By Shelly Wilson
Shelly Wilson is an Assistant Editor at Training & Conditioning.
Training & Conditioning, 11.2, March 2001, http://www.momentummedia.com/articles/tc/tc1102/state.htm
So often in our lives, we are consumed only with the bottom line. We order a burger at a fast food joint and we gripe about the $3.00 cost, giving no thought to the rancher raising the cattle or the teen working after school to serve us. Or we happily accept those handy sheets of address labels the American Lung Association sends us every year, often without stopping to consider actually making a donation to the organization in return. In short, we take a lot of the conveniences in our lives for granted.
In many ways, the work state athletic trainers’ associations do is regarded with the same, well, disregard. Every day, athletic trainers enjoy the benefits of more recognition under the law, broader scopes of practice than 10 years ago, and more jobs, often without a thought to how those professional benefits came to be. But the fact is, many of the gains of the last 15 to 20 years are thanks to a handful of individuals in each state athletic trainers’ association who have been working steadily to unify and advance the interests of their fellow athletic training professionals.
To an extent, the oversight is understandable. After all, most of these associations have no main office you can visit, no one phone number to call with questions, and a governing body spread out to the four corners of each state. And yet, they still manage to get the job done. While you may be a long-time card-carrying member of your state association, the question remains: How much do you really know about your state’s athletic trainers’ association? Its mission? Its past achievements? Its current areas of emphasis and effort? And more importantly, apart from submitting your yearly dues, how could they use your help now? In this article, officers from a number of state athletic trainers’ associations explain their current mandates and share ways more athletic trainers can get involved.
PAST & PRESENT OBJECTIVES
The role of a state athletic trainers’ association—according to most of their mission statements—is to improve the quality of athletic healthcare in the state, improve the profession in all practice settings, facilitate professional relations between ATCs in the state, and enhance the knowledge of its members. Many go about achieving these ends through similar means: by hosting annual meetings and workshops, providing members opportunities to acquire CEUs, publicizing relevant news and studies, publishing membership directories, working with governmental bodies to strengthen the profession’s status . . . and the list goes on.
The fact is, most of the professional comforts you enjoy today are due to the efforts of your state association. At one point, a coach taping his or her athlete’s ankle could call him or herself an athletic trainer. Years of persistence and legal maneuvering have protected the title and reserved its application to only those with the proper education and training in the field. Since then, in many states, licensure has been secured, protecting the public and lending respectability and credibility to those in the profession. But despite these efforts (which for some may seem part of ancient history), leaders in the state associations agree that there are still hurdles to overcome before athletic trainers achieve an equal footing with other allied health professionals. These are the issues that occupy many state associations today, and these are the current projects which, if resolved, will secure professional improvements for all athletic trainers.
One of the foremost pursuits is third-party reimbursement. Particularly for those states that already have licensure, this has become a big priority. Even for those athletic trainers not working in a setting that will be able to take advantage of this allowance (like high schools), it’s a project state associations hope all members will support, as its passing could generate more opportunities for all athletic trainers.
“The big drive, nationwide, is to get third-party reimbursement so athletic trainers can bill for the services they provide—whether they’re working in a clinic or not,” says Jack McNeeley, MEd, ATC/L, Head Athletic Trainer at Cleveland State University and Past President of the Ohio Athletic Trainers’ Association. “It’s an adjustment that will make us more marketable. We’ve seen some members employed in hospitals or clinics lose positions because the institutions had to say, ‘There’s a very limited thing we can do here with you, and we really don’t feel like we can generate enough revenue to justify the additional salary.’ If we are able to bill directly, and actually become revenue producers for clinics and hospitals rather than people they mainly use for outreach, then our value increases and it helps create jobs.”
“We feel that we are regulated, credentialed, educated allied healthcare professionals,” says Tim McLane, MBA, ATC/L, Athletic Trainer at the Watson Clinic in Lakeland, Fla., and Chair of the Athletic Trainers’ Association of Florida Governmental Affairs Committee. “To assure that the public has access to our resources, we have to find a way to continue to exist in the marketplace—that is a pure reality. And one way to do that is to make sure we can provide care within the bounds of the health insurance system as it now exists.”
