To even the most casual sports fan, the various roles of those on the sideline seem obvious. The coaches coach, the players compete, and the athletic trainers help the players stay in top physical shape and recuperate from injuries.
The athletic training profession has a much larger, and important, scope of work that extends far beyond the playing field. In fact, athletic trainers in the sports setting – whether at the professional, collegiate or youth level– account for just half of all athletic trainers.
Let’s first start with the education and training athletic trainers receive, which is extensive and rigorous. To be an athletic trainer, a person must obtain a bachelor’s degree in a program accredited by the Commission on Accreditation of Athletic Training Education (CAATE). Recently, the Athletic Training Strategic Alliance decided that the profession will soon require a master’s degree as a minimum educational requirement. Since more than 70 percent of athletic trainers currently hold at least a master’s degree, this change is simply keeping in line with the educational standards of the profession itself.
Athletic training education includes comprehensive patient care in five domains of clinical practice: prevention, clinical evaluation and diagnosis, immediate and emergency care, treatment and rehabilitation, and organization and professional health and well-being. Upon completion of a CAATE-accredited training education program, students are eligible for national certification by successfully completing the Board of Certification, Inc. examination; and as with many health care professionals, athletic trainers undergo continuous education to maintain the ATC credential.
Another common misconception is that these professionals are limited to the sports world, but these jobs account for only half of athletic trainers. Outside the world of professional, collegiate and youth sports, athletic trainers often work in a variety of settings, including physician practices, hospitals, orthopedic clinics, occupational health departments, police and fire departments, performing arts centers, and in all branches of the United States military. For instance, an athletic trainer may help a professional ballet dancer treat a minor injury or advise a patient on ways to fend off specific workplace injuries by showing them how to move differently as they perform repetitive or physically intense job tasks. Professionals may also be actively engaged in youth athlete safety issues, such as concussion prevention and the promotion of physical activity.
As health care professionals, athletic trainers often take patient histories, evaluate, measure, and fit patients for orthotics, educate patients on how to wear and use orthotics, and provide advice and treatment on injury prevention, among other services under the direction of a physician. However, in many ways, athletic trainers operate as independent health care professionals, with guidance from a physician and the scope of their services defined by the laws of the state in which they are licensed to practice.
As the delivery of health care services continues to evolve, the niche role that athletic trainers fill is likely to increase in demand. Many within the health care industry predict a physician shortage in the near future, which means doctors will need to rely on athletic trainers more than ever. With specific training and focused experience, they have the knowledge and bandwidth to expand upon the health care services provided by a physician. When doctors refer patients to athletic trainers, they free up time to see more patients, thereby giving each patient the specialized attention they deserve. Believe me, as a physician, I can tell you that having more time to see patients benefits everyone.
Unfortunately, the athletic training profession continues to be misunderstood. For example, athletic trainers work in conjunction with other health care providers in providing orthotic services to patients in integrated health systems, hospital-based, multidisciplinary orthopedic practices, outpatient rehabilitation clinics, and physician offices. However, many commercial insurers, and of particular significance, the Centers for Medicare and Medicaid Services (CMS), fail to recognize the level of education, training, and skills of athletic trainers, as evidenced by the recent release of a proposed rule updating the requirements for practitioners of prosthetics and custom-fabricated orthotics. Within the proposed rule, CMS published a list of professionals eligible to become qualified practitioners of custom-fabricated orthotics. Although athletic trainers’ expertise in orthotics exceeds, or is equal to that of the health care professionals identified by CMS as eligible to become qualified practitioners of custom-fabricated orthotics, athletic trainers were not included.
Although some commercial insurers cover the cost of an athletic trainer’s services, Medicare and Medicaid do not cover such medical expenses – something that needs to be reassessed as the demand for athletic trainers continues to increase and doctors rely on their services with increasing frequency. Quite frankly, the fact that athletic trainers frequently treat million-dollar athletes, but may not be able to treat an elderly patient recovering from a hip injury because it isn’t covered by Medicare is disingenuous.
With the anticipated changes in the delivery of care, athletic trainers are uniquely qualified to be an asset to both doctors and patients. It’s time for the health care industry, government, and insurers to understand the full scope and invaluable services provided by athletic trainers. We’ll all be better for it.
Philip Gingrey, MD is a former U.S. Congressman having served Georgia's 11th congressional district from 2003 to 2015. He is currently a Senior Adviser with the District Policy Group at Drinker Biddle & Reath LLP, whose clients include the National Athletic Trainers' Association.
The views expressed by this author are their own and are not the views of The Hill.