Celebrating Athletic Training Month

March is Athletic Training Month, and we’re highlighting one of the most essential—and often underrecognized—members of the orthopedic care team: the certified athletic trainer (ATC).

In this episode, we sit down with an ATC to break down their role across settings—from sidelines to clinic settings. We discuss injury evaluation, acute management, rehabilitation, and how ATCs work alongside PAs and surgeons to optimize patient outcomes.

We also explore career pathways, challenges within the profession, and how athletic trainers continue to evolve within modern healthcare systems.

If you’ve ever wondered what ATCs really do (beyond tape and ice), this episode is for you.

Transcript

Tempo: 120.0

SPEAKER_01 0:00

Welcome to Joint Effort PAs, where two orthopedic surgery PAs get real about life in medicine. From tips and tricks to professional growth, work-life balance, and everything in between. We're here to share what we've learned and what we're still figuring out. Let's get into it. All right, we are back again. Um, this time with another March topic, March related topic, because March is National Athletic Training Month. Yeah, and we've teased a guest now for like 12 weeks. Yes. Yeah, every time we're like, Yeah, last week we we teased a guest that didn't contribute. That is true. That is true. Scout. Scout, yeah. Um, okay, so we have Brandy here with us. Brandy, why don't you introduce yourself? Tell us who you are, what you do, your life background, your story.

SPEAKER_02 0:55

Oh, okay. That could be a lot. We'll keep it we'll keep it. The brief version, I guess. My name is Brandy. I'm an athletic trainer by trade. Um, I do more administrative things now in my role. I work at an EHR company, um, but have lots of athletic training experience. Um, started out more traditional and then moved into the physician practice setting. Um, so yeah, I'm excited to be here.

SPEAKER_00 1:19

I love it. And you you are a very good example of someone who's worked in various like geographical settings, right? So sideline medicine, academic world, physician extender, and then now more administrative, which um I don't think a lot of athletic trainers can speak to that. Yeah, like breached all of those. Yeah. So we we eliminated all of our subparathic trainers just to get you on here. We love that. Elite, elite.

SPEAKER_02 1:47

I love that. I'm gonna write that in my resume.

SPEAKER_00 1:49

Brandy, do me a favor and define what an athletic trainer is and how it is not a personal trainer.

SPEAKER_02 1:55

Yeah, so that's that's a great one because athletic training is a little bit of a misnomer, right? So people think personal trainer fitness, that sort of thing. And so we touch on that a little bit, but basically, like within our realm, we're like a musculoskeletal specialist. So we kind of bridge the gap between injury and then recovery. Um, and then specifically as it relates to like y'all's world um in the physician practice setting, you know, we are extending the provider, and that could be a PA or that could be, you know, an MD, a DO. Um, but the goal is, you know, improving access, managing patient care and flow, guiding patients safely back to function. Um, and then a little tidbit, again, not really related to what you guys do, but we do work across healthcare. So we work in lots of other settings too, like industrial setting, public safety, military, that sort of thing.

SPEAKER_01 2:44

Can work in primary care, primary care, and it doesn't have to be um ortho. Yeah. So it's interesting because I feel like um when I was in school for athletic training, like did they touch on with you at all like the orthopedic clinic setting much? Or were your routes kind of like you're either gonna work in a high school or collegiate setting or eventually, you know, in an educational or um, you know, work in um a teaching type setting?

SPEAKER_02 3:12

I think that my program did a good job of exposing us to as much as possible. So like like the industrial setting wasn't as popular, a military or like public safety wasn't, but but I think I got I got a pretty well-rounded experience as it relates to like what were the more like prominent settings at the time. Um and I think for me, like I always knew like I wanted to like have some fun and definitely do the traditional athletic training things, but like long term didn't see myself like staying like in that world specifically.

SPEAKER_00 3:41

Yeah, so your undergraduate train training that was your degree is in athletic training, is that right? Yes. Okay. So anatomy lab, well, science cadaver, cadaver lab, all the all the things, yeah. Okay, so I think any, you know, undergraduate, you know, candidate that is interested in doing something in that world, I think it's got a lot of the same foundational things that PAs will have, right? So interestingly, I think we do hire a lot of PAs, and I think that it is attractive to me when a PA has an athletic training degree because you're kind of brought up in that science math world, right? Yeah, yeah.

SPEAKER_01 4:16

You get a lot of the exposure. Now, I will say now with the master's situation, like it's a little that's a little bit more touchy of like a subject of rule, like deciding how to, you know, up your education level now that they switched it to a master's when I got mine, it was just purely a bachelor's degree, probably yours as well. But then you end up got your master's afterwards. Um, but now in order to just become an athletic trainer, you have to get a master's degree in it.

SPEAKER_02 4:45

Yeah, so I think that that that you know, I think that's pretty common with PT too, but that that person or that type of employee that's duly credentialed, whether it's P T A T or P A A T, I think they're eventually gonna like disappear, which is interesting. I don't know if it's good or bad, but um I disappeared.

SPEAKER_01 5:04

Well, my AT did. No, you're never on AT. Yes, still in existence. Um, but yeah, no, I mean there's a lot of crossover with it. I think it's like a really um great, not just side by side, but segue into that career type of type of role. So um, yeah. So why let's talk about why um athletic trainers are great in this setting and other settings and why orthopedic surgeons like to work with athletic trainers.

