The Sports Medicine Broadcast

AT Inventors 3 is focused on Logistics and Production for your product to help improve the practice of Athletic Trainers EVERYWHERE. Production Origin of production, taxes, and duties Cost per unit and minimum orders Payment options with vendors How do you price your product E: dial in all of your costs and then add 15% in case of overages. A lot of people do not understand this statement, but it's good to shoot for 5X to cover all the other expenses we talked about. Rent, insurance, time, labor… Really slim margins do not offer you any protection.  Everyone needs to make their money.  Using the SanDisk memory card example - the card is the same shape and size as it changes storage capacity but the price keeps going up. Stay focused and do not spread yourself too thin. E: Shipping can be a big experiment as well. Saving one inch could save you lots of dollars. J: Everyone liked the custom cardboard boxes but they cost more… E: I was going to pay $90 for 10 stickers...I decided to go with a vinyl sticker cutter instead...it has been well worth the time and investment. Passive income streams are another option we did not really cover. What is your relationship with your vendors? How do you handle quality control and setbacks from vendors J: As someone who does not have access to a lot of warehouses I had to prototype to troubleshoot quality control and how they handle the load. I used SGS as a third party inspection company How involved do you want to be with production? Do you want to learn a new trade or use a vendor for production J: Is it worth your time and money to pay someone or do you need to learn how to do this. E: Look at efficiency and what you really want - do you want to learn how to sew. How do you keep things in stock or when do you know you need to purchase more Just in time manufacturing, WIP or large batches of inventory Where do you store large batches of inventory? * Elysia, please answer this one. I do not want people to look into my supplier because of my partnership with the warehouse Logistics How will the products arrive to you? Will you ship your product and storage Order fulfillment systems How involved do you want to be from start to finish? Websites, credit card processing, and fees  J: Affordability was the key - square seemed to be the best fit for me now. They are a one-stop shop for me. E: I got a quote from a company to build a custom site with everything I want for $14K There were not as many eCommerce sites available I felt I would be stuck with that with minimal support. We went with an eCommerce site and used the money to get exactly what we wanted. With your website try to answer every customer service question with an article or video so that you can reduce the personally answered questions.

In AT Inventors part 2 Jay and Elysia discuss establishing a business and product testing. Some of the topics we discussed include: * Establishing Business * Defining your core values before establishing a business If you define the core values and base all your decisions on that then decisions are a lot easier. It is easy to chase every shiny object but as a startup, you need to be focused on doing one thing well. * Articles of organization * Business insurance, product liability and other protections J: I do not have a reseller license, for now, I am a direct-seller only. E: Reseller certificate allows you to get items tax-free that you are going to use for your business.  You need this to sell it anywhere, like a trade show...this is so you can pay more taxes. Depending on structures you may set up monthly sales tax or quarterly. E: Product liability insurance - Mine is high since I am looped in there with skateboards where people break bones often. I have been able to break that into 4 payments so it is not a huge hit My patent fee structure is confusing and I break it up to level out the costs. Design and utility patents are different - again a couple of thousand dollars for the attorney fee. And nobody gets approved on the first round so be ready for that.  Lots of small adjustments. Consider if you really need a patent or can you focus on other aspects of the business? * Business structure types, LLC, sole or other corporations Toki Nakazawa - you can function as an S corp using Form 1120S even though you are an LLC * Funding vs bootstrapping your business financial needs * How do you manage a business partnership? Do you want a business partnership * Is Shark Tank or other investors an option J: the style of my product is already out there, i am just making it more specific for our situation. E: KNOW YOUR PRODUCT LINE J: Is it sustainable? * Method of selling product (direct, wholesale, etc) * Where is all the money going? Proper accounting and continual costs * When to consider employees, worker comp insurance, payroll and managing other people E: I answer all of my phone calls and emails.  Do you want to make money or provide something that enriches the lives of others? If money is your motivation then focus on that. If freedom of schedule is your goal, focus on that. J: My military price is important to me.  I want to support and help those that have protected us and given me so much. * Why people always ask about how much money you make, how many units you sell and if you are a million dollar company * The importance of good business mentors who understand your product line J: I am always cautious because it is a dog eat dog world E: One of my college professors keeps a log of all her incoming and outgoing calls Leave the end of the day with your desk clean

