CH 8
Athletic Training Practice
Credentialing
• Regulates the practice of ATC’s
• Protects the layperson
• Insures competence of ATC’s
AT practice acts- see GA law.-defines the roles and responsibilities of the athlete, ATC and SAT-Varies from state to state
Types of Credentialing
• Licensure • Registration
• Certification • Exemption
Licensure
• Most restrictive form of credentialing
• Protects the rights of the public: limiting the practice of AT to those who have met the requirements of a licensing board established under the law
Licensure
• Licensure prohibits unlicensed persons from performing tasks reserved for AT’s under the law.
• Unlicensed persons can not call themselves Athletic trainers
• There may be an examination to become licensed. May or may not accept NATABOC
Licensure
• Once licensed, AT is subject to to laws/rules of the state practice act defining profession, scope of practice, etc.
• In some states AT is the only allied health profession where the practice act may define patient base
Registration
• Usually an exam is not required
• AT must meet standards of eligibility & pay a fee to be registered.
• Registration defines those able to call themselves AT’s = title protection
• The least restrictive form of credentialing.
Certification
• Not same as NATABOC
• Means person has submitted minimum credentials required of practioners and has taken some form of state exam.
• No title protection but may restrict application of specific skills and knowledge to persons who are regulated
Exemption
• May provide a legal basis for AT practice by exempting them from complying with the practice acts of other professions.
• Without exemption, AT’s would be in violation of the practice act of a licensed profession
• Usually applies to the PT practice act
Scope of Practice
• The practice of medicine is unlimited in scope when performed by allopathic of osteopathic physicians
• All other medical or allied health professions have a limited scope of practice subordinate to physicians
Scope of Practice
• Diagnosis, surgery, prescribing are ascribed to physicians
• Limited scope means the AHP (allied health profession (al)) works under the auspices of a physician
• AHP may apply their knowledge but within a narrow scope of practice.
Standards of Care
• Is the level of medical sophistication and competency that must be demonstrated by someone who has similar education and training to other members of a particular group.
• Different state regulation of AT means the standard of care may vary from state to state. State regulation may supercede agency standards.
Standards of Care
• Standards are used to provide evidence of a duty to act.
• NATABOC standards (see text) help to est. minimum requirements of action for practicing athletic trainers
• You WILL be held accountable to published standards of practice.
Terms
• Tort = legal wrong other than breach of contract for which the courts provide some remedy– Most often are negligence
– Two keys• Professionals have a duty to exercise the skills and and
knowledge normally employed by members of the profession to prevent unreasonable risk of harm to others
• Negligence = can be either an act of omission or commission
Terms
• Negligence– To prove Negligence 4 points must be
proven
1. Duty to use reasonable care to conform to a standard (Duty to Care)
2. Breach of duty
3. Causation
4. Damages/injury
1. Duty to act/care = usually is delineated in a contract, if no contract then interpretation is open.
2. Breach of Duty = the standard of care has been violated
1. Prevention2. Standard of care3. disclosure
3. Causation = determines that the actions led to damages and to what extent a person is responsible for the damages.
1. Foreseeable = causation occurs if the action that resulted in damages was forseeable
1. Using SATs can lead to liability (see text)
4. Damages = the act must be proven to have caused damages
Blond’s Torts
• Locality rule• Success not
guaranteed• Differing schools of
thought• Specialists• Novices• Unreasonable
standard
• Doctrine of informed consent
Negligence
• Proven by expert testimony or circumstantial evidence
• When est. damages are awarded
Reduce Risk
• Prepare for activity– Physical exams
– Monitor fitness levels
– Access activity levels
– Monitor environmental conditions
• Conduct of activity– Maintain equipment
– Instruct techniques
– Allow for adequate recovery time
Reduce Risk
• Injury Management– Make sure the MD is involved
– Eval injuries correctly and promptly
– Supervise
• Records Management– Document MD orders
– Document treatment plan
– Document treatment records
– Document progress
Professional Liability Insurance
• Always maintain
• Make sure you understand your coverage (what about when volunteering and you are not bound by a contract)
• Purchase as much coverage as you can afford
• Seabury and Smith used often
Defenses
• Statute of limitations
• Sovereign immunity
• Assumption of risk
• Good Samaritan laws
• Comparative negligence