Jan 29, 2015Making It Through
Sports medicine departments nationwide are dealing with tighter budgets and fewer resources in our current economic climate. In response, some athletic trainers are finding creative ways to keep their programs alive and well.
By Dan Resing
Dan Resing is Head Athletic Trainer at Hawai’i Pacific University. He can be reached at: [email protected].
When I first arrived at Hawai’i Pacific University in the fall of 2006, the athletic training room was a tiny office into which they had crammed two treatment tables, a computer, a refrigerator for cold packs, and a few other essentials. I was not an employee of the university, as HPU had long been contracting out sports medicine services from a private physical therapy clinic. But there was a plan in the works to bring athletic training in-house, and after my first year, that’s just what happened–with me as the department’s first true Head Athletic Trainer.
At that point, everything was looking up for HPU athletic training. In addition to hiring its first two full-time athletic trainers (myself and an assistant who had worked with me under the old contract), the school brought in two graduate assistants to expand our coverage capabilities. We doubled the size of the athletic training room by taking over an adjacent office and purchased new equipment, including a laser therapy device, an ultrasound machine, and a four-channel combo tower electrotherapy unit. Our budget grew to include money for staff CEUs, CPR certification, NATA and NSCA dues, professional liability insurance, and even cell phone reimbursement.
The school was making a serious investment in sports medicine, allowing us to become one of the most comprehensive athletic training departments in Hawai’i and in the Pacific West Conference. It was exciting to lead a program that was growing right before my eyes.
Then, in the fall of 2008, the realities of the economic downturn caught up with us. Suddenly we faced a shrinking budget, and like many programs across the country, the university-imposed cuts ran deep, affecting both our resources and our personnel.
It’s never easy to deal with less than you’re used to. But until the economy recovers from its current recession, athletic trainers in practically every setting are having to make do. At HPU, we’ve worked hard to limit the effects budget cuts have on our athletes and the services we provide. Hopefully, some of the solutions we’ve come up with can help your program get through these rough times as smoothly as possible.
CUTTING COSTS, NOT CORNERS
When looking to trim the budget, our first decision was that direct care for athletes was the top priority–after all, that’s the reason we’re here. We would look for any other places to make cuts before altering coverage for workouts, practices, and competitions. Thus the first thing we scaled back was staff travel to non-athletic events.
For one thing, this meant we would not send anyone to the NATA Annual Meeting. Anyone who has been to an NATA convention knows it’s an incredible opportunity to learn about the latest research in our field, network with colleagues at other schools, and expand our professional horizons in countless ways, so this was a tough decision to make. But we had to acknowledge that convention attendance was something of a perk, and not truly a necessity in a cash-strapped year.
Our travel cuts also meant forgoing various sports medicine conferences and seminars, which in the past have provided opportunities to earn CEUs. I researched other ways for our staff to earn CEUs, and found that if you look hard enough, there are plenty of alternatives.
For example, the NATA Web site recently started offering free CEU quizzes online to members, and the Hawai’i Athletic Trainers Association offers some free and low-cost opportunities as well. Since our department could no longer afford to pay for staff CEUs, these resources have proven invaluable. Many other state associations offer similar programs.
We learned that another way to get free CEUs is to become an Approved Clinical Instructor (ACI). This involves taking a simple one-day course that prepares you to work with athletic training students and play an active role in their learning process. It provides CEUs while also enhancing your department–working with students is a great way to get extra help and groom the next generation of athletic trainers.
Many universities with athletic training education programs offer this course for free to any athletic trainer who has been BOC-certified for at least one year. They do this to expand the list of athletic trainers and sites that their students can work with and learn from. The course is usually offered during the summer to prepare for the upcoming fall semester, but it can also be held over winter break if there is sufficient demand. The certification is good for one year, and ACIs must take a short refresher course each summer to maintain certified status.
Those cuts were a good start, but we needed to go further–we realized we would have to cut back on athletic trainers traveling with teams to away games. As you might expect, with more than half our conference members being over 2,000 miles away on the mainland, travel is one of our greatest expenses.
This was a tough realization, as no athletic trainer wants to leave the responsibility of caring for their athletes in the hands of coaches, or athletic trainers at host schools who are unfamiliar with the athletes’ medical histories. But when we saw it was a necessity, we tried our best to minimize the impact on our athletes.
We do this by establishing communication with the home team athletic training staff every time a team will be traveling without us. Via phone or e-mail, we share any important details about individual athletes’ status and potential treatment needs.
We find it is helpful to report how many athletes may need taping or other treatment, so the host athletic training staff can plan ahead for the extra demand. Luckily, our colleagues at opposing schools have been very gracious about caring for our athletes, and we offer to return the favor when their teams come to our campus.
Another trick we learned for games when we can’t accompany a team is teaching athletes how to do a tape job themselves–especially if they require special or unique taping. Even if they can’t actually perform the taping on their own body, they can guide a host athletic trainer through the process.
For every contest where we won’t be there in person, we provide the coach with an athletic training kit containing basic supplies as well as insurance information and emergency contacts for each athlete. The athletic trainers in our conference have also been working on a great new idea for this–a system where each school would have a visiting team supply bag on hand, thus preventing the hassle and expense of toting one to away games. It would contain a predetermined list of basic supplies agreed upon by each athletic trainer in the conference, plus any special supplies a team may request. The visiting team’s staff would then only have to worry about bringing insurance and emergency contact information for their athletes.
For any athletic department, the hardest cuts to make are those involving personnel. But when your funding is cut, sometimes you’re left with no choice.