Elysia and Jay are AT Inventors. They created a product because they did not find one on the market that met their needs. Join them in their stories so that when it is your time to become an AT Inventor you have guidance and some warnings. Research

Do you have a Mental Health EAP? Do you have a athletic injury EAP? Dr. Hector Lopez of SMASA shares some of the tips for building a mental health EAP for Athletic Trainers Have you planned what to do in the event of a suicide threat or attempt? The secondary setting is harder because we are dealing with minors A good understanding of mental health Video from YouTube - For NCAA student Athletes’ Mental health: a more educated approach NCAA Sports Science Institute mental health awareness According to the WHO it is a state of wellbeing in which the individual realizes his or her own abilities. Mental illness refers to diagnosable mental disorders and health conditions There is a stigma that it is a weakness Myths about Mental health: * Children do not get mental health issues - 75% begin before age 24* Personality weakness or character flaws cause them* I can not do anything for a person with mental health problems Examples: * Anxiety* Eating disorders* Major depression* PTSD* Adjustment disorder* Social anxiety* Bipolar disorder* Substance abuse* Co-existing learning disabilities* ADHD* Autism spectrum* Chronic Medical illness* Bullying* Hazing* Relationship Abuse* Sexual Assault* Gender Dysphoria* Unexpected Pregnancy* Gambling* Undiagnosed medical issue* Stressors affecting athletes* Team culture* Pressure to perform* Balancing demands Identifiers for a mental health EAP ID based on performance Injury causes isolation or forced retirement Burnout due to early specialization Poor performance “I can’t show weakness” Dealing with injured athletes: Listen What does the injury mean to the athlete? What is your team and AT Clinic culture? Educate about the diagnosis Correct any misinformation Provide a road map for recovery “Dr. google is a big problem in my world” An emotional response to an injury is normal Sadness Isolation Irritation Lack of motivation Anger Frustration Changes in appetite Sleep disturbance Disengagement Response to injury Stress can lead to increased injury, muscle tension, poor concentration, and performance Can trigger depression Problematic emotional responses Persistent symptoms Worsening symptoms Excessive symptoms Summary of possible symptoms Barriers to care: Stigma Poor understanding Difficulty willing to express Lack of time Denial Fear Worried about it affecting play Not accessible

Dr. Paul Saenz shares how the San Antonio Spurs have used Sports Science to help their Sports Medicine. The Spurs have always been on a leading edge of performance have looked at best practices around the globe. The sports medicine team consists of at least 10 positions with multiples at several of these positions. ATs serve as the backbone and primary interface between the players and the medical team. WHY monitor? * Direct Feedback* Injury prevention* Performance enhancements* Rehabilitation baselines Key facets of Athletic Performance Strength Aerobic Capacity Nutrition Recovery - has replaced the word “rest” - its intentional Psychological Wellness - they fill out these surveys onn a daily basis What to Monitor with Sports Science Games and Training - volumes and intensity Player Strength and conditioning Fatigue / Recovery Player Availability ( injury incidence and prevalence) Types of Loads External - the physical load they have endured * Road cyclist - mean power output for given duration - 400 watts for 30 minutes Internal - how have they responded physiologically * HR, RPE, Blood lactate, cortisol, testosterone, inflammatory biomarkers External Load Monitoring Time Motion analysis - GPS and digital video movement analysis Accelerometer Data -  * Catapult system - GPS wearable system that monitors elapsed exercise time. Neuromuscular function The huge collection of data requires the skill to extrapolate and draw conclusions. Internal Load Monitoring RPE - Relative Perceived Exertion Heart Rate Response Biochemical Weight Adductor Squeeze Dorsi-flexion lunge Isometric lunge RPE Scale Self-determined assessment of exercise intensity Correlates well with heart rate Blood draws can be done during this time. Cardio Recovery Heart Rate Recovery - how quickly your heart rate returns to normal Markers of fatigue vs fitness Yo-Yo Intermittent Recovery Test * Short intense runs with brief recovery periods * https://www.youtube.com/watch?v=nkOk_P5VnOA Salivary Biomarkers testosterone /Cortisol markers of stress and recovery Anabolic vs Catabolic state Adductor Squeeze Done with a blood pressure cuff Very well documented with European teams Recovery Methods Light cardio Massage Cryotherapy -  whole body cryotherapy

