Athletic Training Management

1. Athletic Training Management Chapter 4 The Sports Medicine Team

2. Chapter 3 • Sports medicine: • The provision, primarily, of medical or allied health care to athletes, exercisers, recreational enthusiasts and others in the delivery of preventive, primary or rehabilitative care related to the prevention, treatment or rehabilitation of injuries and conditions related to sport, exercise or recreational activity, as well as the rendition of service and advice for fitness and training purposes to individuals who desire to engage in the aforementioned activities, related services or products to those who are interested or involved in sport, exercise or recreation even though in this latter sense, the term ‘medicine’ may be inherently inappropriate.

3. Athletic Trainer Team Physician Internist Orthopedic Surgeon Family Physician Neurologist Radiologist Ob/Gyn Physician’s Assistant Dentist or Orthodontist Ophthalmologist Optometrist Ear, Nose, and Throat Podiatrist Athletic Training Educator Psychologist EMT School Nurse Physical Therapist or PTA Nutritionist Occupational Therapist Coach Who should be on the team?

4. Contracts • Written document binding an employer and employee • Some are quite detailed. One at a major university states that the athletic trainer must perform in rehabilitation correctly or the university could be held to ridicule for failing to return their injured athletes soon enough. • Others are very generic.

5. Contracts • Written are favored in colleges and high schools. • In high schools the contract is almost always a supplementary contract to a standard teacher’s contract, the same as for coaches and the debate coach and thespian club advisor. • A rule of thumb may be roughly the same rate as the highest paid coach in each season, or about 10% of base for Fall, 10% for Winter and 5% for Spring.

6. Contracts • In clinic settings the contract usually will spell out the initial requirements for hire and reference the policies and procedures manual. • Clinics generally have a far more detailed policies and procedures manual than in other settings. • Some contracts are handshake agreements with nothing in writing. These are legally binding, but open to interpretation of the parties of interest.

7. Contracts • In this day of HIPPA all team physicians need to be under contract with the institution they serve. This can be a personal services contract with no money changing hands, but without it the physician may be legally barred from discussing a patient’s diagnosis and treatment plan with the athletic trainer or coach unless the patient gives written permission. Once contracted, you are all part of the same team.

8. Practice Settings • High schools • The sports medicine team in the high school setting may be smaller than other venues due to many student athletes using family physicians • Parents may prefer their family physician • Makes effective health care difficult due to the number of physicians from diverse backgrounds • HIPPA rules apply to what the physician may discuss with the athletic trainer without written permission of the parent

9. Practice Settings • It is required to obtain permission to treat before non emergency treatment is given to a minor • If an athletic trainer is in a licensure state they must have a team physician who must inspect and sign off on all injury evaluation forms not less than weekly.

10. Practice Settings • Dealing with minors • Consent to treat • Discussions with parents of child’s condition • Emergency treatment • Smaller budgets • Less tape • Fewer modalities

11. Practice Settings • College\University • Resources larger • Dealing for the most part with legal adults • FERPA • HIPPA • Insurance issues with parent’s insurance yet lack of ability to discuss the medical problem with parents without the athlete’s permission

12. Practice Settings • NCAA does not require certified athletic trainers at every practice site, but does require someone be present who can administer first aid and CPR • In the many athletic conferences there is a conference rule that the home team must provide an ATC for every home contest AND must take care of the visitor’s injured if the visiting team does not have an ATC present.

13. Practice Settings • Clinics • Medical director • Physical therapist • Athletic trainer • Billing for services • Worker’s comp • In Ohio athletic trainers may perform worker’s comp services if registered with the state worker’s comp board

14. Practice Settings • Professional • In baseball start in the lowest minors and work your way up • In NFL upper level students work summer camp’s and athletic trainers are hired from the camp roster • In the NBA you need to know someone • In the NHL it is very helpful to be a CATA member. Many minor league ATCs are contracted through clinics.

