© 2008 national athletic trainers association (800) try-nata hospital / clinic uw health sports...

© 2008 National Athletic Trainers’ Associationwww.nata.org (800) TRY-NATA

Hospital / ClinicUW Health Sports Medicine

A Day In the Life of a Certified Athletic Trainer…


Physicians are learning that certified athletic trainers help

improve their productivity while improving patient outcomes and satisfaction.

Certified athletic trainers are regularly employed in the

orthopedic, family, pediatric, physiatry and sports

medicine practices.

Athletic trainers work effectively as physician extenders.

Here is how:

Increase Physician Productivity/Efficiency Time Savings

Revenue GenerationPatient SatisfactionPatient Education

Certified athletic trainers help move patients faster through the

appointment and treatment process. This helps to increase the

physician’s productivity and efficiency, which ultimately aids the

Bottom line. By treating more patients in the same period of time,

physicians are able to increase billing, revenue and patient throughput.

Learn how one athletic trainer is working as a

physician extender in this Day In the Life Presentation.

© 2008 National Athletic Trainers’ Associationwww.nata.org (800)TRY-NATA


I am an Athletic Trainer Working in a Hospital / Clinic

NAME: Nicole Lanza

CREDENTIALS: MS, LAT

JOB TITLE: Athletic Trainer

EMPLOYED BY: UW Health Sports Medicine

UW Hospital & Clinics specialty outpatient clinic

JOB LOCATION: Madison, WINATA NOTE:

NATA has about 500 members whose titles are ‘Physician

Extender.’ More work as physician extenders but with

different titles. (October 2007)


Hospital / Clinic Athletic Trainer- Minimum Requirements

Graduation from an accredited four-year college or university with major course work in athletic training or related field

Entry-level administrative and managerial skills

Bachelor’s degree required

Master’s degree preferred

Experience working in a clinic setting preferred

CPR certified

AED certified


UW Health Sports Medicine A Historical Overview

1975 1984

1995

1999

2000

2007

1981

The Sports Medicine Clinic was started in the orthopedic clinic at UW Hospital by Bill Clancy,

MD.

The First Athletic Trainer, Brad Sherman was hired in the Sports Medicine Clinic.

The Sports Medicine Clinic moved from UW Hospital to 3313 University

Ave.

The Sports Medicine Clinic moves again to our current location:

621 Science Dr.(10 exam rooms, 8 physicians –

11,309 visits annually)

Licensure for Athletic Trainers was achieved

in the state of Wisconsin!

LAT’s started charging for their services at UW Health Sports Medicine.

(10 exam rooms, 8 physicians – 19,200

visits annually)

UW Health Sports Medicine is currently adding 9 new exam rooms

and 1 new orthopedic surgeon in August. Our totals will be 19 exam

rooms, 8 physicians.


UW Health Sports Medicine – History • UW Hospital was established by the Wisconsin Legislature in 1924

• It was first referred to as Wisconsin General Hospital, located at 1300 University Avenue but moved to its current location (600 Highland Avenue) in 1979

• UW Hospital was reorganized as a public authority on June 29, 1996

• Bill Clancy, MD brought Sports Medicine to the Clinic

• In 1981, Brad Sherman was the first athletic trainer to work in this clinic

• In 1995, Sports Medicine moved to its current location. The space allowed for 10 exam rooms and 8 sports medicine fellowship-trained physicians. In total, these physicians saw an average of 11,309 visits annually

• In 1999, licensure for athletic trainers was achieved in Wisconsin

• By 2000, licensed athletic trainers (LATs) were billing for services at UW Health Sports Medicine

• From 1995 to 2006, patient volume increased from 11,309 to 19,200 with no change in the number of rooms or physicians


UW Health Sports Medicine – Staff

The number of certified athletic trainers: 33

Other health care providers employed in the Sport Medicine Clinic:– Registered Nurses : 4 – Medical Assistants: 2– Nurse Practitioners: 1 – Physician’s Assistants: 2– Medical Doctors: 7– CA’s / Scheduling: 5


UW Health Sports Medicine – Patients

THE PEOPLE I TREAT:– We see a wide-range of

individuals with injuries related to athletics as well as injuries related to active lifestyles

– Most of our patients are in the athletic population

PATIENT AGE RANGE– 8 years old – 80 years old +

MOST COMMON INJURIES– Orthopedic injuries related

to the shoulder and knee


A Day In The Life Of A Hospital / Clinic Athletic Trainer

TYPICAL SCHEDULE FOR MY JOB:

~ 40 hours per week

Monday – Friday

8 a.m. – 5 p.m.