SPEAKER_00 5:36

I think athletic trainers just in general, as far as their uh availability to orthopedic surgeons, I think they are, let's say you have an athletic trainer that works at a high school, that works for, you know, a semi-professional league or professional league, like that, you're a liaison, right? So you have your hands in communication with the school or the, you know, athletic facility, and also you have direct communication with the physician. So you are a very nice liaison um for access for an orthopedic practice into whatever, into pop corner football, into community, high school scorers, into the community. So I think orthopedics practices in general find it very appealing to have that person. Um so talk a little bit about what your your training looks like and why you think that that's that means something in the orthopedic world.

SPEAKER_02 6:24

Yeah, so I think I mean all of our all of our training starts out starts out like with a like a musculoskeletal mindset, right? So like I I had to take a a um what's the word I'm looking for? Like I had to take a pharmacology class, I had to take a Gen Med class where I learned about you know ringworm and all that other gross stuff. Um gross. But so much of our training is is specifically like musculoskeletal specific. So, you know, that goes hand in hand with with orthopedics in general, right? Um, and then again, we're segueing like the patient gets hurt on the field in a traditional sense, right? Or the patient gets hurt in the in a factory somewhere, whatever. We're segueing that happening into them going to see the next provider, whether that's a PA or MD D O, whatever. Um, so we're bridging the gap, right? And so we're saying, hey, like this is what happened, this is how it happened, this is what I think I'm handing it off to you, and then you guys have access to things that we don't always have access to, like advanced imaging, I can't get a prescription on my end, that sort of thing.

SPEAKER_01 7:27

Yeah. I think like from my perspective, doing both at my athletic training um coursework prepared me better in many ways than like my PA coursework. I mean, it was four years of MSK orthopedic focus versus two weeks in PA school of MSK orthopedic focus. Now, from the PA perspective, you're definitely getting more of like the why and the like the medicine aspect of things, procedural skills, stuff like that. Like there's there was a ton, I feel like I was able to build off of everything I had already learned in athletic training once uh I was in PA school, but I came into it with such a broader knowledge base of ortho and MSK section than anybody else in my class other than the two other athletic trainers that were there.

SPEAKER_00 8:17

Well, I think when I interview, you know, nurse practitioners or PAs, when I see they have an athletic training background, I'm like, oh, okay. So your ability to injury eval is 10 times better than any other run-of-the-mill PA that did two weeks of ortho or something like that. Yeah. Um, you know, the orthopedic special testing, that type of stuff, it's not the first time you hear it because you've probably done it already. Yeah. Um, I do think the difficulty when I see an athletic trainer that is now a PA is the like what's next steps? Because you can tee it up and get it into the physician or into the orthopedic practice, but like reading the x-ray, what type of brace do I use? How quick should I get this to the surgical team? Like that type of thing. Or, you know, are they non-weight bearing for four weeks? Or can they weight bear with this? Like, I'm making those decisions now on top of it. So that's the learning curve with um, you know, former ATs that are now PAs, but all the eval stuff I feel like is spot on, much better than that.

SPEAKER_01 9:15

Yeah, yeah. And this is kind of something we like touched on in the outline. I want to see what you think about it, but like we were talking about loyal loyalty to the surgeon's system, and by that I think we mean their protocols and the way that they like to do things specifically, right? Like, oh, I like to brace this or I like to, this is my rehab protocol for X amount of weeks versus going off and doing your own thing. Um I mean, I like I don't think that's an issue personally, fortunately, that we struggle with at all here. I think it's more from like the outside athletic trainers working with, you know, communicating with a surgeon that they're not working directly with every day.

SPEAKER_02 9:59

So I think that, you know, like and it varies a little bit state to state, but you know, athletic trainers work under the direction of or at least in collaboration with an athletic trainer or with a physician. So for me, I have a protocol that's signed by what do you guys call what do you what's his code word? The captain. The captain, right? The captain signs my protocol, yeah. Um, so so you know, I need to be in alignment with the captain. The captain has to feel good about like what I'm gonna be doing when he's not around, right? Like he has to trust me, I have to trust him. Um, and so you do really cre I mean, he's not gonna just sign anything, right? So you do really have to have like a good working relationship. Um, but with that really does come hopefully like a better understanding of like how they do what they do or why they do what they do or what their philosophy about X, Y, or Z is, and then you guys are working together to you know make that become a reality as it relates to like whatever whatever patient is coming in or whatever injury it is or that sort of thing. So um, yeah, I think I think that that loyalty kind of is is a little it's natural, right? But because it's it's like mutual trust. The way this the the way they structured it, right? And again, it's a little bit different state to state, but yeah, in the state that we're in.

SPEAKER_00 11:13

Do you feel like you had to prove yourself um to the previous surgeons that you have worked with? Yes, but I feel like I have to prove myself to everyone. Well, it's a universal. Well, I guess what I'm saying is there, I think, and again, I can't speak for an orthopedic surgeon, but there is a um basic level of trust that an orthopedic surgeon places in an athletic trainer. However, being on the clinical side and hearing the surgeon say, Well, this one's too aggressive and this one is not aggressive enough, like, do you feel like you had to uh demonstrate your ability in order for them to reach out to the Goldie Locke? Yeah, that, yeah, that.