Casey Paulk has experienced Sales Success as an Athletic Trainer. Not because he was naturally gifted but because he knows what an AT is and does and continues to work hard to help meet the needs of Athletic Trainers. What were some exposures you had to sales as a kid? First time I had sales success was as an intern in the Texas Rangers AAA as a bullpen catcher. I had to convince and prove to the staff I was qualified for the job. I was able to help the Athletic Training staff more and the team more. I also had to sell my services as an AT Skiatook Middle School as an AT and science teacher.  They had never had an Athletic Trainer before. What was your first job ever? Garage door warehouse grunt. I worked in the Oklahoma summer heat hauling garage doors. It was a grind and hard work.  It helped me succeed in my career as an Athletic Trainer and now in my career in sales with Sway What does the life of an AT Sales Success person look like? So now with my sales job I still work a lot of hours but I can set a few more boundaries. I wake up early to check emails and line up my day. Take care of personal business and spend time with the family. Start making phone calls to Athletic Trainers (I do not call when they are sleeping or doing morning treatments) Why do you love the sales side of AT? Serving the Athletic Trainers and helping them return their athletes safely to participation. I cover 14 states as a sales rep so I have a lot of phone calls and emails to get out. The same process of evaluating an injury as an AT has helped me have sales success. Athlete: “Hey, my knee hurts.” AT: “Tell me what happened, when did it start hurting, what makes it better, what makes it worse?” Athlete: answers questions... Athletic trainer: perform tests and evaluates the next steps needed Athlete: “I do not think that will work for me… or ok let’s do it” It is the same with sales. To the AT who is on the fence, what would you say? Reach out to an AT in sales and tell them you are interested. See if you can do some part time work in sales of any sort. Go shadow Casey for a day or week and see what it is like. There are jobs out there but unless you tell people you are looking for one they will not know. Golden Rule for Sales Success: Look to help and serve your customers and be sure you believe in the product. Houston Methodist, Official Healthcare provider of Pasadena ISD just signed up with SWAY.     Call to action: Reach out to Casey Paulk at Sway for questions about sales, life in Oklahoma, or basically any product that can help your patients get better. Watch the Facebook live conversation

Seeking your Doctorate Degree? Which one should you choose: DAT, Ph.D., or Ed.D.? Dr. Matthew Drescher earned his DAT and is enrolled in a Ph.D. program at Indiana State University. Dr. Nikki Harris earned her DAT and is enrolled in a Ph.D. program. Scott Mullet just enrolled in a Ed.D program. Join the conversation to see why they chose their doctorate degree. After listening to the podcast reach out to them and ask your specific questions. We recently recorded a podcast on the DAT where Mat discussed the ins and outs of that program. We followed that up with a podcast about the PhD as an AT Scott Mullett joins the podcast to discuss why he chose the EdD in Interprofessional Leadership Which doctorate degree should Stephone baker choose? What would be a salary difference between the PhD and DAT and EdD? Do not chase the dollar signs... Why should I consider the DAT? There is a shift in our profession How have your young professionals been able to balance the workload and earning a doctoral degree?   Start practicing good time management now. Make sure the stakeholders in your life are fully aware of the demands. Balance is an inaccurate word.  It is not equal, but we emphasize or focus on certain things at different times. How can I use my Doctoral degree in AT? We got the turf replaced by tracking the data and telling the admin. It is a multiplier  “What can you not do?” Any funding available for earning these doctorates? Athletic Trainers do a really bad job of asking...we just assume there is not any. University settings usually have terminal degree programs if you stay on for a certain amount of time. Preceptors can earn credits at certain programs. Watch the Doctorate Degree Facebook video (there was an audio issue...be warned) Contact Us: Matthew Drescher - Email: mdrescher@sycamores.indstate.edu  Twitter: @Matt_Drescher IG: @Dreschem ISU DAT: IG: @indianastatedat Twitter: @isuathltraining Dr. Nikki Harris - @YoungProf_AT Scott Mullett - Facebook.com/ATEfficiencyJeremy - SportsMedicineBroadcast.com/About

