Athletic Trainers as Physician Extenders

Forrest Pecha MS, ATC, LAT, OTC, CSCS

Director of Residency, Outreach, Business DevelopmentSt. Luke’s Elks RehabilitationSt. Luke’s Sports MedicineNATA CEPAT Committee

Physician Extender Liaison

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DisclosuresDisclosures

Institutional and Research Support Ossur Americas DJO

Consultant DJO Ossur Americas

Who is a Physician Extender?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?

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