Materials for Physicians/Administrators


Athletic Training Milestones Project

The Athletic Training Milestones Project Team has worked collaboratively since 2016 to develop the Athletic Training (AT) Milestones to enhance and facilitate assessment of student and resident learning.  The AT Milestones are designed for use in evaluation of athletic trainers in the context of their participation in Commission on Accreditation of Athletic Training Education (CAATE) accredited professional education, residency, and fellowship programs.

Certified Athletic Trainers in Physician Offices Unique Health Care Providers

Physicians are learning that certified athletic trainers (ATs) help improve productivity, patient outcomes and satisfaction. Certified athletic trainers are regularly employed in the offices of orthopedists and in family, pediatric, physiatry and sports medicine practices.

Integrating Physician Assistants and Athletic Trainers Into Your Orthopedic Practice

Pecha FQ, Greene JJ, Daley J, Shea K

As the national healthcare enviroment continues to change, providers and practices must continue to adapt to meet the needs of patients, regulatory agencies and payers. There is constant pressure on orthopedic and sports medicine practice administrators and physicians to improve access, maintain volume and improve quality, all while limiting the costs associated with healthcare delivery.

Athletic Trainers in a Physician Practice: Concussion Clinic Model

Kitano J, Soprano T, Paturzo M

What role does an athletic trainer serve in a concussion clinic?

What type of testing can an AT administer in a Concussion clinic?

In what other ways can an athletic trainer function within a Concussion Clinic?

How can an athletic trainer affect efficiency in a Concussion Clinic?

How does increased throughput generate increased revenue for physicians?


Relative Value Unit for the Athletic Trainer

Burfeind SM, Wetherington JJ

What is a Relative Value Unit (RVU)?

Why are RVUs used?

Practice efficiency, cost accounting purposes/fee schedule

What is the difference between total, work and facility RVUs?

Why do physicians care about RVUws?

Why do athletic trainers care about RVUws?

Why do administrators/private practices care about RVUws?

Patient Perception of Athletic Trainers and Orthopaedic Residents as Primary Clinical Support Staff

Pecha FQ, Nicolello TS, Xerogeanes JW, Karas S, Labib SA

Orthopaedic sports medicine practices utilize a variety of healthcare professionals to assist physicians in the clinic. The purpose of this study was to investigate patients' perception of orthopaedic knowledge and clinical care provided by orthopaedic medical residents and athletic trainers (ATs).

Hypothesis: ATs will be perceived similarly to orthopaedic medical residents in overall patient care and perceived education level.

Conclusion: There is no evidence that patients' perception is different when comparing ATs and orthopaedic medical residents in orthopaedic knowledge and clinical care. Although a statistically significant difference was found in the perceived highest level of education attained, orthopaedic medical residents and ATs were each perceived to have a master's degree level of education. Physicians should continue to use ATs in their practices.

The Financial Impact of an Athletic Trainer Working as a Physician Extender in Orthopedic Practice

Hajart AF, Pecha F, Hasty M, Burfeind SM, Greene J

The provision of care and business of musculoskeletal medicine have evolved signifncalty over the last two decades. It has become ever more important that those who are leading muskuloskeletal medicine practices evolve with the changing healthcare landscape and find new ways to provide higher quliaty and more cost-effetive care. To meet these new challenges, many orthopedic physicians are choosing to hire athletic trainers as a part of their office staff. Athletic trainers provide value to a medical practice through their skills in triage, taking patient histories, performing musculoskeletal evaluations, providing instruction on exercise prescription, rehabilitation, and general patient education. If a practice can become more efficient by narroworring staff to a single ancillary provider that encompasses several skills at a high level, this is where patient throughput and patient satisfaction scores can be improved by the athletic trainer as a physician extender.

Physician Satisfaction With Residency-Trained Athletic Trainers as Physician Extenders

Pecha FQ, Bahnmaier LA, Hasty ML, Greene JJ

Athletic trainers (ATs) have historically functioned in a physician extender role when managing the health of competitive athletes in high school, collegiate, and professional settings. A high level of expertise in the prevention and management of musculoskeletal disorders among physically active individuals has been recognized by physicians who have chosen to utilize ATs as physician extenders in orthopedic and sports medicine clinical operations. The development of postprofessional residency programs that provide specialized education and clinical experiences to prepare ATs to effectively function as orthopedic physician extenders has greatly facilitated physician acceptance of the role, which has dramatically increased the number of ATs working in the orthopedic clinical setting. Such residency programs provide ATs with experience in taking detailed patient histories, performing thorough patient exams, and presenting the findings to the attending physician for delivery of efficient and patient-centered care. The physician can focus on making the diagnosis and developing a plan of care, while relying on the AT to provide appropriate therapeutic exercise instructions, educate the patient about the plan of care, and complete specific components of the clinical documentation.

Previous studies have demonstrated that utilization of the residency-trained AT physician extender (AT-PE) has increased clinical efficiency (i.e., patient volume and revenue generation) and improved patient outcomes. Physician satisfaction with this approach to delivery of orthopedic clinical services has not been previously documented. Thus, the purpose of this study was to assess physician satisfaction with the performance of residency-trained AT-PEs in the delivery of orthopedic clinical services.