Meghan Johnson is a College Athlete, Credentialed Athletic Trainer, Softball Team Captain and graduate student. Dr. Krystal Tyree asked to hear more of her story so Joel over at Athletic Training Chat and I split the interview. Check out Meghan's background interview before or after this one. My friend Joel over at ATChat already interviewed Meghan so go check that one to get the first part of Meghan’s story.  Meghan, what is your dream job as an AT? My dream job is not really out on the market.  I think I need to create it. I want to work with college athletics caring for the mental health aspect of injuries and rehab.  How important is working in college athletics? In my undergrad clinical rotations I had a good bit of experiences including: secondary schools, private schools, public schools, Collegiate Division three.  I got to kind of dabble in a little bit of everything in my clinical rotations. I'd be very happy working wherever would give me the opportunity to marry these two concepts of Counseling and Psychology and Athletic Training Dr. Krystal Tyree - what did your exposure to being an AT and Athlete look like? * Check out her two podcasts with Joel College Basketball player Tore my ACL Transferred school and tore it again. I decided not to continue with basketball as the mental health aspect was weighing heavy on me. I focused on finishing my degree and becoming an Athletic Trainer. Meghan, are sports over for you? I still have next year left to play sports. I am in my 3rd year of playing softball and my first year of graduate school.  I have one more year of schooling and softball then I will do the clinical requirements. Dr. Tyree, what would you have said to Meghan about playing and finishing up your studies? Great job, I could not do it because I wanted to work and earn some money and move out of the dorms.  We did not have any real mental health coaching back then. Meghan, are you currently working as an AT? I actually do pick up per diem hours so I can work at my own pace and focus on school and softball as much as possible. Is there a struggle with just being the athlete and not the athletic trainer on the team? We have a lot of athletic training students who play sports.  Our university is pretty good at referring to the AT Facility and staff when we are in season. Of course there is still a struggle with setting those boundaries for myself and my teammates. If there was an emergency then I would obviously step in but otherwise they went to the on duty person. Life balance: How did you do it with being an AT student and softball captain?  I learned not to spread myself too thin. I did what I had to but I do not think I would enjoy continui...

The teacher of philosophy or PhD is usually a research-focused degree. Dr. Matt Drescher is seeking his because he wanted to answer some questions. He also sees his career leading him to teaching the Athletic Trainers of tomorrow. What is the PhD? The term doctor comes from - to teach A doctor is a teacher and there are obviously many different versions. Technically medical doctor are physicians Doctor of philosophy which is theory and application of that theory. You are doing the research to create the theories Not always applying them into practice The art form of a PhD is being able to apply the abstract idea into practice. The EdD is similar to the DAT - advanced clinical practice degree. https://www.northeastern.edu/graduate/blog/edd-vs-phd-in-education/ Which ones would benefit an AT? Core Values...make your connection towards that. I am really curious about the answers to these abstract things.  I want to find the answers to the questions. Being able to read the research and synthesize that to your patient population. What programs are good for an AT to earn a PhD? Core Values Medical school PT School Ph.D. - education Biomechanics Neurophysiology Basically anywhere What paths have you seen ATs pursue after earning a PhD? The PhD is kind of like the steward that is guiding the profession through the profession and towards growth. Most Ph.D. ATs have practiced but were not getting answers so they went to find them. Only about 10% of people finished their PhD globally. Why should I not choose the PhD? * To make more money* Ok with taking the facts (do not really dig into the details)* If it does not fit your core value Simon Sinek the infinite game Final thought: If you have those questions reach out to a researcher in that field and start to work in that area. Contact Us Matthew - Email: mdrescher@sycamores.indstate.edu  Twitter: @Matt_Drescher IG: @Dreschem ISU DAT: IG: @indianastatedatTwitter: @isuathltraining