According to those involved, it’s an arduous process that requires an enormous amount of networking with government officials, monitoring new laws introduced that may affect the profession, and recruiting legislators to sponsor the association’s bill. In addition, a significant amount of time is dedicated to appealing to and educating newly appointed state legislators, letter-writing campaigns, and organizing rallies.
As the one state to have acquired third-party reimbursement for its members, Georgia has discovered that much follow-up still remains. “There are always hoops to jump through when you pass a new law,” says Kelli Sabiston, MA, ATC/L, Head Athletic Trainer at Marietta (Ga.) High School and President of the Georgia Athletic Trainers’ Association (GATA). “It didn’t happen overnight—it took us three years. And now our efforts are directed toward making sure the new law is being complied with.
“We get feedback from those athletic trainers who are billing,” she continues, “and they tell us if they are having trouble with any aspects of the process. If so, then the GATA can communicate with the insurance commissioner for Georgia, or our lobbyist can reach certain legislators who can direct us to people who can help. But we’re trying to support the membership as we all adjust to this development, even if third-party billing doesn’t affect each of us in the association directly.”
The GATA has also been working hard to inform athletic trainers in Georgia about the new law. “We put together a whole packet of information for our members on the law, and we’ve used the Internet a lot to disseminate information,” Sabiston says. “We’ve explained what the bill means and what it does for the ATCs in Georgia. We’ve fielded questions, had a presentation on it at our annual meeting, and we’re going to have another one on it at the meeting coming up. But there are always stragglers. Most GATA members are informed now, but we still get calls from people who aren’t members and they aren’t even aware that the legislation was passed.”
Universally, state athletic trainers’ associations are also taking on the responsibility of organizing efforts to increase the public’s understanding of the profession. “A couple of years ago, the Ohio Athletic Trainers’ Association ran three public service announcements statewide promoting and explaining athletic training—because there is still confusion among the public about what athletic trainers are,” says McNeeley. “You can pick up a paper here in Cleveland and read something about a trainer being under drug charges, and it’s about a horse trainer who’s been doping horses. You have trainers in boxing who have nothing to do with what we do. And personal fitness training is another area where people use the term “trainer”—those all add to the confusion.”
According to McNeeley, demystifying the field’s role for the public has positive implications for athletic trainers. “Clarifying what we actually do is beneficial, especially when you consider high school coverage issues,” he says. “It allows parents and administrators to understand that we do more than make kids run and lift weights—which is often the perception. Increased recognition will also make it easier for our membership, because when athletic trainers first go into schools, there will be a better understanding of what an athletic trainer can and cannot provide for the school and its competitive athletes.”
Other critical PR efforts are being directed toward government and fellow healthcare providers. “To protect our profession, we need legislators to know who we are and what we do,” says Sydney Ringer, MS, ATC/L, Coordinator of Sports Medicine Services at the University of Tulsa and Vice President of the Oklahoma Athletic Trainers’ Association. “There are some other allied health professions trying to legally define what assisted personnel are, which could possibly interfere with what a clinical/industrial athletic trainer does at a clinical site. And if, for instance, any other allied health professionals introduce a bill that redefines what an athletic trainer can or cannot do in a clinic setting, we do not want that voted on without legislators understanding what our background is.”
TARGETING HIGH SCHOOLS
Another concern state associations nationwide are working to rectify through PR and education endeavors is the lack of athletic trainers positioned in the high school setting—which is seen as the largest potential market for ATCs. Their hope is that current and developing PR efforts will help articulate and identify the need, thereby creating more jobs for all athletic trainers in the state and improving the care of student-athletes.
