day in the life - physician extender - schmitz

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Day in the Life of an Athletic Trainer

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A Day in the Life of an Athletic Trainer…:

Pediatric Physician Extender & Performance Enhancement Program A Day in the Life of an Athletic Trainer…

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Joe Schmitz, ATC, is working as a pediatric physician extender at St. John’s Sports Medicine in Missouri. As a pediatric physician extender, Schmitz helps improve the physician's efficiency. Athletic trainers working as physician extenders assist in physicians offices by: Saving time : Athletic trainers help move patients faster through the evaluation and treatment process, decreasing patient wait time. Increasing Patient Satisfaction : Patients like the personal care and attention that athletic trainers provide. Generating Revenue : Athletic training services are reimbursable by many insurance companies, and services are either directly billed or billed incident to physician services. Increasing Physician Productivity and Efficiency : A 1998 Time on Task study showed athletic trainers working as physician extenders increased clinic production by 12 patients per day. Educating Patients : Understanding their path to recovery helps put patients minds at ease. © 2011 National Athletic Trainers’ Association www.nata.org (800)TRY-NATA

Athletic Trainers as Physician Extenders:

Athletic Trainers as Physician Extenders ATHLETIC TRAINERS WORKING IN PRIMARY CARE The skills of the AT can be substantially utilized not only in the orthopedic setting but even more so in the primary care setting. Athletic trainers are useful because they can assist physicians with patients seeking help with orthopedic issues. This enables the physician to see upwards of seven other non-orthopedic cases in a day. FUNCTIONS OF THE ATHLETIC TRAINER IN PRIMARY CARE Orthopedic evaluation Triage Home exercise prescription Treatment Sports physicals Brace fitting Lumbopelvic and foot biomechanical exams Patient education Follow-up care

I am an athletic trainer working as a Pediatric Physician Extender:

I am an athletic trainer working as a Pediatric Physician Extender NAME: Joe Schmitz Credentials ATC JOB TITLE: Manager EMPLOYED BY : St. John’s Sports Medicine-Health Tracks JOB LOCATION: Springfield, MO

St. John’s Sports Medicine Health Tracks: HISTORY (THEN):

St. John’s Sports Medicine Health Tracks: HISTORY (THEN) HISTORY OF PHYSICIAN EXTENDER MODEL AT ST. JOHN’S SPORTS MEDICINE The physician extender model was started in 1996 by a pediatrician who teamed with an athletic trainer. Initial team was composed of: Pediatrician Nurse Practitioner Two Registered Nurses One Athletic Trainer

St. John’s Sports Medicine Health Tracks: PRESENT :

St. John’s Sports Medicine Health Tracks: PRESENT CURRENT PHYSICIAN EXTENDER MODEL Four Athletic Trainers Three Strength and Conditioning Specialists 12,000 Square Foot Facility Sports Medicine Rehabilitation Nine-table treatment room Sports Enhancement Program

Pediatric Physician Extender Job Description:

Pediatric Physician Extender Job Description Provide services that identify, prevent, remediate and rehabilitate acute or prolonged physical dysfunction or pain which arise from sports related activities Such treatment encompasses evaluation and analysis of patients and therapeutic application of physical and chemical agents, exercise and other procedures to maximize safe return to activities. Ensure professional and technical operation of business unit and that all policies and procedures are followed on a day-to-day basis Responsible for the overall management of the business unit in accordance with system initiatives: communication, customer service, quality assurance and community health care

Pediatric Physician Extender: FUNCTIONS:

Pediatric Physician Extender: FUNCTIONS FUNCTIONS OF THE ATHLETIC TRAINER Provide the highest level of quality cost effective care in conjunction with the medical team Quality care + customer satisfaction = SUCCESS How do you measure success? Reimbursement rates Increased patient flow Decreased patient wait times Increased patient satisfaction

Pediatric Physician Extender: FUNCTIONS CONTINUED:

Pediatric Physician Extender: FUNCTIONS CONTINUED ENSURING QUALITY AND CUSTOMER SATISFACTION THROUGH: Comprehensive evaluation (obtaining patient histories, exam, etc.) Communication Education Case Management Triage Follow-up Exercise Prescription

Common CPT Codes used by AT Physician Extenders:

Common CPT Codes used by AT Physician Extenders Athletic Training Evaluation / Re-Evaluation 97005 / 97006 (or up-code physician visit) Therapeutic Exercise 97110 Therapeutic Activities 97530 Orthotics/Brace Fitting 97760 Treatment Modalities 97010 / 97016 / 97035 Iontophoresis - 97033 Electric Stimulation - 97014 Neuromuscular Re-education - 97112 Manual Therapy - 97140 Home Care - 97535

Pediatric Physician Extender – Patients:

Pediatric Physician Extender – Patients Age range is 12 -16 years old 3,400 injury evaluations/ rehabilitation visits per year 11,000 Sports Performance program visits per year Most common injuries: 1. Ankle Sprain 2. Knee Sprain/Strain 3. Back Pain

A Day in the Life of a Pediatric Physician Extender :

A Day in the Life of a Pediatric Physician Extender TYPICAL SCHEDULE FOR MY JOB: Monday through Friday 11 a.m. to 7:30 p.m. Occasional event coverage on weekends

Educational Background:

