Athl etic trainers (ATs) have historically functioned in a physician extender role when managing the health of competitive athletes in high school, collegiate, and professional settings. A high level of expertise in the prevention and management of musculoskeletal disorders among physically active individuals has been recognized by physicians who have chosen to utilize ATs as physician extenders in orthopedic and sports medicine clinical operations. The development of postprofessional residency programs that provide specialized education and clinical experiences to prepare ATs to effectively function as orthopedic physician extenders has greatly facilitated physician acceptance of the role, which has dramatically increased the number of ATs working in the orthopedic clinical setting. 1-2 Such residency programs provide ATs with experience in taking detailed patient histories, performing thorough patient exams, and presenting the findings to the attending physician for delivery of efficient and patient-centered care. The physician can focus on making the diagnosis and developing a plan of care, while relying on the AT to provide appropriate therapeutic exercise instructions, educate the patient about the plan of care, and complete specific components of the clinical documentation. [1][2] Previous studies have demonstrated that utilization of the residency-trained AT physician extender (AT-PE) has increased clinical efficiency (i.e., patient volume and revenue generation) and improved patient outcomes. 3-5 Physician satisfaction with this approach to delivery of orthopedic clinical services has not been previously documented. Thus, the purpose of this study was to assess physician satisfaction with the performance of residency-trained AT-PEs in the delivery of orthopedic clinical services. Procedures and FindingsA list of orthopedic clinical practices that have employed AT-PEs who completed one of the 8 existing residency programs was used to identify potential participants in this study. With Institutional Review Board approval, surveys were emailed to 40 sports medicine fellowship-trained orthopedic surgeons and primary care physicians in 11 different states. The response rate was 88% (35/40).A web-based electronic survey was created that included 2 demographic "Yes/ No" questions and 8 Likert-type ratings of degree of satisfaction with the performance Physicians are satisfied with athletic trainers who function as physician extenders.Physicians perceive athletic trainersphysician extenders (AT-PEs) as an asset to their clinical operations.Physicians perceive AT-PEs as skilled providers of orthopedic clinical services.

Context: Postprofessional residency (PPR) programs continue to gain popularity as athletic training education prepares for a paradigm shift. The Commission on Accreditation of Athletic Training Education has established didactic and clinical infrastructure for PPRs seeking accreditation. Accredited programs provide athletic trainers (ATs) with an advanced level of knowledge in a focused area of clinical practice. Objective: A case study report to introduce a novel PPR general medical rotation to illustrate the skills and knowledge of ATs, evaluate the impact of the athletic training residents in the rural family practice (FP) setting, and to discuss how employing an AT in this setting aligns with the triple aim of the Affordable Care Act (ACA). Background: Currently, there is very little literature regarding PPRs. Additionally, very little research exists describing how ATs function within the ACA model of health care delivery. Description: The PPR developed a rotation for a rural FP outpatient clinic. Athletic training residents completed 3-week rotations in this setting working with multiple providers. Learning objectives were created to emphasize the evaluation, diagnosis, and management of general medical conditions. Objectives were assessed at the conclusion of the rotation. Finally, data were collected to evaluate the impact of athletic training residents in the ACA model of health care delivery. Clinical Advantage(s): The athletic training residents improved their clinical evaluation and diagnosis skills in a FP clinic through this educational opportunity. This rotation cultivated and fostered interdisciplinary education and interprofessional collaboration. Finally, the observational findings of this rotation revealed the impact of ATs appear to align with the objectives of the ACA health care model, supporting the use of ATs in this role. Conclusion(s): This rotation highlights an area of clinical practice future ATs could pursue. Accredited PPR programs must consider the evolution in health care delivery and the shift in athletic training education standards to develop strong PP programs.