SPEAKER_02 11:54

And then also too, like, I think like like my protocol, like I and we can touch on this in a little bit, but my protocol looked different than some of the other ones because I had different skills. But like we had to sit down and be like, hey, like, I'm gonna be doing this. This has to be added to my protocol. Like, are you okay with the wording? Are you okay with the verbiage? Like, what does this, you know, we gotta be on the same page because at the end of the day, like you're you're signing this, right? Um so there's lots of conversation that maybe people don't always know. Um, and there's definitely like standard of the meal ones too, where like if you're only gonna be doing more traditional athletic training, maybe you don't feel like you need that as much. But I think the more advanced your skills become, the more that, you know, becomes a pivotal part of the relationship.

SPEAKER_00 12:33

Do you think that you have seen certain skill sets in more um experienced athletic trainers that you could say are more like likely to be successful? Or do you feel like, like for example, your personality? Do you think that you could just exist doing mediocre things and the physician would be like, okay? Or do you feel like you have asked, like, oh, I can do this, let me show you. And now I can do this, let me show you. Like, do you think that that's does that come with time? Is that a personality thing? Like, what differentiates some athletic trainers from others in definition of success?

SPEAKER_02 13:09

Yeah, I think some of that is definitely personality, and I think some of it maybe too is like there's certain personalities that are attracted maybe to different settings of athletic training, just like there's different personalities that are attracted to probably different types of medicine or or different specialties within medicine. But um, so I think some people are okay being like more of like a jack of all trade, right? Like they have a lot of broad skills. Um I like that, but I also was like, no, I really want to like be a little bit more specialized, right? Which is like what was really attractive for me, like being in the physician practice setting of like, okay, I'm I'm gonna narrow a little bit, but like what I get to do if I put if I can push the envelope and find a provider that will really support me in a team, I can go a little bit deeper into what I'm doing on a day-to-day basis versus um maybe just you know taking care and then getting to the next point.

SPEAKER_01 14:01

Or like, you know, sometimes personality-wise, I uh in the traditional setting, collegiate or um high school, a lot of like I don't want to use the word independent thinkers because we're all I would like to think independent thinkers, but you're yes, you are still working under a physician's protocol, but you you are your own per like you are the head decision maker in that sense, right?

SPEAKER_02 14:26

Like you're calling the we're not calling the doctor every day and saying to be like, hey, here's everything that happens in your field. What do you think about that?

SPEAKER_01 14:32

You're managing your protocols, you're managing like you have your own EMR, like you are your own manager. Yeah. Um, and so I think some I think that is desirable to some people, just like that independence level with it versus like the space is much more collaborative, yeah. Yeah, sure.

SPEAKER_03 14:51

Yeah.

SPEAKER_01 14:51

Um, and then you know, I don't I don't really have much experience to speak on for some of those other interesting uh roles, like the industrial settings and whatnot. But um, but yeah, I think a lot of it depends on that aspect of personality too. Like, do they want to be super, super collaborative? Do they like to be their own boss, so to speak?

SPEAKER_02 15:09

Right. Yeah, I definitely think one one probably overarching theme is they probably all got into it because they enjoyed sports in some sort of aspect, right? Like, I think that that's that's definitely um Did you play sports? I did, I yeah, I didn't listen to Torma ACL playing basketball. That's that's the pivotal moment that started all this.

SPEAKER_01 15:24

Oh man, see, we were just talking about this earlier, like, yeah.

SPEAKER_00 15:29

Like I think you as an athletic trainer going through personal athletic injuries that holds more weights than your hypotheticals, right? I just think that someone is going to listen to you a little bit more so than the next person, specifically because you've been through some stuff.

SPEAKER_01 15:44

Listen, I've been here. Yeah, when I've done that. I get it.

SPEAKER_02 15:49

I know what it's like to tear your ACL and have to do rehab.

SPEAKER_01 15:52

Yeah, gosh, how many people in in this office are left to tear their ACLs?

SPEAKER_00 15:57

Good lord. There's more left than there's than there is those that have, but give it time.

SPEAKER_01 16:02

Give it time, and we'll all be added to the list at some point.

SPEAKER_00 16:06

Now better watch out. Brandy, making your transition to the clinical side, okay. And now I've been an orthopedic for about 20 years. Athletic trainers, in my experience prior to coming here, we had a DME coordinator that was an athletic trainer. And I feel like that's a very good transitional thing. Right. Yeah. Um, you had entered our practice being the head of the athletic training residency. Okay. So uh the orthopedic practice that we work at had an athletic training residency where we take athletic trainers, they apply to the program. Um, and it's one year of working as physician extender. So, one, your intro into that, I guess I'll call it academic, but it was clinical, like you with the academic and clinical hat. What was the biggest shift that you saw on the clinical side that you thought, you know, was different than your expectation, right? So athletic trainer working on the field, contacting the surgeon, and then now you're behind the scenes. Like what surprised you the most about that?

SPEAKER_02 17:08

Um, I don't know about surprised, but I think the like the biggest learning curve was like the like the business aspect of it, right? Like when I was working, um, you know, I did division two, division one, but like if I thought a patient would benefit from like an ultrasound treatment or a laser treatment, I just did it. Just did it, right? And I didn't think about insurance. Insurance, or will we get reimbursed for this, or is this worth my time? Yeah, I was just like I clinically appropriate, I think has therapeutic, like positive therapeutic things for this patient. Might as well try. Might as well try.

