Transitions are difficult. Lots of questions arise, especially in the case of transitions that are unfamiliar or require us to venture into the unknown.  In this particular blog entry, I wanted to talk about the transition from traditional athletics to the physician practice setting. This is a transition that I have gone through the past few weeks as I recently started working in a specialty office that treats concussion patients. I wanted to share some of my insights about the transition, the benefits I see so far in this setting, and the adjustments that are required for this type of position compared to traditional settings.  I wanted to share some of the things I have learned and observations I have made during my transition and encourage that we implement more of them in traditional practice. Hopefully you all will find this informational and valuable! (Especially if you are looking to make the transition yourself! 🙂 )

So, for reference, I have been certified for the past 3 years, and have worked almost exclusively in the secondary school setting during that time. I think the first difference that many, including myself, don’t think about when it comes to changing settings is our role as a healthcare provider. In the secondary school setting, especially rural areas where patients may not have access to care, you are the one, usually sole person, guiding the care plan. Only when a patient fails to improve, or shows signs of needing care outside of our scope do we refer out to another provider. In the current setting I am in now, I no longer have as much say in the care plan for the patient. A patient’s restrictions, medication, and therapy are all dictated by the physician. I wouldn’t say this is a bad thing, but coming from a setting where you tend to have to do everything yourself, it can feel jarring that you are not making those types of decisions anymore.

This next difference is one of the main reasons I wanted to get into the physician practice and that is specialization. Being an athletic trainer obviously requires you to be proficient in a wide range of skills, especially in the traditional athletics setting. However, in the physician practice setting the skillset I use on a day to day basis is much more focused. In a nutshell my duties include reviewing prior documentation of the patient, obtaining a chief complaint, change of status, review of systems from the patient, any clinical testing, and properly documenting my encounter with the patient before updating my physician. Now there are other things I do outside of those four or five things, but those are the skills that best allow me to be successful. I enjoy this because when it comes to things like continuing education and quality improvement I can be hyper-focused on what my weaknesses are and what I can do to improve. The counter to this though is there are a lot of skills that I no longer use in my practice. The drawback being that if I ever were to start working in traditional athletics again I would probably experience some skill decay. Again, these are things that you need to consider when entering a specialized setting like physician practice.

Some other changes that I have gotten accustomed to are things like schedule, patient interactions, and differences in documentation. Something as simple as having a patient schedule may seem like such a small thing but it makes a world of difference being able to review a patient’s prior notes and visits to have a better game plan heading into each encounter. Concerning patient encounters, one thing that I have observed is that patients typically value and have positive perceptions of a provider that spends meaningful time learning about them and their problem. Now I can understand that younger patient populations might actually prefer their encounter go by faster because they are more concerned about getting to practice, or they really hate the idea of being injured. I think that being able to focus on the patient, and not have to worry about field setup, or being rushed by 5 patients at once is a valuable aspect of the physician practice setting. Now documentation is obviously going to be a different animal depending on your setting and system. Since our clinic is part of a hospital system we use a program called Epic. This system is used by the entire hospital, and it has functions that go well beyond what an athletic training staff would need or want. However, as we hopefully grow closer to more colleges and university implementing an independent medical model, the ability to have access to documentation from all other healthcare providers within a hospital system is invaluable. For athletic training staffs that are employed by hospitals to have the ability to access and use similar systems would be a huge step up in terms of quality for documentation and I would fully encourage any ATs who have not seen a system like Epic to find a way to see how the rest of the healthcare field documents patient encounters.

That really wraps up some of the differences and experiences I have had so far within my  physician practice setting. Obviously every physician practice setting is going to have a different environment and certain aspects of a job might be different. For anyone who is currently in the traditional setting that thinks that some of the benefits of the physician practice setting are great and wants to maybe incorporate things like a patient schedule or a better documentation system into their practice, here’s my advice: Everyone’s situation is different, so I can’t address every type of scenario. My biggest piece of advice would be to talk to your supervisor and stakeholders. Figure out what is feasible for your setting, and do a little bit of homework on what you want to implement. Do a small pitch on the benefits making changes in your setting could have for the organization. Starting a conversation is the key in most situations when it comes to making change and improvements. I only bring this up because having worked in the secondary school setting the past 3 years, I think there are a lot of small changes we can make within our practice that would make our jobs a lot easier and help us be more effective. However, if you don’t start having conversations with supervisors and stakeholders on the benefits of such changes they will never happen.

Hope you all enjoyed this post!  I’d love to hear more about what specialty areas others work in and what is one piece of advice you have for those transitioning to the physician practice setting?