In our case, it was first necessary to move our assistant athletic trainer from a full-time 12-month schedule to a full-time 10-month schedule, which would save the department from paying her salary during the summer months. This put her in a difficult spot personally, but she found an excellent solution. She worked with the leaders of our school’s nursing department to develop some entry-level sports medicine classes she could teach over the summer to supplement her salary. This proved to be a win-win for the time being, as it provided the extra income she needed while giving the nursing program a simple and cost-effective way to expand its offerings.
The hardest cut we had to make came just this past fall, when lower-than-expected enrollment forced us to lay off the assistant athletic trainer. At the time, she was primarily responsible for our women’s volleyball team, which was in the middle of its season and fighting for a conference title. The players felt this loss immensely, as they had formed strong bonds with their athletic trainer, and we were of course very sad to lose a valued member of our staff.
The change was logistically tough as well, as the rest of us–two graduate assistants and I–had to put in extra hours to cover the work she had been doing. We learned early on that keeping everyone’s sanity required frequent short meetings to plan the schedule weeks in advance.
In addition to volleyball, we were also covering men’s and women’s soccer and three competitive cheer teams in the fall. At the same time, men’s and women’s basketball were starting official practices. It was clear we would need to ration our coverage, so we looked at the schedule and made a few common-sense decisions.
Here’s a specific example of a challenge we faced with our smaller staff and how we met it: Both men’s and women’s soccer practice typically started at 4:30 p.m. and didn’t finish until at least 6:30, while men’s basketball practice started at 6:00 at a facility 13 miles away. We didn’t have enough staff to cover both in their entirety, so we talked to the coaches and devised a plan that would meet the needs of both teams.
I decided it was most important to be there at the beginning of team practices to provide taping and any needed treatment, and to evaluate any problems athletes may have noticed once they began working out. I would arrive at roughly 3:45 for a 4:30 soccer practice and stay until about 5:15, then head to the men’s basketball facility, where I would arrive by 5:45 so I could tape the athletes who needed it and prepare the team for practice.
It obviously wasn’t a perfect system, but we made it work. The players knew in advance when I would and wouldn’t be there, so they understood the need to plan their taping and treatment time around the modified schedule. And when the soccer team had a home game, I stayed with them for the entire contest and was “on call” for the basketball team via cell phone in case of an emergency. Likewise, when the soccer team had a light practice the day before a game, I would have soccer players who needed taping come into the athletic training room earlier in the day and get taped, allowing me to attend all of basketball practice that day.
Whenever there are events without athletic training coverage, it’s especially important to ensure that coaches are certified in CPR and first aid. All our coaches are certified by the American Red Cross, and while we hope they never need to use that training, we feel it’s an essential precaution.
Anytime you lose a staff member, you lose a unique set of skills that’s difficult to replace. At such times it’s especially important to look for untapped resources that may help.
For instance, the assistant athletic trainer we were forced to lay off had been our staff’s only certified kinesiotaping practitioner. That modality has become increasing popular with our athletes in recent years, so we were happy to learn one of our assistant women’s soccer coaches is also certified in kinesiotaping. We worked out an agreement whereby she tapes athletes who need the modality as long as we provide her with the specialized kinesiology tape. To make this as convenient as possible for her, we sometimes arrange to send athletes to the shiatsu clinic where she works in the daytime (just down the street from our campus) to receive their tape jobs.
When budget cuts are required, it’s easy to make the mistake of thinking only about subtraction: “What will we have to do without?” But this is also a time to think about adding cost-effective alternatives to fill gaps and minimize the impact of losses.
Immediately after we laid off our assistant athletic trainer, I met with the athletic director to discuss what we could do to get through the busy fall semester. He understood my concerns, and agreed that one full-time athletic trainer and two grad assistants weren’t enough to care for the 350 athletes in our department. He was able to secure funding for a part-time athletic trainer to work up to 20 hours a week.
It’s always more difficult to fill part-time positions–especially on an island in the middle of the ocean–but we were able to find a real estate agent who was also a certified athletic trainer looking for part-time work. Her schedule was complicated by the fact that she has young children, but we found ways to schedule around her other responsibilities, and her kids became a regular fixture at games she covered.
The part-time hire was obviously a stopgap measure. For the longer term, we’ve decided the best way to meet our needs and work within our limitations is to add a third graduate assistant. For less than the cost of a full-time employee, we can cover more practices and games with this approach.
While the main impetus for adding an extra grad assistant was to save money, we felt it was important to not shortchange the applicants by skimping on the benefits package. With that in mind, we are offering a full tuition waiver, books, and a very competitive stipend that will allow the assistant to pay for rent, food, and other living expenses.
In addition to the compensation they receive directly through the assistantship, we always try to offer our graduate assistants other ways to earn money, since a stipend can only go so far. For instance, it’s a great idea to set up opportunities for them to provide athletic training services at various camps or intramural sporting events on your campus or in your area. Another nice touch is to pay NATA dues for your graduate assistants, since that can be a large expense for someone on a limited budget.
Nothing is easy about making cuts that change the way your department runs. But as economic realities force programs everywhere to do more with less, I choose to see a silver lining. When we have no choice but to be more efficient, to communicate better, and to get creative in dealing with tough situations, we often find ways to refine our operations and the care we provide to athletes. When times improve and the funding returns, as I’m optimistic they will, our program is poised to be better than ever.
NEED INEXPENSIVE CEUs?
Training & Conditioning gives athletic trainers the opportunity to earn NATA and NSCA Continuing Education Units by reading the magazine and completing a quiz for each issue. Check them out online at: www.Training-ConditioningCEU.com