15. Practice Settings • Important to remember that in most pro sports, the minor league level is considered a temp job, lasting only the preseason and competitive season. Many of these people work in clinics in the off season. • Limited opportunities for women. • One NFL assistant, 3 NBA assistants, no women in NHL, no women in AA, AAA or major league baseball.

16. Practice Settings • Olympics • Work as a volunteer for two week session in one of the Olympic training centers (Colorado Springs is the biggest, Lake Placid, Chula Vista, CA, or Northern Michigan University in Marquette, MI) • Team rosters picked from the volunteer lists • Multiple visits to the center are usually required to move onto a travel roster • USOC will provide dorm room and dorm food, you provide transportation to and from the center when volunteering

17. Practice Settings • Should you be picked for international travel, they will provide all transportation, food, and competition clothing. . • Industrial settings • In traditional athletic training the athletic trainer is the intermediary between the athlete, coach, and team physician.

18. Practice Settings • In the industrial setting the athletic trainer is the intermediary between the worker, the supervisor, and the company physician. • OSHA has identified sprains/strains as 45% of injuries, fractures as 13% of injuries, and wounds and contusions at 10% each.

19. Practice Settings • Salaries are competitive with other settings. • Benefits also include a consistent work schedule, and may include changeover breaks, and holiday breaks. • Athletic trainers are employed in heavy manufacturing (steel mills, foundries) light manufacturing (assembly plants in many different industries) and even prisons (staff, not inmates).

20. Practice Settings • Athletic trainers may also get involved with ergonomics, work-readiness conditioning, biomechanics, job-specific training.

21. Job Descriptions • Define the expected, allowed, and disallowed roles an athletic trainer may attempt. • These roles should be in the policies and procedures manual. • First step in defining job descriptions is to define everyone who has a role on the sports medicine team. • In this age of HIPPA, the team physician must be contracted.

22. Job Descriptions • Consultants should be listed in the policies and procedures manual. • Relationships must be fostered with EMS professionals to help with roles. • In many jurisdictions after a patient has been turned over to the EMS, they have total jurisdiction over any and all procedures to be used. • Detailed job description for each person reduces confusion about responsibilities.

23. Job Descriptions • Detailed job descriptions protect athletic trainers from administrators who choose to distance themselves from an unpleasant situation by stating the problem was caused by an athletic trainer acting outside their defined duties. • When the 1st edition of this book was written we surveyed 20 athletic trainers in all practice settings around the USA and found only 2 with written job descriptions.

24. Position Announcement • A position announcement is sometimes also called a job description, leading to confusion with the previous section. • This announcement contains all of the information about a position including qualifications, responsibilities, duties, and how to apply for the job.

25. Position Announcement • Description of the position comes first • Nature of the employment agreement (FT, PT, staff, faculty, clinic, clinic-outreach, etc.) • Proposed rank or level in the position • Job Responsibilities • Different in each placement setting, so sell the uniqueness of the position. Failure to communicate a full understanding of the job will result in candidates applying who do not fit and waste your resources interviewing for a position they would turn down.

26. Position Announcement • Starting Date • If the starting date is flexible, it should be noted in the announcement. Most dates are not flexible. An example of a flexible date would be when we hired Dr. Multer. She could not arrive until December, while our position started in August. We agreed to a January start date in order to hire our choice. • Qualifications • Degree (accredited ATEP or not), credential (ATC, license, etc.), experience (type of clinic, specific sport, etc.), instructor credential (CPR instructor, etc.)

27. Position Announcement • It is common practice to list required credentials and then desired credentials. Only those meeting the required credentials may be hired, desired credentials help sort out the field to hire from. • Salary • It is common practice to use a phrase like “Salary is commensurate with experience.” What this means is I will not tell you up front and may try to get you as CHEAP as possible. • It is your responsibility to find out salary information by doing local research BEFORE you get to a job interview.

28. Position Announcement • Location • This defines both where the job is set and the surrounding community. • Application Procedures • What information is required in the application (letter, transcript, resume, recommendations). • Closing date • Hard date means no applications after that date may be considered • Soft date (Review of applications will begin January 15 and continue until the position is filled.