SPEAKER_00 17:40

Yeah.

SPEAKER_02 17:41

I got the time, they got the time. Um, so that like that that mindset shift um was, I mean, not bad, but just like, you know, different, right?

SPEAKER_00 17:50

Um I think that surprises PAs coming out too. Yeah. Just the business. I think also like, because you have to do and your athletic training residents had to do a fair amount of documentation. I think that that um I don't think that that's communicated very well in PA school how much you have to document. Did you see any thing on your end that was like, oh, that's that's important. I have to write that down.

SPEAKER_02 18:11

Um yeah, like I think that the idea of like, you know, we definitely document an athletic training, right? Um, but I think again, we documented what we did because that's what we did versus we have to doc like documenting and I never thought like I need to document this or I need to make sure this specific sentence is in my note because if I don't do it, I'm not gonna get reimbursed. I don't I don't have I don't have to specifically say that the patient has tried and failed conservative treatment, blah, blah, blah, blah, blah. I was like, this is what we did today, right? This is what they came and told me. This is what I saw objectively. Here was here's my assessment plan. This is how we're going forward. So much more logical. So much more logical.

SPEAKER_00 18:48

But but that's not a level four, Brandy. It's not yet, it's not a level four.

SPEAKER_02 18:51

And if you don't put this one sentence in there, then they're gonna deny whatever's coming next because you didn't, you didn't, they didn't take aspirin for seven days first to see if it helped. Yeah.

unknown 18:59

Yeah.

SPEAKER_00 19:00

Did you uh uh demonstrate any more appreciation for like what the surgeons have to do? Because I feel like again, from an athletic training standpoint and from your communication with surgeons outside of that, it's kind of glamorized, right? Like they see an injury, I tee it up, they get it, and they just have to fix it. But yeah, you see all the other stuff, right? I mean, the surgeons are just not operating, like on the clinic days, they're seeing stuff and convincing patients why it's not surgical and then convincing that it is surgical, and then talking them through wrists, and then dealing with the parents. Like, did you gain any more appreciation for the surgeon role?

SPEAKER_02 19:34

Yeah, because I think, you know, and in our role as athletic trainers, like we get to know our patients really well, right? So, like I didn't really ever have to do a lot of convincing because I had like a personal relationship with each one of them, right? Like maybe there was some like harder conversation with parents or something, right? Because I was working with like adults that were 18 and um didn't, you know, didn't need mommy and daddy all the time. Um, but you know, it was very interesting to like be in a room with a physician and and convince the patient that was like convinced they had something else and they came in that it's not that, right? Or they were so sure they needed surgery and they're like, actually, there's a really great conservative option for you. Like we shouldn't start out with surgery, and then for that patient to get pissed because it wasn't what they wanted it to be. So, like, I think like having an appreciation for like one, like that's really cool that we get to have that relationship, so it makes it easier, but two, like, oh, like navigating that when you don't is is a lot trickier and takes a lot of like skill.

SPEAKER_01 20:28

Yeah, yeah, yeah.

SPEAKER_00 20:30

So um now, as far as orthopedic surgeons and athletic trainers, okay. So this is kind of what I really wanted to talk about. You have, and again, this is you know, me to Brandy, but me to Hannah, like when you are working with a surgeon, you kind of get their protocols and you know when they want to see someone, right? Like you can see a patient, they injure themselves, whatever practice or a game. You're gonna send them into the surgeon when you think they need further imaging, you think they need, you know, a better exam, you you think they need more treatment than what you're capable of doing. So insert the PA into that. Like how working as an athletic trainer, but then also working as a physician extender, like where does that, where does that play in? Like, did you, what was your impression of PAs? Did you like them? Were you like, why is this person getting in my way? Like, what does that do to the dynamic with it?

SPEAKER_02 21:20

Yeah, I don't know that I've ever felt like PAs were in the way. I feel I feel like I definitely have had circumstances where I feel like the PA was like, felt that I was in the way or I was taking something from them. Um, but to me, like, I mean, I would in in our practice, right? I was we were really fortunate that I would refer to a PA just as quickly if I could to an MD, especially if the MD wasn't available and I knew the next step was imaging. You can order an MRI just as well as they can. So why wouldn't I let you T that? You know what I mean? Like, because again, like at the end of the day, it's like, are we taking care of the patient well? And then that's all that really matters to me. Um, so I don't know that I ever like had my like personal feelings of other than like If I felt like they had strong feelings about me or my role, like how do I like navigate that? Yeah, you know. Um, but I I personally never felt like, oh, I would never send a patient to a PA first. Like that was never really my thought process.

SPEAKER_01 22:14

But um But I have seen like some athletic trainers or worked around some who do have that mentality that they're like, ooh, don't see a PA, make sure you see somebody else, you know.

SPEAKER_02 22:24

Yeah. They don't have that trust. Like understanding like the dynamic between in and in my in my previous role here, you know, I had to explain that to patients a lot. I only want to see the doctor. And I'm like, the p if that PA is on that doctor's team, like they're like having a collaborator, they're another like yeah, another extension of that provider. There's no way that they're gonna do something that like would completely negate what the doctor would like. They're gonna be on the same page. If the PA had a question, they'd consult the physician before they I was like, you're you're getting the same quality of care. In this case, you really want a quick appointment. The first available is with the PA. Take it or leave it, it's up to you.