“I would say the majority of high schools in Georgia have some sort of coverage,” says Sabiston. “It may be someone employed by a clinic serving the high school part time, which is better than nothing, though it’s not the ultimate arrangement. The best way to take care of athletes is to be on campus and to be available to cover all sports—not just football and basketball. The association has made that argument by making presentations at the Georgia Athletic Directors Association convention. Representatives from our organization have met with the Georgia High School Association. And we’ve sent letters to athletic directors and administrators of high schools explaining the value of an on-campus athletic trainer.”
In some states, associations are finally beginning to see some results from these education efforts. “Our members, working in conjunction with the National Secondary Schools Committee and the Chicago Public Schools System, have recently reached an arrangement whereby the system has agreed to begin hiring athletic trainers,” says Donna Wisely, ATC/L, Head Athletic Trainer at Hoffman Estates (Ill.) High School and Vice President of the Illinois Athletic Trainers’ Association. “That school system has 72 high schools broken up into six regions. The system has agreed to begin the process by putting one athletic trainer in each region to let him or her examine the needs of that region. If we can show there’s definitely a need there—which is going to become apparent pretty quickly—then more jobs will be created along the way.”
With the advent of renewed legislative efforts has come an increased need for fundraising—yet another responsibility state athletic trainers’ associations are addressing. “Before we started our legislative efforts,” says Sabiston, “there wasn’t a strong need for raising money. Now there is a very strong need, and we have to do more in that area if we want to continue to pay a lobbyist to help us.”
McLane agrees. “You don’t enter the legislative arena without having to do extra fundraising,” he says. “It’s the world of politics and that is the way it’s done. And it’s a reality athletic trainers have had to come to almost overnight. That’s why we’re so anxious to have everyone participate with their dues.”
“This is the first year we’ve employed a lobbyist,” says Wisely. “And we deliberated about it for a long time, because in the past we had been so successful in achieving legislative change ourselves. But this year, it became apparent that we didn’t have the bodies to travel to Springfield, knock on doors, etc. And a lot has changed in the legislature, as well. Its not as easy to get things passed anymore because there are lots of groups who are very critical of what’s going on in the medical community as a whole. We’ve run into some resistance along the way, which has made things more difficult.”
How much fundraising are we talking? “It will cost us at least $20,000 a year for the lobbyist and his expenses,” says McLane, “and that doesn’t include any Political Action Committee money or campaign contributions, annual meeting expenses, association operational costs, or accountant fees.” But in light of the legislative strides a lobbyist can help an association make, association representatives agree the expense is well worth it.
Despite the increasing financial obligations, state athletic trainers’ associations are as interested in getting members to step forward and help with events and projects as they are with collecting annual dues. “We always need more bodies,” says McLane, “because there always seems to be a core of about five percent of the membership that does the bulk of the work. The membership wants these things accomplished, but for whatever reason, we all come up with excuses as to why we can’t help. But if everyone would get a little more involved, the load would be lighter on everyone. Plus, when an organization fails to have enough new, different, or revisited input, it can become stagnant.”
Officers agree that when coupled with the numerous goals they’re working toward, members’ reluctance to assist with projects is a big obstacle they haven’t quite figured out how to resolve. “I think a lot of it boils down to the fact that athletic trainers feel they’re overtaxed in their jobs as it is, and this would be just another thing to add to their plate,” says Ringer. “Many take a passive stance and think, ‘Oh, they’ll get it done. They don’t need my help.’ Where, in fact, a state association relies heavily on the members of that state. We’re a small organization. And when five or 10 people are always carrying the load, those people are going to get tired and just throw their hands up and not do it. So the responsibility needs to be spread around.”
The benefit, they say, is not just that it helps the association meet its goals. Active participation can also help athletic trainers do their jobs better. “Anytime you’re educating the public on the profession, you’re improving your situation and gaining respect, and that’s better for anybody in any job,” says Sabiston. “I also think just being around peers and bouncing ideas back and forth is valuable. It’s fun to be around other athletic trainers, from all settings, who care a lot about others, about medicine, and about helping. And it’s great to talk to people like the Atlanta Falcons’ athletic trainers and realize that they have the same headaches as I do at a high school.”