29. Searching • Where to look • Depends on the setting • Depends on the role the person will play • Advertising • Must reach a desired pool of candidates • Equal Opportunity/Affirmative Action • Prevents discrimination on the basis of anything except job qualifications.

30. Searching • ADA • Allows a written job description that describes the duties actually performed in the position • Employers establish the qualifications (knowledge/skills, experience, education, certifications, licenses, and other job-related criteria). • Those disabled individuals meeting the qualifications must be considered. Peripheral functions cannot be used to exclude disabled people. • The law does NOT require that persons incapable of performing the job without harming others be allowed to do so.

31. Searching • ADA • For more information on ADA contact: • US Department of Justice • Civil Rights Division • Coordination and Review Section • P.O. Box 66118 • Washington, DC 20035-6118

32. Where to Advertise • For athletic trainers • NATA Placement Center (membership required) • NCAA News • Local newspaper • Contact ATEPs • Chronicle of Higher Education • ACSM electronic job listing • Human Kinetics electronic job listing • atcplacement, a Yahoo group

33. Advertising • NATA National, District, and State Meetings all have some placement area • At the 2004 annual meeting the placement desk handled 148 new job postings • At that time the total FT positions listed with the Career Center was 355 with an additional 201 PT positions • During June 2004 104 applications were filed by 27 candidates for 87 positions

34. Recruiting • Can mean two things • Seeking people to apply for a position • Seeking volunteers or consultants • You need to understand that athletic training is still a small enough profession that candidate pools, especially for college/university positions, can be established by phoning or contacting peers and asking who they know who is good. You can never burn bridges.

35. Screening • After the applications are all in, the hiring committee must meet to establish two things: • Who meets the written qualifications for the job • Who will be interviewed for the job

36. Interviewing • Three phases • Orientation or expectations-setting • How the interview will proceed, what the position will entail, and describe the organization • Experiential presentation • Test the candidates knowledge, strengths and weaknesses and follow-up questions • Organizational sell • Four points: interest level of the work, security, mentoring, and socialization.

37. Questions Legal and Illegal • Those conducting the interview must be aware of the legal consequences of the questions they ask. (refer to Table 4-3 for examples or contact your Affirmative Action Office or the US Department of Justice Office of Civil Rights) • In general, questions dealing with the applicants qualifications and ability to perform the job are legal, everything else is not

38. Who to Interview • First step is to refer to the job description and eliminate those not meeting the stated qualifications • After the pool has been narrowed, other factors help to separate the pool into more desirable and less desirable candidates • Communication is an often overlooked skill • Athletic trainers must interact with athletes, physicians, coaches, other allied health care personnel, and athlete’s families

39. Who to Interview • In the collegiate environment where an ATC may be hired to cover a specific sport, experience in the sport is desirable • In the high school environment a variety of athletic training experiences working with both males and females is required. • Additionally if the position is tied to a teaching position, having a teaching credential in an open teaching area is necessary

40. Who to Interview • In clinic settings previous experience in that setting is a positive, even if it was a clinical rotation during the applicants educational program • In professional settings, experience with professional caliber athletes while in the college setting may be a factor

41. Who to Interview • Number of applicants in the final cut usually between two and five • It is wise to delay rejection letters until someone has accepted the position in case no one can be hired • Avoids embarrassment of rescinding a rejection

42. Selecting • After the final interview, an offer is made to the leading candidate • Hopefully the unanimous choice of the selection team • If there is no unanimity, the job is usually offered to the person with the greatest support on the selection team • Some search committees will make a recommendation to the search committee chair who will make the final decision

43. Selecting • In some settings the committee makes a recommendation to the supervising administrator • In a case where a single best candidate cannot be identified, several names may be forwarded to the administrator • In some institutions this is always the case and the senior administrator picks his/her choice from among 2-3 candidates

44. Selecting • In high schools and clinics a personnel department will usually make the job offer based on input from the search committee • One factor found again and again is that the person who is most compatible with the person having ultimate responsibility for hiring usually gets the job