By Dr. Steven Lesh, Jeff Konin, & Bernie DePalma
Steven Lesh, PhD, MPA, ATC, PT, SCS, is the Graduate Research Coordinator at Southwest Baptist University. He is also an educational consultant and president for RidgeCrest Learning, Inc. Jeff Konin, MEd, ATC, MPT, teaches in the athletic training education program at James Madison University and is a partner in Scholarly Solutions. Bernie DePalma, MEd, ATC, PT, is the Head Athletic Trainer at Cornell University and a recipient of the NATA’s Most Distinguished Athletic Trainer Award.
Training & Conditioning, 12.8, November 2002, http://www.momentummedia.com/articles/tc/tc1208/profits.htm
Healthcare challenges at the beginning of the 21st century are many and diverse, but they seem to present with a common theme: Money.
Athletic training is certainly not immune. Fluctuations in collegiate athletic training room budgets jeopardize the continuity of care for student-athletes and limit programs’ abilities to meet escalating costs and growing demands. In short, it’s getting harder to do your job the right way.
We propose that it’s time for athletic trainers to think “outside the box” when it comes to funding programs, and to claim control of the athletic training department’s fiscal health. The “box” is viewing the athletic training room as merely an athletic department’s line-item expense—a burden on the budget, with no return on the investment. It’s also accepting the status quo, which grants athletic training programs, with their comparatively small numbers of students and staff, little respect in budgetary politics.
Instead, athletic trainers should adopt an entrepreneurial outlook. Recognize the value of your program and make others see it, too. You know that the services you provide are of value, but is there a way your program can be compensated for them? Might there be ventures you’re involved in that provide greater benefit to the other party and should be redesigned so that the value of the exchange is of equal or greater benefit to the athletic training department?
To be sure, some of these ideas will face resistance. For many athletic trainers, this reflects an entirely new way of viewing their profession. Others outside the athletic training room, too, may face some adjustments before accepting a new model of operation. But as the challenges of working under the old rules increase, new approaches will have to be considered.
In this article, we explore creative ways to provide primary and secondary funding for the athletic training room, and we offer suggestions of how to take more control of your program’s fiscal life. Some are ambitious, and you’ll have to weigh the potential gain against the investment in time and effort. But we present them to stimulate your thinking about what is possible.
Probably the first thing that comes to mind when talking about the value provided by athletic training is reimbursement. Some athletic training departments are billing athletes’ insurers for their services, and many others are considering it.
Going this route, of course, requires some hard thinking and consultation with accountants and other specialists. Administrative costs have to be compared to potential earnings to determine profitability. But consider joint ventures with rehabilitation facilities or hospitals, as well as outsourcing elements of billing and collection to make the process more manageable.
At all times, however, the athletic training department and university should appreciate that the potential for billing of rehabilitative and preventative services is substantial and should not be given away below market value. For example, don’t simply send out rehab work that can be done in-house. You’re sending away money.
And don’t overlook less-ambitious approaches to treating athletic training as an income-generating enterprise. For example, consider having the athletic training room establish an open-house type of period during which community members utilize rehabilitation services. Community members could pay a periodic or per-incident fee.
Another idea is to provide rehab services to the student body population. To cover the start-up, capital, and operational costs for the venture, consider asking university student services to direct a portion of student fees to the athletic training room budget. If budgeted properly, the operation can generate insurance reimbursement income for your program and the university. In selling this idea to university administrators, remember to emphasize that you’ll be providing a quality service to the students.
In some cases, rendering these services may require adding full-time staff. But the arrangement could conceivably be designed so that while their salaries are paid for through the new revenues, their outside work doesn’t require a full 40 hours a week. The rest of their time would be spent on the core work of the athletic training room, thus enlarging the pool of available staff hours without extra cost.
If the above examples are a little more ambitious than you were looking for, similar ideas can be developed within partnerships. At Iowa State University, for example, the athletic training program has teamed with others to create Cyclone Sports Medicine (http://cyclones.ocsn.com/trads/iast-trads-phytherapy.html).