“It definitely provides you with more resources because of all the networking you’re able to do,” agrees McLane. “You may work on a committee with an athletic trainer from the south end of the state who you don’t see or talk to often. But that person might be a good resource to tap for ideas regarding what you’re facing with your athletes—be it rehab protocols, motivation, or dealing with coaches or parents. And having more resources within your own personal network always enhances what you do as a professional.”
For many members, the perceived time commitment that involvement requires is a discouragement. For others, they might fear that they are too new to the profession to have any experience or wisdom to offer the association. Both counts, say those active in associations, are misconceptions.
“The majority of our members are fairly young, in their 40s or below,” says Ringer. “We’re all learning together. So every member has something he or she can contribute. The only expectation is that you’re willing to work hard, want to follow through on projects, and see that things get done.”
The same is true of time commitments. Officers stress that a member’s volunteerism can be as time-intensive or brief as he or she would like.
“It doesn’t have to be that demanding,” says Sabiston. “Usually, people volunteer on a project-by-project basis, so it’s not that much of a drain. If you want to help with a particular event, you can help with that and when it’s over you get a break. At most, our executive board—myself, the vice president, secretary, and treasurer—meets quarterly. We have one formal meeting in January for all the committees, and then it’s up to the committee chairs to schedule their meetings. And usually they’ll try to hold their meetings at the NATA district meeting or the NATA annual meeting. But ultimately, we just do a lot of communicating by phone and e-mail.”
Even so, often, when elected positions open up, nominees run unopposed. In fact, the lack of volunteers is so great that many associations don’t even have all their main committee slots occupied. As Vice President of the Illinois Athletic Trainers’ Association, Wisely is in charge of planning the annual state meeting and is constantly looking for people to join her committee and help. “One person could find speakers and put the program together,” she says. “Another could reserve hotel A/V equipment for the speakers’ presentations. And I can always use someone to organize and recruit members to cover the table so everybody can enjoy the meeting.”
But potential avenues of involvement go beyond executive and committee positions. According to representatives, there are events and projects to satisfy any interest. “For members who don’t want to be on the board, but do want to help the association out in other ways, there are tons of opportunities to contribute,” says Wisely. “For instance, we could use additional bodies at the athletic director and school board meetings we present to. If we could put together a panel of speakers representing each of the different athletic training settings, then that would be a better presentation. Another way is helping to provide coverage at special events, like our state’s Prairie State Games. Or members could volunteer to help man our booth at the state fair for part of one weekend.”
“Members can also help PR efforts by speaking to the civic organizations they’re involved with—their PTA groups, for example—and explaining what athletic trainers do,” says Ringer. “We even have an NATA PowerPoint presentation and videos, as well as brochures, that members can use as aids in their presentations.”
And if you are particularly passionate about the legal changes being proposed in the profession, there are ways to contribute in that arena as well. “When it comes to trying to influence the legislature, it can’t be left up to five people to show up on the legislature’s steps,” says Ringer. “We need a unified front showing up.”
“With the changes that we’re trying to get passed in the legislature,” says Wisely, “it becomes an effort that each athletic trainer really has to work on. We all live in a different area and district, so calling and writing our representatives and senators, as well as taking the time to appear with the association in Springfield, is really important. The more legislators who have heard about those changes before the bill goes to the floor, the better their discussion is going to be, and hopefully the more positive the outcome is going to be. If those legislators don’t know anything about athletic training, then they will just sit back and listen to these discussions, thinking to themselves, ‘Well, it’s not important. Nobody in my district seemed to care about it.’ And then the bill just gets passed over.”
MAKING AN IMPACT
Ultimately, your state athletic trainers’ association is an athletic trainer’s greatest professional advocate. It exists to help ATCs help themselves as well as provide its membership a voice at the district and national organization levels and in the state legislative arena. The impact of state associations on the profession is inarguable.
“If you want to effect change, improve situations, and educate yourself and others, your state athletic trainers’ association is the place to do it,” says Sabiston. “And getting involved in your state organization, in my opinion, can help more than involvement at any other level.”