Educational Background

• BACHELOR OF ARTS Exercise & Sport Science

Emphasis in Athletic Training (Carthage College, Kenosha, WI)

• MASTER OF SCIENCE Athletic Training (Indiana State University, Terre Haute, IN)

* Most of the athletic trainers employed at UW have acquired a Master’s Degree


A Day In The Life Of A Hospital / Clinic Athletic Trainer

SALARY RANGE:– $44,000 - $57,000

EMPLOYEE BENEFITS: – Health Insurance– Dental Insurance– Disability Insurance– Life Insurance– Paid holidays– Retirement– Paid time off– Tuition reimbursement

ESTIMATED WORTH OF BENEFITS– Budgeted at 40% of base salary

– EXAMPLE: If you make $44,000 the actual cost to UW Hospital is $17,600 for benefits

NATA NOTE:The average salary for an NATA member working in the clinic setting,

according to the 2005 salary survey:

Clinic - Hospital-based Clinic $43,341 Clinic - Outpatient/Ambulatory/Rehab $43,223

Clinic - Physician-owned Clinic $42,688 Clinic - Secondary School/Clinic$35,227

Clinic – Other $42,782


My Career Path I began working in this setting after graduate school (2000-2001)

I began working as an Athletic Trainer for the USOC (United States Olympic Committee) 2001-2002 in Chula Vista, CA

After this one-year position, I relocated closer to my family in Madison, WI

While waiting for a position to open at the UW Health Sports Medicine Clinic, I was employed by The Princeton Club as a Personal Trainer (2002-2003)

I then traveled throughout the U.S. with NPF (National Pro Fast Pitch), a Women’s Profession All-Star Softball Team, for a summer promotional tour for the initiation of the WPSL

I started working for UW Health Sports Medicine (2003- current) as a half-time employee with clinic/outreach responsibilities

Over the last few years I have increased my appointment time to a full-time physician extender. My current responsibilities include clinic and administrative duties


Why I Like Working In The Hospital / Clinic The Hospital/ Clinic offers athletic trainers an opportunity to utilize

skills to help a much wider and diverse patient group Hospital/Clinic allows athletic trainers to practice beyond high school

and collegiate athletes

There are many ‘active’ people – whether professional or recreational – who deserve great care

It is within these settings that athletic trainers can be a force that drives improved care, while simultaneously establishing heightened awareness for our profession

I have the opportunity to work directly with several physicians on a daily basis

I feel challenged and continue to learn new things daily

I have had the opportunity to view/interpret different diagnostic tests (X-ray, MRI, CT, EMG, etc..)

I have regular hours throughout the week

I don’t work weekends


Employer TestimonialWhy Athletic Trainers are a Good Fit as Physician Extenders

“The athletic trainer is a very skilled and versatile healthcare provider that is

capable of assisting with nearly the entire spectrum of care within an orthopedic

clinic setting. The orthopedic training that an athletic trainer receives prepares

them exceptionally well for this role.”

“Athletic trainers are beneficial from a financial standpoint as they help us

increase our throughput and are able to generate revenue. This is in addition to

the very positive role they play in patient education and in improving overall

patient satisfaction. We plan to continue to expand their role in the future as

they have proven their worth time and time again.”

- Joe Greene, Supervisor of Athletic Training Services

UW Health Sports Medicine


Daily Duties- MorningMORNING DUTIES: Administrative duties

Working on details such as constructing the department newsletter

Triaging patients into appropriate clinics

Creating continuing education documents for our sports medicine clinic staff

Improving overall clinic function & efficiency


Working with Physicians

• Typically each physician has 25 - 30 patients scheduled in one half day of clinic

• 8 to 10 of these patients are typically new patients, whom have never before been seen by that particular provider

• In addition, our physician assistants and nurse practitioners are responsible for 3 - 6 patients seen for pre-operative workups

• With 3 athletic trainers scheduled to work each physician clinic, 1 individual may see an average of 8 patients in one afternoon


Daily Duties of a Physician ExtenderResponsibilities associated with thisphysician extender role include, but arenot limited to:

– History taking– Physical examinations– Ordering diagnostic testing – Case presentation of clinical

findings and impression to the physician

– Suture removal – Brace fitting– Exercise instruction– Clinical documentation and / or

referrals– Dictation of medical record

clinic notes


Daily Duties- Outreach Clinic and outreach athletic trainers

are contracted for 15 hours per week at their respective high schools

Athletic training facility hours are generally from 2:30 p.m. - 5:30 p.m.

Outreach athletic trainers are responsible for a high school’s extra event coverage during the week and on weekends (extra pay for extra work)

A select few of our outreach athletic trainers also work with area semi-professional teams


Other Duties As Assigned

Our organization hosts an annual Sports Medicine Symposium in Madison and typically our staff volunteer where help is needed

Continuing education meetings are held every Friday morning for our athletic trainers, sports medicine fellows, physical therapy interns, orthopedic and primary care physicians

Information is presented each week by one of the above individuals, and time is allowed for discussion on current research

Development of athletic training employer-based

education (aka fellowships) and mentorship programs continues


Essential Skill Sets

Personable with diverse population of individuals, including patients and other health care providers