SPEAKER_00 23:01

But I promise you your care will be equal. Yeah. Do you think that your communication with PAs is easier or they're more available than the surgeon, or is that very completely dependent on sort of human relationship?

SPEAKER_02 23:15

Different. Um, and I think too, I think like how long has the PA been on that team? Like, what is their experience? You know, like I think with like you guys, like I think that was always really easy. I think like maybe like some of our newer like urgent care providers that were newbies, and a lot of times I knew more things, more about vasculoskeletal stuff than they did. Right. Yeah, with my approach would be different. So it really depended on like the dynamic of the team. But um, for sure, if if I walked by your pod and you were there, okay, cool, best here, that's who I'm gonna talk to you about, whatever this patient is. Yeah, yeah.

SPEAKER_00 23:44

Um, now as far as roles, right? So an athletic trainer in the clinic can be a physician extender. We employ a lot of athletic trainers as medical assistants, and I think it adds a next level of the HPI better. They can kind of guide their questions better, so they're a different caliber than just rooming the patient, a medical assistant that let's say doesn't have ortho experience. So I think, you know, as far as a role distinction in the medical assistant setting, I think that that's, you know, they they have the upper hand, but athletic trainers can do a lot of things, right? So, like, let's say I'm checking out a patient and I want to go over um exercises with them. Like, either I'm gonna do that in the room with the patient, spend 10 minutes, or I'm gonna send you in and trust that you're probably gonna do a better job than I do, right? Because you you can employ home exercise programs. Some athletic trainers will do postoperative rehab with these patients. Um, but more recently, and you can speak to this, athletic trainers can get their OTC, is that right?

SPEAKER_02 24:44

Yeah, so it kind of depends on the state what the if they have to get an additional credential or not. And our state, it just made it easier. So it's like a path of least resistant type of thing. And honestly, it has to do with credentialing more so than like skill. Um, but yeah, so with that in in our state, with that extra credential, like I was able to go into the the OR and and scrub in and and for the most part function very similarly to um to a PA, right? Or like a surgical first assist, right? So um very interesting experience for me because didn't get that training in school. So a lot of it was um on the job training for me. Yeah. So right. I mean, the test basically I took a test. I basically, because of my ATC credential, I could sit for the exam. I didn't have to like take go back to school. Yeah, I didn't have to go back to school, no courses, nothing. Um, and and to be fair, really didn't didn't study for the I mean like I already had the knowledge, right? So the knowledge was there, took the test, but then I was like, okay, well, now I can I can do this on paper, right? The hospital's credentialed me, but like never scrubbed in a day in my life other than like, you know, I've been in the old. So you're like the yeah, but yeah. Um, but like never really like scrub scrubbed in. So, like, what does that look like? Learning on the fly, sterile technique, like all the things, right? Learned a lot by doing the wrong thing and getting yelled at. Um, come on. Strongly, yeah. All right. So yeah, it's a strong word.

SPEAKER_00 26:00

But but did you ever say you're skeptical, or did you ever get that feeling that you were a like ever that animosity or uh maybe I mean everyone kind of just wants their own like space, right?

SPEAKER_02 26:12

Like so there is like, you know, like I have my niche, you guys have yours. Um, so there is, you know, I'm not trying to take away from anyone, but I do want to create space for myself, right? Like I really, you know, enjoyed this setting. And so, like, how do I how do I create space for myself and get to, you know, expand my knowledge and skill and ability in a way that benefits me, but also benefit the practice and benefits patients and that sort of thing. Um, this is probably a topic for another day, but I honestly feel like I probably stepped on, I felt more there was more of a threat from people in the like OR suite, like those people, probably there was much more friction than like the PA some stuff.

SPEAKER_00 26:46

Yeah, but I think though, if you're let's say they are, right? So you're first assisting, and let's say you're doing it because you want to, let's say you're doing it because we need you to, right? Or let's say you're doing it because you just want to gain extension.

SPEAKER_01 26:57

You volunteer too on a on a day that volunteer somebody is needing.

SPEAKER_00 27:01

Yes. But I mean, it's really hard for those, you know, not the surgeon, not the PA, but let's say the pre-out pack you or the scrub techs, right? It's hard for them to place you because at least Hannah and I, when we're in surgery and then we're out of surgery, like we're calling patients, we're doing this, we're doing that, like we're doing other things that the nurses can come ask us to do. And here you are, and they're like, Hey, I need you to put orders in. You're like, oh no.

SPEAKER_02 27:23

I actually can't.

SPEAKER_00 27:24

Or like, hey, I need you to send us a prescription. You're like, oh, can't do that. And that, you know, I think you were met with a little bit of like, what's her problem? Versus like, let me here, let me give you my laminated form of what I can do. So don't hold me responsible for that. So I think there's a little bit of role blurring there, but you know, not necessarily in an in a mosque. And then so much of that goes back.

SPEAKER_02 27:44

I mean, there are some states where like athletic trainers have standing orders to be able to do some of those things, like in that setting, the physician has to sign off on a table.

SPEAKER_01 27:53

And we even can do that, right? Like uh, especially for non-controlled things, yeah.