Hiring Patterns of Athletic Trainers in Ambulatory Care Settings

Frogner BK, Westerman B, DiPietro L

Athletic trainers (ATs) are often employed to provide direct patient care in ambulatory care settings, particularly in orthopedic practices. Given their training, ATs may both complement and substitute for services otherwise delivered by physicians or other providers such as physician assistants (PAs) and nurse practitioners (NPs). With concerns about projected primary care provider shortages,1  ATs may be hired to deliver cost-effective ambulatory care practices and to help keep up with the growing demand for primary care. The value of ATs in ambulatory care practices, however, is not widely recognized, in part due to the limited amount of research on the role of ATs in these settings.

This study aims to add to the literature by identifying the motivations of ambulatory care practice administrators for hiring an AT, and to gauge the perceived value of ATs in ambulatory care settings. In our expert interviews, we learned that ambulatory care practice administrators were satisfied with the work of ATs and that they planned to maintain or increase the number of ATs working in their practices. The respondents placed a high value on the knowledge and skills of the ATs they employ. While a larger study is necessary to track and assess the role of ATs in ambulatory care practices, the findings of our study highlight the value and potential growth in the demand for ATs for delivering patient care in ambulatory care settings

Athletic Trainers Pump up Care in Orthopedics Clinic

An editorial by Tyler Smith

The words “athletic trainer” might conjure images of hard-core sports enthusiasts of the professional or weekend warrior variety, sweating through rehab regimens to get their joints in shape so they can hit the fields or the slopes once more. The picture is not untrue, but it is incomplete. In the wider world, certified athletic trainers (ATCs) can help people recovering from orthopedic procedures get back to no-less-important activities, like gardening, walking the dog, or wrestling with the kids.

Certified Athletic Trainers An Evaluation of Their Effect on Patient Throughput & Revenue Generation

Pecha F, Karas SG, Xerogeanes JW, Dougherty T, Mines BA, Labib S, Kane A

While medical assistants (MAs), physician assistants (PAs) and nurses (RNs) are the “typical” clinical assistants used in physician practices, certified athletic trainers (ATs) — highly educated health care professionals who specialize in the prevention, assessment and rehabilitation of musculoskeletal injuries and illnesses — are gaining recognition as unique, skilled and valuable health care professionals in orthopaedic offices. In an effort to evaluate the benefit of employing certified athletic trainer, Emory Sports Medicine Center implemented a study to determine the financial and clinical effectiveness of using them as the primary clinical assistant in the orthopaedic office. By comparing the number of patient encounters and financials (bill charges and collections) of two primary care physician practices — both before and during the introduction of a certified athletic trainer — it was shown that certified athletic trainers had a positive effect on patient throughput and revenue. Results showed that ATs can increase a physician’s productivity up to 23% and increase revenue by up to 42%.

A New Twist: Using Certified Athletic Trainers as Physician Extenders

Holm L

A new health care model has evolved that uses certified athletic trainers (ATCs) as physician extenders. ATC's commpliment the work of other health care professionals such as physician assistants (PAs), nurse practitioners (NPs) and physical therapists (PTs).

Adding Athletic Trainers to Care Team Can Increase Docs' Productivity

An editorial by David Mitchell

According to the National Athletic Trainers' Association, or NATA, nearly 8,000 of its members worked in hospitals, clinics and physician offices last year (2003), and the number is growing. That figure, which represents more than a quarter of the association's members, is up more than 4 percent since 2001. The services these health professionals provide can bring significant value to a medical practice, says one family physician.


The Athletic Trainer as Orthopedic Physician Extender

An editorial by John W. Xerogeanes, MD

Supply and demand are the primary factors that drive our capitalistic economy. Professional opportunities and monetary compensation in a free market society are primarily determined by these factors. No matter how talented and highly skilled a particular group of professionals may be, success in the marketplace depends upon the specific needs of consumers and employers and possession of the specific professional capabilities to fulfill that demand. Between the two worlds of orthopedic surgery and athletic training, we have both the need and the skill to form a symbiotic working relationship. What we have been missing is a reproducible mechanism to bring the two together in a more integrated manner. In the last issue, Forrest Pecha’s editorial promoted the Orthopedic Athletic Training Fellowship concept as a valuable educational experience for athletic trainers. I will try to expand on his message from the perspective of an orthopedic surgeon.

Practice Profiles: Athletic Trainers in Orthopedic Offices

Featuring Aaron Hajart, Bryan Diekmann, Forrest Pecha and Mike Doyle

Athletic trainers (ATs) are routinely employed in hospitals, clinics, and in sports medicine, family, pediatric, orthopedic and physiatry practices. Physicians and practice managers say ATs working in these settings improve physician productivity, patient outcomes and satisfaction. They move patients more effectively and efficiently through the appointment and treatment process. By treating more patients in the same period of time, physicians are able to improve patient access, throughput and revenue generation

Comparison of the Effect of Medical Assistants Versus Certified Athletic Trainers on Patient Volumes

Pecha FQ, Xerogeanes JW, Karas SG, Himes ME, Mines BA

Research has shown increases in efficiency and productivity by using physician extenders (PEs) in medical practices. Certified athletic trainers (ATCs) that work as PEs in primary care sports medicine and orthopaedic practices improve clinic efficiency.

Hypothesis: When compared with a medical assistant (MA), the use of an ATC as a PE in a primary care sports medicine practice will result in an increase in patient volume, charges, and collections.

Conclusion: ATCs can optimize orthopaedic sports medicine practice by increasing patient encounters, charges, and collections.

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