Is the DAT the right choice for your advanced degree? Should you pursue your Ph.D. or maybe an Ed.D.? Dr. Matthew Drescher, a PhD candidate, already earned his DAT from ISU and joins me to answer some of my questions. In the next two podcast we will discuss the Ph.D. and Ed.D. and compare them. What is the DAT The DAT is a post professional degree program. It's a clinical doctorate stands for Doctorate of Athletic Training. Most of the programs that are currently across the country are focused on clinical education, advanced clinical education and clinical leadership, but I kind of looked at in a different light so I tend to look at it as a metaphysical idea It's a mindset to meet the gap is a commitment to the profession to be the leader and push forward. * Promote advanced practice leadership * Promote us as a profession as healthcare providers * Helping lead the profession forward We understand that's a hard thing to do, but we can do hard things and the DAT is a commitment to that mindset to continue doing what's right for the profession and moving it forward.- Dr. Matthew Drescher What would I expect out of my DAT education? The beauty of the post professional degree, is that it can be marketed to the market. So, all of the programs, hit on the same central tenets, but they all do them in a different way. When you're thinking about going into this level of education, it's really about aligning that with your values. Part what I learned in the ISU DAT was really how to be a clinical leader, what it looks like to be that person, the person who does hard things, the person who asks the hard questions. Promoting yourself as a lifelong learner, that's something that I value immensely. Some other programs focus on different aspects. At ISU we focus a lot on manual therapy and advanced manual therapy skills, some programs focus on more of the leadership aspect. Or they focus on what we call practice-based research, but each program has a little bit of a nuance. What you would expect from a DAT program is that mindset of thinking differently. The DAT should help make changes at the system level. How do you think that that helps me get Athletic Trainers into the intermediate setting? I think you make a really good point. I guess you could call it the clout, having that title of Dr. Jackson would bring. But part of that mindset of the DAT is that it's not really about the degree to the outside world. It's, an easier concept to understand that you're a doctor versus You're not a doctor but when you're with, The concept is not necessarily the clout, but it's the skill and the knowledge to be able to make the changes to know the steps to how those changes have to be made. You can't just run in and say, put an athletic trainer here, please. It's knowing how to line up all of the blocks to work with you and that's what I mean more about a systems level change. Because at that level, the systems are dynamic, and they're complex, so being able to know how to speak that language to align the blocks to prove that value and worth. That's something, those are skills that the DAT degree can give you. On top of the confidence and credibility that the degree itself carries,

Todd just launched Love Handle 2 LEAN as his new online business. Welcome back, my friend.  Why a fitness coach? In December I launched my first online rehab offer.  I went one for 12 in bringing those people on as clients. The one glaring need that kept coming up in all of these conversations. LIGHTBULB moment I am passionate about the health and fitness aspect of life. How do I incorporate the mental aspect into health? The name Love Handle to LEAN Method or L2L, tell me about that. The phrase came up over and over It needs to resonate with potential clients Low hanging fruit Education -  how can we simplify Audit Never-ending Let’s discuss the mentorship investment…$10,000 so someone could tell you how to start L2L? I wish I would have done it 4 years ago. I knew if I was going to continue on the path that I was on it would take way too long. I was fed up and needed help. It was scary to make the investment but which was worse the cost of the program or the cost of staying where I am. What is on the other side of making the investment? Watch Love handle 2 LEAN on Facebook Contact Us: Todd Sabol - @ToddSportsMed on IG - Twitter - and FB Jeremy Jackson Related Podcasts: $100k Side Job with Tim Neal Full transcript of Love Handle to LEAN created by Otter.Ai Todd Sabol  0:00 As you know my life like I like a lot of other trainers are. And I was always trying to find ways to push my body push my mind to the highest level of ability that I could because I was an athletic person per se, I should work pretty hard to get what I had. So, yeah, so, in December, actually launched an odd my first online rehab injury offer. And I had, you know, 12 - 14 people reach out and, you know, I was able to get have lengthy conversations with about 12 of those people. And I went one for 12 and bringing the two people on so I was feeling pretty down, and it wasn't. Yeah, I think I might have gone in with too high of expectations who my first time and I wasn't sure what to expect, but through those conversations. You know, When we're trying to connect with people and you know, for the athletic fans that are listening you always are trying to create that connection and learn more about the person because that's what really matters, but, you know, the skill never they are cool but if you can't make a claim for that person, you can't help them. So, whose conversations I was having that one glaring need that kept coming up was like yeah, like,