SPEAKER_02 27:58

So it's really again state to state. Yeah, but I I think I was more successful. I don't know, in some ways, I think there was some like especially like closing, like closing a win, like there was some there was some friction there. Why can't you do that? And I can't. Um, and I'm like, well, like my state practice act says I can. I have this extra credential, like my credentialing at this facility says I can, like the doctor has signed off on it. I've done it before. I've done yeah, I took courses to be, yeah, like I like check, check, check. Um, but um, yeah.

SPEAKER_00 28:28

And I think again, you kind of broke the mold, at least at our practice, with doing the next thing because you wore the admin hat and you you could do the medical assistant thing, and then you were administratively running certain departments, but also you're scrubbing in. Like I think, you know, if you're an athletic trainer looking at this, like that's through how many years of experience?

SPEAKER_02 28:49

Oh, see, I got I got certified in 2010.

SPEAKER_00 28:52

Yeah. So I mean, we're talking this is not a new grad situation. Yeah, but I think you also have to demonstrate competency and gain the respect of the surgeon, not just as an athletic trainer, but also as a competent individual that we want to use on our team. Yeah. Um, I do think when you have a physician assistant who's trying to define themselves, and then you have this other person who's super capable, I think that can cause a little bit of friction, but again, personality dependent. I had a medical assistant that was an athletic trainer that came very capable. Like he said he can do all the things, and I wanted to watch him do the things to make sure that I trusted him. And turns out he did a shitty job, right? But I mean, that that led to a very uh unfortunate situation where he said, no, let me. And I was like, absolutely not. Listen to me, let me tell you how I want it done. He was like, I don't need you to tell me how I want it done. Like that was an example of that didn't work out.

SPEAKER_01 29:44

Yeah, it didn't work out. Example of how things can go poorly.

SPEAKER_00 29:46

Yeah, but I think in the right setting with the right person, I think athletic trainers as physician extenders in various roles in orthopedics, great, super supportive of that. Yeah, yeah.

SPEAKER_02 29:56

Yeah, don't put me in women's health, right? Don't like there's plenty of things like don't put me there. I will not thrive. But yeah, orthop orthopedics, even like family practice a little bit. Yeah, because there's some but um but yeah, not not everywhere. We don't belong everywhere, and that's okay. Yeah, we're not trying to belong everywhere. Yeah, yeah.

SPEAKER_01 30:12

And I think that was the goal of the residency program too. I mean, at one point when it existed, it was to kind of like create that space and try to find out where people felt like they fit or how you could fit into multiple roles at once. Because I mean, and I'm not saying that this is ideal necessarily, nor did you probably find it ideal, but wearing like 20 different hats at once, and I mean, you're simultaneously like still doing sideline coverage, administrative things, yeah, you know, insert 10 other things.

SPEAKER_02 30:44

And I think our practice is, I mean, we're not small by any means, but we're small enough to we're like like we still do that. I mean, I I did that last Saturday, right? Like I still do that to kind of like, you know, keep my hands dirty per se. But um, but I think in in bigger practices, you know, the you you don't have people like they're still doing sideline coverage and in the clinic and that sort of thing. Um and that that's tricky too to like kind of like people probably tend to transition into like physician practice setting or this sort of thing because they want to narrow down a little bit. And so navigating that, but also meeting the needs of the practice or whatever else it is, you know, you you gotta find balance in all of it.

unknown 31:22

Yeah.

SPEAKER_00 31:22

And we have athletic trainers. We have one who used to work on our concussion specialist team, a lot of them. We've got two that work on our sports med team, one on our hand team, um, one on our spine team. I mean, there's one on joint scene. There's a lot of niches that these um athletic trainers can fill. And again, if you're a female and you want a family, it's not, you know, you're not on the you're not on the bus with the ice cream. Right, yeah. I mean, there's some balance that can be found in this setting that cannot be found in traditional division one. Yeah. Yeah. Yeah. So I I think that um, you know, for those looking to see what clinic life is like, I think you you both of you guys can say that that probably m you know made you well-rounded and introduced this whole other idea of what athletic trainers can do.

SPEAKER_01 32:06

Yeah, yeah. I think there's like there's just such a a plethora of things that going into it, um, you're already so much more experienced in and like that you can hand off um trust-wise, like doing a large majority of the note and documentation and things like that. A lot of the um like we didn't even talk about like casting and splinting and things like that. Those are all things that we learned in the city.

SPEAKER_02 32:32

Like the athletic trainer sees a lot of the follow-ups in clinic by them. Like, you know, again, the physician or the PA is there, but they're seeing those patients, they see the the simple, non-complicated post. You know, like they're they're doing a lot of stuff that's like taking pressure off of the PA or the physician that either allows them to see more patients, which is good for the practice, or just allows them to not be burnt out. I mean, I think there's like there's lots of correlation, there's lots of studies on physician burnout and adding an athletic train to the team and like how that changes the situation of that.

SPEAKER_01 33:03

You know, I love when I leave a room and I'm like, don't have to do the IM injections or something like that. Yeah. Or I mean, yeah. Even when I worked in the urgent care setting, right? Like the difference between working with an athletic trainer versus a non-athletic trainer who can order the appropriate imaging, right? Somebody who comes in the room and already evaluates them and is like, I actually think it's coming from their back and not their hip because they did these tests and asked the right questions initially and got the right x-ray because of that, um, or neck versus shoulder thing, whatever. Um, and then so that part is is teed up and easier, um, can do the injections and you know, does the HEP or you know, all the splinting and everything. Okay, we've taken off a lot of the burden of the provider so they can't. And then you can see more people, right?

