Jan 29, 2015

By Kenny Berkowitz

T&C examines the recent lawsuit filed by the National Athletic Trainers’ Association (NATA) against the American Physical Therapy Association (APTA).
Just three short years ago, leaders of the National Athletic Trainers’ Association (NATA) and American Physical Therapy Association (APTA) were promising to work cooperatively. There were discussions about common goals, proposals for student exchange programs between the two disciplines, and joint presentations at the 2006 NATA national convention. But the relationship has been steadily eroding, and on Feb. 1, the NATA filed suit, claiming the APTA and its Orthopedic Section have caused substantial and irreparable harm to athletic training.

“The National Athletic Trainers’ Association is protecting its members’ rights to compete fairly in the marketplace,” says attorney Paul R. Genender, who represents the NATA. “The NATA is not going to allow the APTA to prevent athletic trainers from working in the marketplace consistent with their education, training, qualifications, and licensure.”

Based on the Sherman Antitrust Act, the claim argues the APTA is conspiring to gain a monopoly on the manual therapy market by excluding athletic trainers from continuing education classes, manipulating the Coders Desk Reference for Procedures to discriminate against athletic trainers, disseminating misinformation about the nature of athletic training education, and trying to bar dual-credentialed ATC/PTs from presenting at NATA conferences. Filed in the U.S. District Court in Dallas, the suit asks for a permanent injunction against these anticompetitive practices and compensation for triple the cost of damages to the NATA.

In response, the APTA’s Web site calls the suit “wholly without merit” and characterizes the NATA’s approach as “needlessly hostile.”

On his blog, Evidence Based Rehab, Physical Therapist Jason Harris, PT, DPT, was more direct, calling it “frivolous” and “hilariously ridiculous.”

“This is just another example of people wanting more than they are willing to go to school and get the education for,” Harris wrote. “To me, it seems the NATA may be trying to convince the public that they are in fact physical therapists without having to go to physical therapy school.”

Genender isn’t laughing. “The suit is certainly not frivolous, and if anyone is saying that, I strongly suspect he or she does not have all of the facts,” he says. “The NATA determined there was unlawful conduct occurring and made the decision to stand up for its members. This lawsuit has plenty of merit, which is why the NATA has chosen to pursue it. The NATA will not stand by and permit the APTA to improperly use its market power to prevent athletic trainers from working in the manual therapy marketplace in a manner consistent with athletic trainers’ education, qualifications, training, and licensure.”

The easiest way to resolve the complaint, says Genender, is for the APTA to comply with the requests made in a letter by NATA President Chuck Kimmel. The letter, dated Dec. 21, 2007, demands the APTA stop excluding athletic trainers from performing legally-allowable rehabilitation techniques, attending clinical training programs, and misinforming its members and students about the limitations of athletic training. But the APTA’s response is already clear, spelled out in a Jan. 25, letter that calls the demands “outrageous” and warns the NATA not to file a lawsuit.

By law, the APTA needs to respond to the suit within 20 days of notification. Assuming the APTA denies the charges, the likeliest results are a set of negotiations between the two groups or a year-long case in civil court. “The NATA’s positions are very straightforward,” says Genender. “This complaint can be resolved as quickly as the two parties want, or the legal process will determine the outcome.”

Kenny Berkowitz is an Assistant Editor at
Training & Conditioning.


The claims of the NATA are a huge stretch and this was verbalized with
passion and due diligence by a letter from APTA President R. Scott Ward. Ultimately, I hope this issue resolves itself with no damage to either profession and we can refocus our energies on our patients/clients.

– Eugene “Bo” Babenko, Student PT
Long Island University-Brooklyn Campus
Department of Physical Therapy

It’s about time the NATA stood up for its members. With all do respect to Mr. Babenko he is incorrect to say the claims made by the NATA are a “/huge stretch/” The claims by the NATA and are extremetely accurate and true. As a certified and licensed athletic trainer with over 15 years experience I have worked along side and co-treated with physical therapists for several years at the clinical, collegiate, and olympic levels. Why after decades of athletic trainers and physical therapists working together is the APTA trying to change this relationship?