David Silverstein has been an Athletic Trainer for 12 years and has yet to need his CPR skills. That all changed in an instant as his actions helped "Z" survive long enough for the EMS to arrive and take over. David, you just recently saved a life.  Tell us the story. * SCA leading cause of death in exercising athletes typically caused by underlying structural or electrical conditions. * 75% of deaths occur in football, basketball and soccer. Male and African Americans are at highest risk. Survival declines 10% each minute waiting for defibrillation. * Early defibrillator increases survival chances by 80%* Eyes rolled back, brief seizure-like activity and agonal breathing was distracting and those were all the signs pointed out in the video.   * Differentiated from EHS or sickle cell in that SCA is sudden without signs of struggling or exhaustion* Any athlete who has collapsed and is unresponsive should be assumed to be in SCA until proven otherwise or another cause of the collapse clearly is identified. What is your prior experience using CPR? None other than teaching and getting certified. I first took the class when I was in undergrad. Tell us some more of your Athletic Trainer Story. Graduated from MSU during the internship era. GA @ CCF Got out of Athletic Training and came back to it after 5 years. Served mostly in high school settings but working at a DC office now while doing a lot of PRN coverage. How did you process the situation afterward? Didn’t want to be there Replayed events in my head to see if I performed up to par What are you going to change because of this event? EAPs 1E. Every school or organization that sponsors athletics should develop an EAP specifically for managing serious and/or potentially life-threatening sport-related injuries (athletic EAP) 2E. The athletic EAP should be developed and coordinated with local EMS, school public safety officials, on-site medical personnel or school medical staff, and school administrators 3E. Every school should distribute the athletic EAP to all athletic staff members 4E. The athletic EAP should be specific to each venue (including maps, directions, etc) 5E. On-site emergency equipment that may be needed in an emergency situation should be listed 6E. The athletic EAP should identify personnel and their responsibilities to carry out the plan of action with a designated chain of command 7E. Appropriate contact information for EMS 8E. The athletic EAP should specify documentation actions that need to be taken after an emergency  9E. The athletic EAP should be reviewed and rehearsed annually by all parties involved 10E. Health care professionals who will provide medical coverage during games, practices, or other events should be included Call to action: Drill EAPs more often TUFSS AT Cares More consistent hours at Shaw Resources from David Silverstein:

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) Texas Practice Act 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.

