTION THROUGH:Comprehensive evaluation (obtaining patient histories, exam, etc.)CommunicationEducationCase ManagementTriageFollow-upExercise Prescription
10 Common CPT Codes used by AT Physician Extenders Athletic Training Evaluation / Re-Evaluation97005 / (or up-code physician visit)Therapeutic Exercise97110Therapeutic Activities97530Orthotics/Brace Fitting97760Treatment Modalities97010 / / 97035IontophoresisElectric StimulationNeuromuscular Re-educationManual TherapyHome Care
11 Pediatric Physician Extender – Patients Age range is years old3,400 injury evaluations/ rehabilitation visits per year11,000 Sports Performance program visits per yearMost common injuries: 1. Ankle Sprain2. Knee Sprain/Strain3. Back Pain
12 A Day in the Life of a Pediatric Physician Extender TYPICAL SCHEDULE FOR MY JOB:Monday through Friday11 a.m. to 7:30 p.m.Occasional event coverage on weekends
13 Educational Background MY ATHLETIC TRAININGEXPERIENCE LEVEL IS:Bachelors of Science in Sports Medicine & Athletic Training from Missouri State UniversityApproved Clinical InstructorFunctional Movement Screen EvaluatorCertified Club Coach by USA Weightlifting8 years in the health system
14 A Day in the life of a Pediatric Physician Extender SALARY RANGE:$40,000 – $60,000EMPLOYEE BENEFITS:Health, dental and eye insuranceRetirement investment health system matching planHealth System Personal Pension PlanContinuing education/job development trainingSick timePaid vacationFlex 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, thehealth care of my patient encompasses ateam approach. Athletic trainers are an essential part of that team.“This team approach is the most efficientmethod to administer care in any healthcarepractice.”-Bernard Griesemer, M.D.PediatricianBoard Certified in Sports MedicineAmerican Academy of PediatricsCouncil on Sports Medicine andFitness
16 A Day at the Office MONDAY, FEBRUARY 12, 2007 84 pediatric visits 53 for physician31 for nurse practitioner18 rehab patientsDivided four athletic trainers50 strength and conditioning patientsDivided among two strength & conditioning specialists152 total patientsThe 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.
18 Daily Duties: Afternoon/Evening Patient evaluation and rehabilitationConsultation with physiciansNutrition counseling (supplements)Monitoring floor for strength & conditioning programPediatric patient evaluationLumbopelvic Biomechanical evaluationsFoot Biomechanical evaluationsOrthotics fabricationFunctional movement screen evaluationsBrace/splint fitting
19 Other Duties Outreach Coverage of Events Strength & Speed Camps Community Education ProgramsAdvertising Programs
20 Every AT must have a skill set that separates them from the field: Essential Skill SetsEvery AT must have a skill set thatseparates them from the field:Lumbopelvic Biomechanical AssessmentFoot Biomechanical AssessmentOrthotic FabricationSplint/Cast Fabrication & ApplicationThrowing Mechanics AssessmentPre-participation Sports PhysicalsTriageNutritional Supplement KnowledgeStrength & Conditioning Programming
21 The Major Issues Justification of your salary How you produce revenue Billing at your clinicHow 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 TrainersCertified Strength & Conditioning SpecialistsNurse Practitioners, Physician AssistantsRegistered DietitiansRegistered Nurses, Licensed Practical Nurses, & Medical AssistantsFront 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 SchoolsArea UniversitiesParks DepartmentClub TeamsCommunity Olympic Development Program
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.