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The Future of AT Practice

If you have read and are up to date on the latest proposed standards for AT education, and thus too for future AT practice, are you concerned about the direction(s) they are implicating for our profession?
PR Geisler, EdD, ATC

“Liberating education consists in acts of cognition, not transferals of information.” ~ Paulo Freire


  • I've read through some of the expected competencies that an entry level Master's AT would have. Some of it seems out of our scope of practice to me. My biggest question in regards to an entry level Master's is this: How will this create more jobs, and increase salaries of the AT jobs that already exist. There is no shortage of AT students becoming certified, what I see is a shortage of jobs for them, and low rates of pay for these entry level jobs. So we will expect an AT student to invest more money into their education, go further in debt, for the mere possibility of an AT job, with the same chance that they will not find a suitable AT job.
  • WARNING, WARNING LONG POST DUE TO IMPORTANCE OF THE ISSUE - In my humble opinion our profession is in trouble. I think the leadership at the national level has either lost touch with the athletic trainer in the field or doesn't think they can make a difference in the things that matter. Once again in my opinion the biggest issue in athletic training today is low paying jobs and poor working conditions (mostly number of hours). We have decided to pursue a Masters degree in athletic training and are requiring more and new competencies to make ATs even more qualified but yet are doing nothing about raising the wages of athletic trainers and improving their working conditions. As usual we are chasing other professions (primarily PT and Nursing) as we try to lay the ground work for our future. There are those that will preach to you that moving to a Masters level degree will produce fewer ATCs to the market (true as many schools will drop their AT programs) thus causing a supply and demand effect that will raise wages. HORSE HOCKEY!!!!! That is exactly what was preached when we went from the internship and curriculum model to the accredited program model and guess what that didn't prove true. No one can prove to you that AT wages have increased beyond the normal economic growth due to this change. In fact if people were honest they would tell you that AT wages have not kept up with the normal economic growth index. As anyone in the profession knows this coupled with the large amounts of hours required of most ATs has had many leaving the profession to pursue more lucrative jobs with better work/life balance. The biggest problem with this is that many of these are quality ATs not just the lazy slugs. I used to be one of those ATS that wore that badge of honor (so I thought) of low pay and long hours. "Welcome to athletic training " I'd say when a student would complain about hours or pay. "That's the AT way" you'd hear "You don't get into athletic training to get rich. You get into it because you love it" All this was thrown out so we could feel better about ourselves for letting others treat us poorly. It took me a long time to wise up. Our national leadership had the chance to make a major difference and come to the ATs aid when ATs in the field started challenging in court the overtime laws (thanks San Antonio Ats you were at the forefront here) but the national office choose to stay out of the fight and just observe to see what would happen. That is not my opinion that is fact as confirmed to me by Eve Becker Doyle. The FLSA had not been changed in 65 years and when it finally was it was not in the favor of ATs. So here we are working 50, 60, 70 and in some cases more hours a week and not being paid over time. I am well aware that Taking on the FLSA would be a daunting task especially in light of what has happened. But, for some reason our leadership is not interested once again. When I asked about this very issue at an educators conference I was told we were not interested in aligning ourselves or being lumped in with garbage truck drivers. For some reasons nurses were not mentioned. We are very much like nurses and again seem to follow them when it comes to things like competencies and level of education but apparently our leadership doesn't think we should be paid or treated like them. Go ahead do a poll of ATs and ask them if they would be happy with working long hours if they were getting paid overtime I'm pretty sure your hear a resounding yes! Then ask them if they couldn't be paid overtime but could have their hours limited to 40 hours per week would they be happy and again I predict you will hear yes! But hear we are working more than 40 hours a week and not getting overtime. What's wrong with this picture? I know many old time ATs might scoff at the idea but why shouldn't ATs be on a 40 hour work week? Why shouldn't we be paid as well and have as good of working conditions as somebody in Detroit putting lug nuts on a Cadillac? (By the way those guys make more than the average AT and don't need our level of education). Once again in my opinion the educational changes coming down the pike will cut the number of AT programs in the country and will thus produce fewer ATs but if you think schools are going to suddenly be competing for ATS and offering attractive compensation packages for them you are sadly mistaken. Things are only getting worse for AT students. As you may have noticed GA positions are going away in favor of internships this is a direct result of the changes being made to the AT programs. No more will students be able to get their undergraduate degree then get a GA position to help pay for, or completely pay for their Masters degree. Oh no they will instead incur more debt (Oh Joy!). Having spent a fair amount of time with athletic training students recently in my role as an educator I have seen that many of today's students are not interested in working the long hours for low pay of the past. In fact for those programs going to the pure graduate level athletic training program model I ask how is that much different from the old days when you could go to XYZ University that had an internship athletic training program and get a degree in economics and become an AT as long as you had the 7 classes and the hours? In fact those programs will go from what in most programs now days is 3 years in the AT program to two years but at a graduate level. Sounds a little confusing to me. In fact here is how I see it from a student perspective. If you are a good student with average to above average intelligence you could get your undergraduate degree then have the choice of going two more years to a graduate AT program to get into a profession with long hours and low pay or enroll in a PA program for 2 years and get into a profession that will offer you a much higher earnings potential and better working conditions. Hmmmm sounds like a no brainer to me. Oh but don't worry AT we can still get those students who do not have the grads to get into PT or PA school. If athletic training isn't made a more attractive and viable profession we are only going to become less and less of a player in the field of healthcare. Want to hear another scary and very possible scenario? What if someone were to come up with a two year undergraduate even JC level program called something like Sports Medicine Aid or some other title that watered down an AT curriculum but taught enough to do basic taping and evaluation some what like an EMT but in our field. Do you think high schools, JCs, and colleges would hire those people? Absolutely they would and pay them less. There would be plenty of people that would do that. And by the way since were on the subject hasn't one of our major missions in the NATA been to get ATs into the high schools? How many of these new Masters level ATs do you think will want to go out and get a low paying high school job after incurring all of that debt going to school? There will always be some students from the get go that will want to be a high school athletic trainer and thank God for that because we need those folks but you can't build or sustain a profession with those folks. I believe our profession is at a major crossroads and if it is not handled properly it will lead to athletic training be an also ran profession. I'm sorry for bending your ear for so long but this is something that I am very passionate and at this point worried about in our profession. I fully respect your right to disagree with me and would welcome further discussion.
  • WOW Randy!!!Thank you for hitting the nail on the head!! I am one of the "old timers" and I too was one of those that wore the "badge of honor " and said all the same crap about long hours and low pay. Then I too woke up. I find it totally disgraceful that a profession with as many highly qualified medical professionals as we have get so completely dumped on and disrespected. That may sound like strong language, but I assure you, I have seen it and experienced it first hand on many occasions. I am lucky that i was able to finally, after many years, get my dream job, but for many that is a pie in the sky. I have gone to the NATA annual meeting every year for 20+ years and listened to our leadership make promises of better salaries and working conditions. WHY HASN'T THIS CHANGED IN THE 30+ YEARS I HAVE BEEN PRACTICING!! The nursing profession has made great strides, the PT profession has killed it during that time span, even the Chiropractic profession has knocked it out of the ballpark. Why can't Athletic Trainers get the same traction!!?? Come on leadership, stop keep coming up to the plate and go down looking. START SWINGING AWAY!!! Who knows, you might even hit one out of the park!!
  • NATA and the profession of Athletic Training WANTS to be able to bill for services. This is nothing new. However, as I sit back and think about this for a few minutes, I cringe at the thought of insurance infiltrating the profession of Athletic Training. I work in a clinical setting during the summer months and insurance is one of the main issues PTs, PTAs, manager and most importantly, the patients, complain about. Insurance companies literally create a barrier between you and the patient. It's odd to think that I couldn't wait for the summer to be over with, so I could get out of the clinic to get back into the high school. The thought of billing my athletes for evaluations, taping strategies and rehabilitation at the high school level is insane and I truly hope it does not move in that direction. If/when it reaches the colleges and universities, it won't be long... I realize this point of view may not be "mainstream", but when healthcare intersects money, there’s a lot of room for conflict of interest. Just look at the current system and that alone should be enough incentive to feel lucky we do not have to deal with that crap. I believe NATA's desire to be able to bill for services, increase our "value" and salaries, will have negative consequences that will actually ruin the uniqueness of the profession and most certainly take out the fun in Athletic Training.