Deaf Athletes speak a different language, they are not disabled. They maybe Hard of Hearing but not any less capable. We have to learn how to provide healthcare for them the same as the hearing athletes. Jennifer Warren learned signed language as a kid to communicate with one of her teammates and has continued learning and using the skills through her career. Josh Woodall and John Ciecko have first hand experience working with deaf and hard-of-hearing athletes and share some ways we can provide more equitable care. Jennifer, what is the best tip you have for working with hard of hearing or deaf athletes? I would suggest that the hearing community speak naturally to those who are deaf or hard of hearing.  Many can read lips, but when we accentuate our words, it distorts our mouths, which can make it more difficult to read lips.   Second tip, most people who are deaf and hard of hearing appreciate any sign language you may know.  Spelling out words or signing slowly is welcomed and appreciated.  John: Communicate eye to eye, never tell the interpreter “tell them this…”, people of various abilities should never be excluded from sports. Only 30% of the English language can be read on lips, and that’s with perfect lighting and a couple of strong cups of coffee. Helmets, low hats, or any kind of obstruction to see someone's face and mouth hinders this ability to catch what’s being said on the lips. This is why it’s so important for Athletic trainers to learn the basics of ASL. Josh, give us an example of how you have used this or other tips from Jennifer? The first week in Bryan ISD I had an athlete with a broken radius/ulna so had to learn real quick how to communicate with an interpreter. Jennifer, what should we know about working with deaf and hard of hearing athletes? Not all disabilities are cognitive disabilities.  In fact, the deaf community does not see hearing loss as a disability.  The deaf and hard of hearing community prefer to be seen as a community that uses a different mode of communication, rather than a group with a disability.  American Sign Language is considered a foreign language, which is simply a different mode of communication.  The need to use sign language is comparable to the need to use Spanish when a student’s primary language is Spanish.  This means that deaf or hard of hearing students are very capable or able to participate in athletics and other extracurricular activities. Also, the words ‘deaf or hard of hearing’ can seem like a harsh way to describe a people group, but it is actually what is accepted and preferred by the deaf community. And, Deaf and hard of hearing students may not hear the starter’s gun or whistles blowing.  Adjustments may need to be made to allow for access to the audible elements of the sport. Discuss some of the hearing devices and how we can protect those for participation. Most students self-care for their devices by the time they make it to the secondary sports level.  But, AT’s (Athletic Trainer/Assistive Technology) may find it helpful to know how to support these athletes: FM systems - wireless assistive hearing devices that enhance the use of hearing aids.  The coach or AT may wear a mic that is bluetoothed to the student’s hearing aid or cochlear implant.

Mike and Kathy exemplify the "AT in the Capitalist Economy." Share in the discussion and consider if being an AT business owner is right for you. Mike, what does “Capitalist Economy AT” mean to you? What can an AT do and what is the value of our skillset? Will people pay you for your services? We are bridging the gap and speaking directly to the public. Live the American dream This is all about advocacy for me. 17 years ago I started my business D&D Sports medicine. I am worth being paid for the services I am providing. Part of our COPA committee is developing resources for the capitalist AT. Kathy as a business owner where do you see us going? We have become so diverse. Pandemic has caused a lot of ATs to try running their own business. Helping with reimbursement even though “cash is King” Reimbursement opens the doors wider. When the poop hit the fan and sports stopped the earth shook. I made the decision 7 years ago to go out on my own. I try to look at my business as telling the athletes how they can get better. How can we do this to positively impact the profession? This entrepreneur road is a great way to keep good ATS here. Kathy - I have been a mentor each time I switched jobs out of a sense of duty. I constantly get questions about how they can follow my path. “First guy through the fence always gets a little bloody...I was that first guy” - Mike Stella Knowing your “why” is crucial. When I am faced with making a business decision I go back to my core values and see if it fits. State practice ascites were written 20-30 years ago and when ATs were only in sports settings. We need to update them to include a lot of the new settings. READ your state practice act and have a good understanding of it. Standing Orders: keep or trash them and why? Kathy - What we are seeing is a result of a profession that has always worked under the supervision of a physician. In the medical community, there are a lot of providers working under a physician. Mike - Having the medical team in place is important. Working under a physician puts the thumb on us and creates an automatic glass ceiling. I was told, “You can not start a business because you can not hire my boss.” The doctors I worked with decided they wanted a piece of the pie. Now we have to jump through hoops that a massage therapist does not with one year of training. “If we want a different solution or answer then we have to ask different questions.” Access to insurance billing, does it hurt or help, and why? CMS recognition helps as a sign of credibility Do you lose some patients who want to bill insurance? As it stands right now ATs are an expense item on the budget where as PT and Chiro generate revenue