Jan 29, 2015
Branching Out

Also occurring on Monday morning is a special topic presentation titled “The Efficiency and Effectiveness of Utilizing Athletic Trainers as Physician Extenders in an Orthopedic or Sports Medicine Practice.” Led by Shari Khaja, MS, LAT, ATC, of the University of Wisconsin Health Sports Medicine Center, this session should be of great interest to athletic trainers looking to branch out as a physician extender. T&C tackled this emerging career option in the article “Doctor’s Orders.” In case you’re wondering what being a physician extender is all about, here are a couple of excerpts from that article.

According to the latest statistics, there are close to 1,000 certified athletic trainers currently working in the role. They may balance part-time clinical work with an outreach position at a local high school or college. Or they may work full-time in family medicine, primary care sports medicine, orthopedics, osteopathics, pediatrics, physiatry, occupational medicine, or chiropractic care.

Less than a decade after the NATA officially recognized the position–and began actively promoting it as a viable alternative to the traditional setting–there’s still wide variation in responsibilities from one work site to another. However, Jim Raynor, MS, ATC, Administrator at St. John’s Sports Medicine in Springfield, Mo., argues that being a physician extender is essentially the same role that athletic trainers have always played, even if they don’t realize it.

“Too many athletic trainers don’t understand they’re already working in the physician extender model,” says Raynor, who supervises athletic trainers at three outpatient clinics. “They’re already acting as physician extenders in the athletic training room, whether they’re at a high school, college, or clinic. Every time they evaluate an injury or treat an athlete, they’re working as an extension of their team physician, and functioning under a physician’s protocol. We’ve just never identified an athletic trainer this way.”

In a typical day at St. John’s, physician extenders alternate between assisting physicians and taking care of their own patient load. They may have scheduled follow-up appointments on injury rehabilitation progress, or be called to join a physician in diagnosing or treating a patient.

Over his nine years working as a hands-on physician extender, Raynor encountered a wide variety of issues. “I worked on a broad range of problems, from the traditional football athlete with a blown out knee to the female athlete who didn’t realize she was pregnant to the boy who refused to play baseball because his dad was pressuring him too much,” he says.

“For example, the female athlete originally came in for a pre-participation physical,” he continues. “The doctor did the medical component and I took care of the parts related to history, nutrition, and sport readiness. When I asked her questions related to eating disorders and amenorrhea, she realized she hadn’t had her menstrual cycle in three months. I consulted the doctor, who ordered the pregnancy test, and lo and behold, this girl was pregnant. That incident really sharpened my awareness of issues we don’t usually see in a school athletic training room.”

Raynor describes his clinics’ philosophy as a collaboration between physicians and athletic trainers. “Because the physicians are confident in the skills and abilities of our athletic training staff, we’ve been given a lot of professional discretion in what we do,” he says. “That’s made us better athletic trainers because we have to be sharp to work with the physicians here.”

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