I have experienced first hand some of the actions that the APTA has taken to limit and actually prevent athletic trainers from treating patients and’or athletes. At no time has the NATA every attempted to prevent another profession from treating patients; yet, the APTA is attempting to keep athletic trainers from treating patients. Athletic trainers work under the supervision of physicians. If a physician feels that his patient(s) should be treated by an athletic trainer instead of a physical therapist who is the APTA or any physical therpist to supercede the instructions of a physician. After all, physicial therapists also work under the direction of a physician when a prescription is given. This is no different.

The APTA has been trying to limit and prevent athletic trainers from treating patients for over a decade. In some cases athletic trainers have lost their jobs, have lost hours, and have had their initial job descriptions reduced to “aids” due to misleading or false claims by the APTA and/or state PT associations. The latest tactic is trying to prevent continuing education access for athletic trainers to courses given by physical therapists. This is ironic since the NATA for decades has _required _athletic trainers to acquire a specified number of continuing education. The APTA only until the last 4 or 5 years /only now/ required physical therapist to acquire continuing education. (Prior to that it was only /recommended/ in PT by-laws to attend continuing education but was /not required/.) Now the APTA is trying to set standards for continuing education and trying to do so on a profession that they have no ruling over. Interesting.

It’s ashame that what was once a cooperative relationship in healthcare, (which benefited patients), has become an attempt at a greedy monopoly. Whatever happened to serving our patients and the physicians who refer them?

I encourage students and others who are new to this situation to truly look at both sides and not just the letter from the president of the APTA to the NATA or just by what a professor may or may not tell you. Go to the NATA website, look at the scope of practice of athletic trainers and /educate yourself/ on the profession. Each profession,
whether it is athletic training or physical therapy has its place in
healthcare. For either side to limit the other is frankly, quite arrogant. All the NATA is doing is protecting its members and the integrity of its scope of practice from being discriminated against.

– Carla E. Larson, LAT, ATC, CSCS

Taken from Carla Larson’s recent letter: …”/The APTA only until the
last 4 or 5 years /only now/ required physical therapist to acquire
continuing education. (Prior to that it was only /recommended/ in PT
by-laws to attend continuing education but was /not required/.)”…

The above statement is not entirely accurate. It is up to the states to
establish whether or not continuing education is required of the
Physical Therapists who are licensed in each state, in order to renew
their license, typically annually. I am licensed in Nevada, therefore I
follow the requirements of the Nevada State Board of Physical Therapy
Examiners. APTA does not and cannot mandate that I pursue continuing
education, but the state that licenses me most certainly can. Perhaps Ms
Larson is referencing a suggestion? If she can provide access to the
document which she is referencing, it can be reviewed.

I am a friend to the Athletic training community and I am honored to
have a very skilled PT/ATC (Chris Gregor-Maxwell) who teaches my work
and will present to Athletic Trainers in Indiana this July (2008)

– Jerry Hesch, MHS, PT

Mr Hesch is correct in his explanation of continuing education requirements. It is correct that each state’s regulations and requirements supercede that of the national organization and are often times more strict than that of the national organization. The document I was referring to was an individual state’s continuing education policy. As I mentioned in my eariler comments it is the APTA,(not Nevada or an individual state), which is trying to dictate what another organization can and cannot do.

Mr. Hesch’s comments of “APTA does not and cannot mandate that I pursue continuing education” reiterates my point that the APTA does not impose a standard for its own members/profession but is trying to impose restrictions on another profession. I do not know what all 50 states require of their PTs for continuing education. I do know in our area of the country that only within the past few years have individual states required a specific number of continuing educaiton units for physical therapist other than merely recommending continuing education. The NATA has required this longer.

Again, the point about continuing education in this process is that the APTA is trying to keep athletic trainers from receiving continuing education from presenters that are PTs and are trying to keep PTs from presenting to athletic trainers. It is interesting that the APTA is trying to micro-manage who can and cannot present to whom when they themselves do not have a standard for required continuing education. I am thankful to the physical therapists who will continue to present to athletic trainers and work cooperatively.

There are several points that can be made in the context of this law suit. The bottom line is that athletic trainers and physical therapist should be allowed to co-exist equally and should be allowed to treat patients equally within each scope of practice. It is a very simple concept which has been done for decades. Why the push to change that now, I don’t know what the real reason is. I have great co-treating relationships with the physical therapist I work with and have a cooperative approach to patient care. I do believe this is the majority across the country; however, there is pressure to make it the miniority.

– Carla E. Larson; LAT, ATC; CSCS

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