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

Disclosures Institutional and Research Support Consultant Ossur Americas DJO Consultant

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

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 ?)

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

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

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

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 *

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”

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

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

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

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

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

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

Thank You! Questions for the panel? Boise ID