Clear and constant communication

Ability to multi-task

Grace under pressure of fast-paced environment

Professionalism

Strong educational foundation

Evaluative skills


Helpful Continuing Education: WHAT:

Orthopedic Tech CertificationThis is by no means a requirement, but it enhances the abilities and versatility of the athletic trainer in this setting

OBTAINED FROM: National Association of Orthopedic Technologists (NAOT)

PURPOSE:Allows athletic trainers to help with casting, splinting and bracing. Increases the potential to grow professionally when working in a clinic/outreach facility

LEARN MORE:

www.naot.org


Learning Curve As with most positions, there is a

major learning curve in the initial few months. The difference between a sports venue and a clinic is significant

We currently have re-developed the orientation process. The athletic trainer now has at least four separate shadowing opportunities in the clinic, while progressing his/her role each time

A mentorship program has been developed for all new employees that allows for both professional and personal growth. Even with these two programs in place, the learning curve is very high initially


Issues and Opportunities:Our facility does not have major issues. However:

Issue: Individual state practice acts can be limitingOpportunity: Get involved to change your state practice act and lobby for Medicare

legislation at the federal level

Issue: Not all insurance companies reimburse for athletic training servicesOpportunity: Help your hospital/clinic administration and state athletic training

association educate third-party payers

Issue: Athletic trainers and their physician currently cannot be reimbursed for services provided to Medicare patients

Opportunity: Contact your members of Congress and ask them to co-sponsor the Medicare Access to Physical Medicine and Rehabilitation Services Improvement Act (H.R. 1846)

Issue: Physician understanding of and compliance with an athletic trainer’s knowledge and abilities

Opportunity: Educate physicians on the entry-level and advanced educational qualifications

Issue: Lack of athletic trainers in the sports rehabilitation realmOpportunity: Encourage more people to work in this setting so we have improved

networking opportunities and broader learning communities

Quality of Life“Overall, there is good quality of living because of the regular hours.

A balance of administrative time & actual clinic time is essential to quality of work life.”


Helpful Continuing Education:

Interpreting radiographic images Surgical procedures

© 2008 National Athletic Trainers’ Association


MESSAGE FOR THEATHLETIC TRAINING EDUCATORS

A strong educational foundation will include not only the hands-on and basic concepts of physical examination skills and critical thinking skills, but it will also include exposure to the clinic environment

Special attention should be paid to knowledge of radiological testing and clinical documentation

High quality hospital/clinic rotations are essential


Key Resources to Learn More!

COMMON WEB SITES I VISIT ARE:

– www.nata.org

– www.watainc.org

– www.uwsportsmedicine.org

– www.anatomy.tv

ASSOCIATIONS/ORGANIZATIONS I AM INVOLVED WITH INCLUDE:

– Wisconsin Athletic Trainers’ Association

– Great Lakes Athletic Trainers’ Association

– National Athletic Trainers’ Association

http://www.nata.org/

http://www.watainc.org/

http://www.uwsportsmedicine.org/

http://www.anatomy.tv/


Key Resources to Learn More! CONFERENCES AND SYMPOSIUMS RELATING TO MY JOB:

– UW Health Sports Medicine Symposium– NATA Convention

BOOKS I HAVE FOUND HELPFUL ARE: – Arnheim DD, Prentice WE: Principles of

Athletic Training, 10th ed., 2000, McGraw-Hill

– McKinnis LN: Fundamentals of Musculoskeletal Imaging, 2nd ed., 2005, F.A. Davis Company

– Konin JG, Wiksten DL, Isear JA: Special Tests for Orthopedic Examination, 1997, SLACK incorporated

OTHER REFERENCES I USE INCLUDE:– Other UW Health, health care professionals

that work at Research Park including, physical therapists, radiologists, physicians and exercise physiologists


Learn more at www.nata.org

Visit CAN-WORC on NATA Web site and find:

- Videos- Brochures- PowerPoint Presentations- Studies- Marketing Materials- Advisors to assist with your specific questions*NATA members only

http://www.nata.org/members1/CANWORC/index.cfm

Visit CAN-WORC TODAY

© 2007 National Athletic Trainers’ Associationwww.nata.org

(800)TRY-NATA


Still Need More Information about Athletic Trainers as Physician Extenders:

Contact the NATA National Office Staff:Kathryn Ayres, External Marketing, [email protected] | 800-879-6282 ext. 138

Write to Nicole Lanza, UW Health Sports Medicine: [email protected]

Write to Joe Greene, Supervisor of Athletic Training Services, UW Health Sports Medicine: [email protected]


LOOKING FOR A JOB? WANT TO HIRE AN

ATHLETIC TRAINER?

www.nata.org/careercenter

Visit the NATA Career Center today and find resources to help you find a job or hire an athletic trainer.

© 2008 National Athletic Trainers’ Associationwww.nata.org

(800)TRY-NATA

http://www.nata.org/careercenter

© 2008 national athletic trainers association (800) try-nata hospital / clinic uw health sports...

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