Educational Background MY ATHLETIC TRAINING EXPERIENCE LEVEL IS: Bachelors of Science in Sports Medicine & Athletic Training from Missouri State University Approved Clinical Instructor Functional Movement Screen Evaluator Certified Club Coach by USA Weightlifting 8 years in the health system

A Day in the life of a Pediatric Physician Extender:

A Day in the life of a Pediatric Physician Extender SALARY RANGE: $40,000 – $60,000 EMPLOYEE BENEFITS: Health, dental and eye insurance Retirement investment health system matching plan Health System Personal Pension Plan Continuing education/job development training Sick time Paid vacation Flex spending account

My Company Hired Me Because…:

My Company Hired Me Because… “I hired an athletic trainer because I needed someone with the same knowledge as myself in sports medicine, but who also had a comprehensive skill set. “With the size of my patient practice, the health care of my patient encompasses a team approach. Athletic trainers are an essential part of that team. “This team approach is the most efficient method to administer care in any healthcare practice.” - Bernard Griesemer, M.D. Pediatrician Board Certified in Sports Medicine American Academy of Pediatrics Council on Sports Medicine and Fitness

A Day at the Office:

A Day at the Office MONDAY, FEBRUARY 12, 2007 84 pediatric visits 53 for physician 31 for nurse practitioner 18 rehab patients Divided four athletic trainers 50 strength and conditioning patients Divided among two strength & conditioning specialists 152 total patients The AT saves the physician time by helping increase patient load through the day. It takes 42 minutes for a full orthopedic exam. When an athletic trainer assists, the physician can see approximately seven other patients. This is because the AT provides a comprehensive orthopedic exam with exercise prescription.

Daily Duties- Morning:

Daily Duties- Morning Chart notes documentation Supply ordering Managers meetings System meetings E-mail follow-ups Joint Commission compliance tasks Chart audits Marketing projects Financial review Patient evaluation/rehabilitation

Daily Duties: Afternoon/Evening:

Daily Duties: Afternoon/Evening Patient evaluation and rehabilitation Consultation with physicians Nutrition counseling (supplements) Monitoring floor for strength & conditioning program Pediatric patient evaluation Lumbopelvic Biomechanical evaluations Foot Biomechanical evaluations Orthotics fabrication Functional movement screen evaluations Brace/splint fitting

Other Duties:

Other Duties Outreach Coverage of Events Strength & Speed Camps Community Education Programs Advertising Programs

Essential Skill Sets:

Essential Skill Sets Every AT must have a skill set that separates them from the field: Lumbopelvic Biomechanical Assessment Foot Biomechanical Assessment Orthotic Fabrication Splint/Cast Fabrication & Application Throwing Mechanics Assessment Pre-participation Sports Physicals Triage Nutritional Supplement Knowledge Strength & Conditioning Programming

The Major Issues:

The Major Issues Justification of your salary How you produce revenue Billing at your clinic How you benefit the physician .

Making it in a Managed Care Environment :

Making it in a Managed Care Environment Chasing the healthcare dollar has become more and more difficult. The idea is to justify our existence by continuing to produce revenue. The Team Medicine is the most efficient and profitable approach to medicine. Who makes up the team? Physician(s) Athletic Trainers Certified Strength & Conditioning Specialists Nurse Practitioners, Physician Assistants Registered Dietitians Registered Nurses, Licensed Practical Nurses, & Medical Assistants Front Office

Performance Enhancement Program Integration <a quick side note>:

Performance Enhancement Program Integration <a quick side note> Our performance enhancement program initially began not only to improve sports performance but primarily as an injury prevention program. The program is set up to start at age 11 through college age. In order to be successful, your program must diversify to include relationships with many already established organizations. Our success story include relationships with: Public Schools Area Universities Parks Department Club Teams Community Olympic Development Program

WHAT I wish I knew before this job::

WHAT I wish I knew before this job: I wish I knew more about the daily operations of a pediatric clinic prior to being hired. If I had this knowledge prior to my hiring, I would have had a smaller learning curve and could have been more efficient. © 2011 National Athletic Trainers’ Association www.nata.org (800)TRY-NATA

Key Resources to Learn More!:

Key Resources to Learn More! First and foremost is - seeking advice from colleagues is a MUST. I utilize the NATA for most professional improvements but have found the NSCA and NASM as great organizations to aid in my personal and professional improvement. Finally, I have a great group of co-workers that also push me to think outside the box.

Learn more at www.nata.org:

Learn more at www.nata.org Visit Career Development Resources on NATA Web site and find: - Videos - Brochures - PowerPoint Presentations - Studies - Marketing Materials - Advisors to assist with your specific questions *NATA members only section http://www.nata.org/members1/CareerDevelopment/index.cfm Visit Career Development Resources TODAY © 2011 National Athletic Trainers’ Association www.nata.org (800)TRY-NATA

Still need more information about Athletic Trainers as Physician Extenders? :

Still need more information about Athletic Trainers as Physician Extenders? Contact the NATA National Office Staff: Kathryn Ayres, PR and Marketing Coordinator KathrynA@nata.org | 800-879-6282 ext. 138 Write to Joe Schmitz: Joeschmitz11@hotmail.com (417) 234-7637

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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. © 2011 National Athletic Trainers’ Association www.nata.org (800)TRY-NATA

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