    We all know every professional sports team, college and university employs one or more ATs, but roughly 30% of all high schools still have no athletic trainer or even access to one at all. Even if only one AT is hired for each of these schools, the potential market for jobs is pretty big at 12k+ more job opportunities and this doesn't even begin to take into account the potential job possibilities at middle schools. This has improved greatly in just the last 4 years when only 42% of high schools had access to an AT. Although this is great, in recent years the push has been to broaden the scope of practice for ATs to find work as physician extenders, industrial or clinical setting. Athletic trainers have been trying, with some success, to make a case to both employers and third-party payers that we are every bit as prepared as physical therapists, physical therapy assistants, occupational therapists and other health care providers to work with diverse patient populations, which is all fine, but not exactly where our strengths shine.

    Athletic trainers are extremely well prepared to deal with physically active patients who have sustained injuries related to sport activity. In fact, we have better academic preparation and clinical training than ANY other group of health care professionals to work with this population. This is our niche within the health care system and we are very good at it. No other professional is prepared to direct prevention efforts, provide on-site emergency and non-emergency care, direct appropriate follow-up and ensure sufficient rehabilitation and recovery for return to safe participation in sports. In doing so, we provide a much needed service to a very specific patient population in a health care setting very few other health care professions are interested in serving. This is what makes our profession so unique and fun. We are athletic trainers after all. If we are not at every high school in America yet, we are failing thousands of student athletes, coaches and parents. Until we reach that goal, I think we should keep our focus at the high school level which still has significant needs, while the current health care system continues to implode with less reimbursement from insurance providers, more red tape for clinicians and direct impedance to excellent patient care.
  • I agree totally with the idea of getting paid for overtime.. an entry level Masters will not provide the opportunities AT's are looking for. As long as the APTA can continue to suppress athletic training our credibility is being undermined. As long as Coaches, athletic administrators view athletic trainers as water toting, ankle tapers.. or "trainers" we will be an under class within the health care field, athletic departments, the general public-we have a once a year gathering to tell ourselves how great we are, what a good job we do and so it-funny part is its TRUE-we are the best health care providers to athletes in the world, WE are the GOLD STANDARD of athletic health care. our problem is WE CARE TOO MUCH FOR OTHERS, AND TOO LITTLE FOR OURSELVES-after 32 yrs time to say goodby.
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