SPEAKER_02 33:55

Yeah, yeah. So quicker. And and I mean there's lots of studies too that show that like like like patients like feel like they get the same quality of care. There's lots of studies that like as it relates to like musculoskeletal stuff, like athletic trainers get the same diagnosis 98% of the time as a doctor. So I mean, like we like we like it's our area of expertise, like you know, like so letting us contribute to that, um, everyone benefits. Yeah, yeah.

SPEAKER_00 34:20

As far as like future goals for yourself, what your experience as you know, um division two athletic trainer, uh clinic administrative now in your new role doing um, you know, an even broader scope of learning about EMR and applying your knowledge to the rest of the world. Like what else is in store for you?

SPEAKER_02 34:45

Yeah, that's a good question. I mean, I think that it's been fun so far to really contribute to like the EHR business, like, you know, I I definitely am contributing like from a clinical perspective, right? Um, I think I'll all you know, like I'll always be an athletic trainer, I'll always have my hand in it. Again, like I still do some more traditional stuff. Um, you know, I'm staying credentialed, both from like, could I jump into clinic one day if you guys needed me? Um, could I jump into the OR on a weekend if someone adds a case and their PA is not available? Like, yeah. So um definitely keeping all those things like where they need to be. Um, I don't I don't know that I ever see myself going completely back to like even like in the physician practice setting, like being on a team and and doing that. I think I always enjoyed the administrative stuff enough to know that like I wanted some of that in my life, and so we've we've kind of shifted pretty far to that. So we'll we'll see. Um, but I really can't imagine a world where I wouldn't be attached to athletic training and specifically like physician practice setting in some sort of capacity. Yeah. Yeah, cool.

unknown 35:45

Yeah.

SPEAKER_02 35:45

How fast can you tape an ankle?

SPEAKER_01 35:47

Um, oh my gosh, so fast. And I could probably do it blindfolded. So blindfolded. That's why we're gonna we have to do our beer Olympics. Let's do it. Blindfolded beer Olympics. We used to do AT Olympics in undergrad.

SPEAKER_02 35:59

There was no beer involved because that would have been, you know, frowned upon but we're depending on the real adults. Yeah, we're real adults now. So it's fine.

SPEAKER_00 36:06

Yeah. No, that sounds great. Is there anything that you wish the athletic training occupation offered you that you don't have?

SPEAKER_02 36:15

Um I think that something that's missing is like, and something that like, you know, there's there's discussions about is like being able to like actually like like bill for our services. And and there's lots of athletic trainers that have like they own their own clinic and they do cash pay, right? So like that is driving and that's alive and well in in in our profession. Um, but being able to like from a CMS perspective, like you know, like being able to recognize me as a recognize me in a in a different but equitable way that you do PT or PA or you know, pick pick anything else that's like comparable. Um, kinda do you think that would push the profession forward in a in a different way than we've able been able to push forward so far.

SPEAKER_01 36:55

Yeah. Because I have seen like uh athletic trainers open, I don't know that I call it practices necessarily, but like businesses where they're um contracting out services, right? They hire other athletic trainers that are then you know, like schools or whatever.

SPEAKER_02 37:11

But it's cash pay athletic trainer and they're and they're doing the same thing. And honestly, like in some ways you can feel better about that because that athletic trainer is working like underneath a physician, right, in some sort of capacity. So um, you know, what they're doing is you know, right and make sense. But um, but yeah, so that that's cool and people have found that niche and they've been really successful. Um, I don't know that would ever have been for me. Um, but I would love to like have the opportunity to explore that, but maybe in the more in the in the framework of like what medicine currently looks like, which is you know, third party reimbursement.

SPEAKER_00 37:46

Yeah. Is there any advice that you would give to an athletic trainer looking to get off of the sideline? Like where do they start? What type of skills should they highlight when they meet with a physician team?

SPEAKER_02 37:56

Um, I think the biggest thing is like that we're multifaceted. I think we get so stuck on like some of the things we can do, some of the domains of our profession and not all of them. Um I think another one too is I think a lot of like older athletic trainers will tell you if you transition out of something that's traditional, you're not a real athletic trainer anymore. Yeah. Like I use my skills in a a lot of different ways every day. Like like I could I could never touch an a patient or an athlete again. And in some capacity, I would still feel like an athletic trainer if that makes sense. But um, so I you know, just like the naysayers, like don't give, you know, don't give them a lot of credit for that because like that was their journey and that's really great, but there's so many opportunities and everyone needs to do what's best for them as far as like what they want their life to look like. Yeah. Yeah, a real athletic trainer.

SPEAKER_01 38:42

What is that? What does that even mean, right? What does that even mean? Yeah, if you're not on the sidelines like murdering yourself, yeah, working out when you're not real, yeah.

SPEAKER_00 38:53

Well, if you don't have like what a crossbody bag, yeah, you don't have your fanny panty pants, the dry fit polo and khaki pants. Khaki pants, are you a real athletic trainer?

SPEAKER_01 39:04

Well, I don't, and I'm not. Do you still have khaki pants?

SPEAKER_02 39:08

I um maybe own perhaps one pair. I'd have to go. Okay, I think you do. It sounds like you do.

SPEAKER_01 39:14

It sounds like you definitely have to do that.

