2. Athletic Trainers as Physician Extenders
Forrest Pecha MS, ATC, LAT, OTC, CSCS
Director of Residency, Outreach, Business Development
St. Luke’s Elks Rehabilitation
St. Luke’s Sports Medicine
NATA CEPAT Committee
Physician Extender Liaison
Boise ID

3. Disclosures Institutional and Research Support Consultant
Ossur Americas
DJO
Consultant

4. Who is a Physician Extender?
Look Around You
All Athletic Trainers are “physician extenders”
To work under the guidelines and supervision of a physician
To evaluate, treat, prevent athletic injuries (orthopaedic)
Know your state practice act

5. Evolution and History Temple University: Early 1970’s
Ted Quedenfeld ATC
Sports Med center for H.S. Athletes & adult recreation to be seen by MD and given same care as college
University of Wisconsin Hospital: 1981
- Brad Sherman ATC
- Bill Clancy MD
Indianapolis Indiana – Ortho-Indy 1983
Marje Albohm ATC (current NATA president)
Marje moved on to become Practice Administrator (1st ?)
OASIS – San Diego CA. 1985
Mark Howard ATC
Gary Losse MD
Dr Losse wanted MSK specialist in clinic and OR
Duel credentialed as OTC allowed assist in OR (1st ?)

6. How to find a PE position?
Past:
AT working in U or HS:
MD approached AT visa vera
Recent:
AT’s more aggressive in pursuit for position less demanding hrs
“Transition” position as MA
Educational training programs

7. What does an AT-PE offer MD’s?
A highly trained professional who is a recognized health care provider
A clinician who can provide optimal patient care and knowledge of muscular-skeletal injuries.
Increase Physician efficiency in clinic, giving them the ability to see more patients & ^ collections
ATC can use PM&R codes and perform services “in incident to” the physician and can be billed for.
Ability to hire an educated individual at approx 60% of a PA salary

8. How AT’s Support MD’s Practice
AT’s work as liaison b/w MD and patients
MD having a MSK specialist as a clinician
AT’s increase patient care with education
AT’s can improve cost effectiveness in clinic

9. AT Clinical Skills vs. Sideline skills
Taking patient histories *
Performing complete physical exams *
Presenting findings to physicians *
Pre-operative instructions/booking surgeries
Post-operative care *

10. AT Clinical Skills Answering patient phone calls
Answering Parent phone calls *
Completing patient paperwork (FLMA/disability)
Understanding of radiological findings
Teaching therapeutic exercises to patients *
Casting, splinting and brace fitting *
Coding and billing for AT services
“In Incident to service billing”

11. AT Clinical Skills Electronic Medical Records training and utilization
Patient medication reconciliation *
Electronic dictation of patient
Scribing for physician dictations
SOAP Notes *

12. AT/OT Operating Room Skills
AT obtains scrub privileges
May need duel credentialing
OTC
OPA-C
Possible to bill with other credential
Will increase MD efficiency

13. AT Operating Room Skills
AT can Assist Physician in:
Prepping and Draping of patients
Identifying and marking anatomical landmarks
Positioning patients
Perform PE under anesthesia
Understanding of instruments
Retracting Tissue
Preparation of ACL grafts

14. AT Operating Room Skills
AT can Assist Physician in:
Close and dress wounds
Apply post-op bracing
Provide post-op instructions and exercises
Coding and billing for OTC services

15. Athletic Trainers as Physician Extenders:
Can provide skills of multiple healthcare providers
Have an extensive musculoskeletal education
Can assist the orthopaedic physician in the clinic and OR
Improve the Business model for orthopaedic practices

16. What can an Athletic Trainer expect working as a PE?
Rewarding and challenging job
Refined and excellent physical exam skills
Understanding of the Orthopaedic/Sports Medicine practice
How to make your physician efficient in clinic = $$
Good paying position with good benefits and hours
Liaison between your physician and patients

17. Thank You!
Questions for the panel?
Boise ID