An internal joint venture among the athletics department, the student health center, and the Department of Health and Human Performance (which houses the Athletic Training Education Program), Cyclone Sports Medicine staff members serve students, faculty, and university staff. They also assist in the rehabilitation of student-athlete injuries, support athletic training clinical education, and provide medical coverage for athletic teams.
Another example can be found at the University of Nevada-Reno, where the multi-million-dollar Reno Orthopaedic Clinic Sports Medicine Complex (http://nevadawolfpack.ocsn.com/school-bio/cashell.html) opened in 1993. Funded by the Reno Orthopedic Clinic, it provides sports medicine services to student-athletes and doubles as a diagnostic and rehabilitation center for area residents.
Partnerships can also be a good idea outside the concept of billing for services. Take a look at the needs of your local high school athletic programs, for example. A college athletic training department could provide partial or full athletic training services to high schools in return for a fee.
Another idea is to ask local rehabilitation clinics to support or establish graduate assistant positions for the department. If designed properly, the agreements could provide graduate-student manpower to both the clinic and the athletic training program.
Along a different line of thinking, how about utilizing your staff’s knowledge base as a revenue source? Consider, for example, organizing continuing education courses with other departments on campus. An athletic training department might join with a department of anatomy to establish a continuing education course in practical anatomy, with the business school on a course in managerial or leadership techniques, or with the physical therapy department to offer a course in lumbar manual therapy. When produced and held on college campuses, such courses tend to have relatively low overhead compared to the same course being hosted at a local hotel.
Continuing education courses can also be conducted with off-campus partners. An athletic training department may contact established continuing education providers and offer to host a course for a portion of the proceeds. Alumni could attend for reduced rates, offering the double benefit of attracting more paying customers and enhancing alumni relations.
The educational-event idea can also work outside of continuing education. Could your program put together clinics for area coaches, high school students interested in the profession, or other groups? If planned efficiently, these ventures not only will generate small revenues, but can also serve as a wonderful learning experience and resume builder for your staff.
TRADING ON YOUR GOOD NAME
Long a major presence in athletics, business sponsorship is becoming more common in sports medicine. Naming rights for stadiums are widely accepted in professional sports and growing steadily among universities and colleges. But it’s not just buildings. For example, the National Athletic Trainers’ Association routinely solicits sponsorships for officially endorsed products.
If a physician’s group or hospital claims that they are the official provider of sports medicine services for the student-athletes of the university, then why shouldn’t the athletic trainer find a way to have monetary support of this claim directed to benefit the athletic training room? Or, more importantly, can you convince the professionals you regularly work with that an official affiliation with the department is worth paying for? If so, there are many potential sponsors at your disposal: an official team doctor, a dentist, a chiropractor, a podiatrist, a physical therapist, an orthotist, a radiologist or radiology services firm, an ambulance service, and possibly a durable medical supply company.
The athletic trainer practicing outside-the-box thinking should remember that an exchange of services in lieu of a monetary commitment may also greatly benefit the athletic training room. If the potential exists for contracting naming rights within or for the university athletic training room, consult legal counsel before proceeding too far.
CASH IN ON THE PAST
Perhaps the most enduring budgetary supplement for ongoing and one-time needs on any campus is one that comparatively few athletic training operations have tapped: alumni giving. The creative athletic trainer may find significant long-term financial stability for athletic training services if alumni relationships are encouraged and nurtured.
It takes a long-term commitment and attitude of giving among staff, students, and alumni as well as significant involvement from the university or departmental development staff. But it can lead to endowed positions, scholarships, or building funds created from the annual revenues generated from the investment accounts of the accumulated gifts. Endowed funds may also complement annual budgets for continuing education, equipment purchases, or supplies.
Designated athletic training staff members should meet with the appropriate fund-raising or developmental people at their institution. These experienced professionals can provide the new-to-fund-raising athletic training staff with direction on specific strategies. Next, jointly set goals and generate a mailing list of potential alumni (both former athletic training students and student-athletes) or organizations to contact for donations or pledge gifts. Early in the discussions, realistic yearly fund-raising goals should be established and specific uses of the endowed funds should be identified.