SPEAKER_00 39:16

Not in like the traditional three of that. Or a pair of like smart athletic shoes that you can run in at any point in time.

SPEAKER_02 39:22

I I don't, I mean, whatever athletic shoes I have are the ones that I like wear to the gym or do whatever else. And I don't have shoes that are specifically for athletic training, and my fanny pack is a crossbody, and I've had it since undergrad. So it's, I mean, it's still kicking and living in the house.

SPEAKER_01 39:36

I love that you don't have like the big Mueller bag anymore. I don't. And apparently all the all the rage now is like heart. It's the heart shell cases. Dude, last time I covered a game, it was like this massive. It was like what a foo! And they were like pulling out different compartments. I'm like, holy shit, like my bag looked like a fucking disaster. Like there was just like pre-wrap and intertwined with like mixed up with everything else. Yeah, there was the mustard was exploded onto everything.

SPEAKER_02 40:03

Last Saturday, I I again I worked some soccer and I was I text Athletic trainer that I was covering for, and I was like, listen, I don't know about this hard kit life, but I was like, this is awesome. Like, we didn't have any of this shit. I was doing this before. I was like, it's so organized, it's so great. So organized.

SPEAKER_00 40:19

Final question. Um What do you feel about a gator? Like, how fast will you take a gator?

SPEAKER_02 40:24

Oh man, I haven't driven a gator in a long time. But we were like back in the day, we're whipping that, you know, whipping that thing again.

SPEAKER_01 40:29

Yeah, I mean, that would be a that was like the number one benefit to me personally was driving the gator.

SPEAKER_02 40:34

When you were a student, being like being getting to the level where they trusted you to drive the gator, that was an accomplishment. Yeah.

SPEAKER_01 40:40

Um you felt cool, like you were driving around campus and you were like, I get to drive the gator. And in my mind, I was like, people are looking at me right now thinking I'm cool.

SPEAKER_00 40:48

I'm like, I like so nobody thought that editorials. No, I cover I covered one of the high schools, and um, it was like it was a massive, like busy game or whatever, and my two kids wanted to come with me, so I was like, Oh my god, I'm not gonna get there for the stars. I parked like way far away. So I tested the athletic trainer and was like, hey, is there any chance you can come get me? She's like, I'll be right there. So she pulled up in the gator, my kids got in the back, and they were like, that was the cool coolest thing. Like, why are you not an athletic trainer? I'm like, that's a great question. Like that that stuck.

SPEAKER_01 41:18

Like, I just want to ride the gator.

SPEAKER_00 41:19

Like a core memory for them. Yeah, yeah, core memory. It was like off-roading and like, you know, nobody asked any questions.

SPEAKER_01 41:26

Oh my god. That was what really appealed to me. Yeah, when I was in high school. Saw the gator whip around the corner. Actually, we only had a golf cart for the first couple years.

SPEAKER_00 41:36

Abandoned, and I'm in.

SPEAKER_01 41:38

Maybe I should just like live in one of those golf cart communities.

SPEAKER_00 41:42

Yeah, like we're yeah, you'll be driving around like she was an athletic person. Yeah, like missing with my visor. She's yeah.

SPEAKER_03 41:51

Amazing.

SPEAKER_00 41:52

Well, thank you. I love it. Yes, thanks.

SPEAKER_01 41:54

Um well, we were talking about the fact that once you're more established than this, you'll have to come talk to us about uh the inner workings, yeah, the other side of things. The dark dark side.

SPEAKER_02 42:06

Well, you know, hopefully the goal is to do things to make it um easier. You're curing complexity. That's the company that I work for. So that's what their motto.

SPEAKER_00 42:15

I want a shirt that says that.

SPEAKER_01 42:17

Yeah, maybe we should.

SPEAKER_02 42:18

Curing complexity.

SPEAKER_01 42:20

So also I appreciate that you wore your backstreet boys shirt today. Yes, absolutely. Notice that.

SPEAKER_02 42:24

Brandy was my Backstreet Boys Backstreet Boys sweet. Backstreet Boys buddy. Yeah. And I'm paying too much for the shirt not to wear regularly. No, no, no.

SPEAKER_01 42:31

That's what was dude, merch prices at the sphere. It was insane. But after a couple of cocktails, yeah, when you're like you're there and the the experience is overwhelming, you're like, I will pay anything to wear the spirit jersey.

SPEAKER_02 42:46

Once you're gone, you can't, yeah, it's too hot for a spirit jersey today. Otherwise, I would have that one on. But it's for the memes. And once you're gone, it's not available. I don't think you can order it online.

SPEAKER_01 42:54

So I drink out of a cup very often because I'm like, wow, this was this was a life investment for me. Amazing. All right. Well, appreciate it until next time. And um, happy athletic training month to all the ATs out there.

SPEAKER_02 43:10

Care you can count on. Is that the motto?

SPEAKER_01 43:13

That's the theme of this year, yeah. Oh, I love it. Care you can count on. Can we put that on on the back of the shirt? Curing complexity. Curing complexity, care you can count on. Wow, it's like a can't wait. Yeah, tongue twister. Perfect. All right, till next time.

SPEAKER_00 43:36

Thanks for tuning in to Joint Effort PAs. If you enjoyed this episode, be sure to subscribe, leave a review, and share it with a fellow PA or med-minded friend. You can also follow us on Instagram at Joint Effort PA's for updates and extra content. See you next time.