for an AT to Practice within the Law requires a depth of understanding. Luckily there are people like Joseph Hacker and Tammi Gaw to help us out.
Tammi is a Lawyer and Athletic Trainer and Joseph is Practice Manager for University of Kentucky Surgery and Sports Medicine.
What are the biggest compliance issues ATs face?
Privacy is the largest
Athlete information because betting is allowed in certain states
Electronic medical records
The US is behind on Data Privacy rules
- Make sure it is a reputable company
- Does it really protect patient privacy
- Is it secure all the way up the chain?
- Is schools wifi secure enough?
- Is your personal phone secure enough for you to enter data.
- What if you are 3 years removed from an institution and you get sued, can you keep that information? Can you access it?
Engage your risk management in all the decisions made regarding records management.
Request a seat at the table!!!!
How are you allowed to communicate?
Not knowing what is in the state practice act or understanding the language.
We need an easy guide to help the practitioner know “yes or no.”
We are unclear on who is a Licensed Health Provider, how much more unsure are we which we should be following.
Looking at the Texas practice act let’s discuss this as I understand it and as you understand it. (layman vs. Lawyer)
110.12. Scope of Practice. (New Section adopted effective October 1, 2016, 41 TexReg 4435)
(a) A licensed athletic trainer prevents, recognizes, assesses, manages, treats, disposes of, and reconditions athletic injuries and illnesses under the direction of a physician licensed in this state or another qualified, licensed health professional who is authorized to refer for health care services within the scope of the person's license.
(b) The activities listed in subsection (c)(1)-(7) may be performed in any setting authorized by a licensed physician and may include, but not be limited to, an educational institution, professional or amateur athletic organization, an athletic facility, or a health care facility.
(c) Services provided by a licensed athletic trainer may include, but are not limited to:
(1) planning and implementing a comprehensive athletic injury and illness prevention program;
(2) conducting an initial assessment of an athlete's injury or illness and formulating an impression of the injury or illness in order to provide emergency or continued care and referral to a physician for definitive diagnosis and treatment, if appropriate;
(3) administering first aid and emergency care for acute athletic injuries and illnesses;
(4) coordinating, planning, and implementing a comprehensive rehabilitation program for athletic injuries;
(5) coordinating, planning, and supervising all administrative components of an athletic training or sports medicine program;
(6) providing health care information and counseling athletes; and
(7) conducting research and providing instruction on subject matter related to athletic training or sports medicine.
(d) A licensee shall not provide health care services which are not within the definition of “athletic training” in the Act except in accordance with state and federal laws and rules applicable to the provided services including but not limited to, Occupations Code, Chapter 157, relating to a physician's delegated authority; other licensure laws; and laws relating to the possession and distribution of controlled substances.
***this is a catch all***
A skill is in the standing orders but not in the state practice act. What could go wrong?
Example joint relocation –
Rectal Temp – In Kentucky it is outside the state practice act. Even though it is the gold standard, we are not currently allowed to do it.
***Local Policy → State practice act → Standing orders → position statement
People can sue for anything.
Taking the most conservative path defends your actions but does not make you bulletproof.
Liability – does it ever fall on the physician signing off on standing orders?
If they act outside of their scope of practice, then possibly.
But if you are doing your due diligence then it should not be needed
If you need an answer then get it in writing to CYA
A relationship with the signing physician is important so you can continually educate them on what you can and can not do.
It allows them to update the orders as needed.
THERE IS NO NEGATIVE TO DEVELOPING RELATIONSHIPS WITH YOUR PHYSICIAN!!!
Crossing state lines… as long as I’m with my team I’m good right???
Well, it depends…practice act, licensure rules, situation.
Licensure Clarity Act – a key part was for liability insurance to cover you.
Tammi Gaw – @TammiGaw
Joseph Hacker – Joe.Hacker@uky.edu
Jeremy – @MrJeremyJackson
Resources to Practice Within the Law
Look at your local societies.
Look at your state organizations
Reach outside of your bubble
District levels are great as well because they cross state lines as an NATA district.
Local Health Department – is another great place to know
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Donate and get some swag (like Patreon but for the school)
DragonflyMax – one-stop EMR
HOIST – no matter your reason for dehydration DRINK HOIST
MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free, and support the podcast.
Marc Pro – Use “THESMB” to recover better.