One strategy is targeting specific generations of alumni. Very young and older alumni are typically most receptive. Recent graduates may be more primed to making an annual donation, whereas alumni who graduated more than 20 years ago and have accumulated more wealth may welcome the chance to put an endowment provision in their estates.
Another strategy is to target particularly successful alumni. Many student-athletes who find great wealth in professional sports donate to athletics at their alma mater. The donor often seeks a sense of giving back for the care, support, or education they received, and that can include sports medicine.
A critical concept to remember when fund-raising: Giving relationships are best started when future donors are still students and developed over many years through continuous, pertinent communication. One way to open and maintain communication is an athletic training newsletter. Whether delivered online, through the mail, or both, a newsletter should contain current staff biographies and stories about past graduates. It could contain updates on retired athletic trainers who both cared for older alumni when they were student-athletes and mentored athletic training students, along with pertinent contact information.
The newsletter may also include dates of reunions, homecoming, special events, and updates regarding athletic training services at the school. A continuing-education component may be added, filled with professional updates, perhaps written by alumni. And, certainly, the newsletter should regularly contain current information about relevant endowment or giving funds to which the alumni can contribute.
Another mode of promoting continuous communication with graduates is frequent phone calls or e-mails. These contacts should be regular but not overwhelming and should always have some purpose, preferably other than asking for money. During vacations or trips with teams, determine if there are alumni in the areas in which staff will be traveling. Suggest lunch or dinner to foster relationships. Keep alumni informed of continuing education programs, golf outings, or summer activities that may be of interest to the working professional. Alumni who hear from their alma mater only when they’re asked to send money are far less likely to give than those who have established regular communication lines with the university. Communication like this fosters the relationship and develops its gift-giving side. Simply going out and asking for money rarely works over the long term.
Whatever path you choose, at whatever level of extra time and effort you can afford, the goal is to give your athletic training program more control over its financial future. Comparing the athletic training room to a business may go against the grain of traditional healthcare mentality, but that entrenched mentality is the barrier to creativity in finding and securing revenues. A business that gives its products and services away for free or for below market value eventually will not be in business.
For an article on seeking reimbursement from athletes’ insurance companies, go to www.athleticsearch.com and enter “billing” in the search window.
Sidebar: A PR Primer
Athletic trainers have traditionally prided themselves on getting their jobs done behind the scenes. But sometimes, it pays to step into the limelight.
Whether it’s getting a higher priority in the institutional budget, soliciting public donations for a special project, or establishing sponsorships, the entrepreneurial athletic trainer should remember that it is much easier to solicit and generate revenues if you have a positive image. First, though, you have to have an image.
To start, get to know local media people. From beat writers to sports anchors, journalists are always looking for positive community stories. What athletic trainers do every day can create many public interest stories without inappropriately revealing privacy or breaching confidentiality issues. Send out press releases on program events, public events, department activities, research, and your successes.
Also work on building a relationship with local media members so that they know to contact you and your staff when questions arise concerning sports medical conditions such as heat illnesses or the prevalence of anterior cruciate ligament tears. Suggest story ideas that place staff members as the experts and primary media contact people. You might even offer to write a regular column on health and athletic training for the local newspaper.
Beyond getting your name in print, a public profile can be enhanced through supporting others. This can include assisting local charitable and community events, for example. Even though the department may not have actual funds to give, athletic training students and staff can be encouraged to donate time. It is not uncommon for student clubs or organizations affiliated with a university to provide services to a community or a charitable organization who later supports a request from such clubs to help with funding projects through donations or reciprocal services. The gift of time can plant the seeds for a return in the future.
Think about how you can support others at your institution, too. For example, there may be opportunities for the athletic training department to help buy a piece of equipment that can be used across several academic departments. Many departments operate in isolation, failing to establish goods-and-services ties with colleague departments. The payoff will come down the road, when you are looking for assistance in setting up a CEU course or trying to hire a top-notch graduate student.
You want to create a bridge of communication and potential source of assistance for when the department seeks funding for unique projects. The goal is to build an image and heighten your program’s profile, which is a must before asking for donations, seeking sponsorships, and partnering with others.