By Mike Matheny
Mike Matheny, MS, ATC, is Head Athletic Trainer and Clinical Associate Professor in the Department of Exercise and Sport Sciences at Ithaca College. He can be reached at: email@example.com.
Two years ago, an opportunity presented itself that solved several problems we were experiencing in the athletic training department at Ithaca College. It also enabled us to develop a collaboration with our campus health center and help them out.
But first, here’s an overview of the issue. To start, we had a part-time athletic training position whose primary responsibility involved working with our women’s volleyball and wrestling programs. This was a difficult position for us to fill and maintain with any continuity, as it offered only a part-time salary, did not include benefits, and, since we’re not in a large metropolitan area, there were a very limited number of potential applicants. We had been able to fill it in the past, but the person usually only stayed for a year before moving on to full-time work. This meant indoctrinating a new staff member each year. It also ultimately meant providing less than optimal care to our volleyball and wrestling teams, since the person filling the position was invariably new each year and almost always a recently certified, inexperienced athletic trainer.
Meanwhile, our on-campus health center utilized a clerical position as an aide to our team physician during the 15 to 20 hours per week that he was typically on campus seeing athletes. The aide’s responsibilities mainly involved managing the team physician’s schedule, managing patient records, and some very minimal patient intake work. When the person occupying that clerical role resigned to pursue another job, we saw an opportunity to combine that position with our part-time athletic training position to create a new, full-time post. We thought we could utilize the skill set of an athletic trainer to vastly improve the assistance provided to our team physician, as well as provide continuity and increased expertise to our volleyball and wrestling teams.
Creating this unique position required cooperation from several different areas of campus. Because money for the part-time athletic trainer position was housed in an academic budget (we have an accredited undergraduate athletic training education program, and our athletic trainers are on faculty contracts with release time to athletics), and money for the clerical staff person was part of the health center budget, we had to get one area to agree to turn that portion of their budget over to the other area. This way, we would have enough money to create a full-time position with benefits.
We also had to decide if the athletic trainer would report to the health center or the head athletic trainer. After several meetings and much discussion, it was decided that the health center money would be turned over to the academic unit, and the athletic trainer would report to the head athletic trainer. This reporting model is consistent with all of our faculty/athletic training positions. Two differences being that the position is staff rather than faculty, and the athletic trainer works in the health center half the day rather than teaching courses. While we had to work to facilitate cooperation between the health center, our academic unit, the office of human resources, and our budget office, the result has been well worth it.
While our initial goals with merging two positions into one were to improve the assistance provided to our team physician and provide continuity to our volleyball and wrestling teams, we have seen other significant benefits. These have included:
• Improved communication between the IC athletic training staff and our health center. Because we now have an athletic trainer in the health center in the morning and in our clinic in the afternoons, it makes it easy for information to flow back and forth. Specifically, because the athletic trainer is in the room with the team physician for almost all patient visits, it makes it very easy for us to find out exactly what was said between the patient and the doctor. Even though we always get a written note back from the physician summarizing the visit and patient instructions, additional information is sometimes needed. Rather than having to contact the team physician, we can usually just ask the athletic trainer who was there for clarification.
• Improved scheduling efficiency. Our health center appointments are for either 15 or 30 minutes. Our athletic trainer is able to maximize our team physician’s time by scheduling appropriately based on the nature of the injury, whether the appointment is for an initial visit or follow-up, and whether the injury will require time for X-ray or ultrasound guided examination. More efficiency has translated into more available appointments during the same amount of time, less wasted time for our team physician, and less waiting time for busy athletes.
• Improved assistance for our team physician. In their role at the health center, our athletic trainer is able to utilize skills during the patient visit that the previous clerical person did not possess. By the time the doctor sees the patient, the athletic trainer has done a preliminary assessment, including history, observation, palpation, and special tests. They may have also entered an order for X-ray, pending the team physician’s approval. Following the patient visit, the athletic trainer is responsible for scheduling follow-up visits and any necessary brace or crutch fitting, as well as directing the patient through the process for obtaining prescribed medications or additional testing, such as MRI.