"We were finding no one department really felt ownership for all the costs. Physical therapy didn't feel it was their place to hire trainers. The orthopedics department felt it was a huge expense that didn't justify itself," he says.
But the expense is more than justified when you consider downstream revenue and the marketing benefit to sports medicine, argues Geier. MUSC has six athletic trainers who work with local high schools and a professional soccer team, and all the downstream revenue—from surgery charges to revenue generated by physical therapy and imaging—is tracked in a database that records the patients who each trainer sends to the institution.
Sports medicine volume tends to come in waves—one in the fall coinciding with football season, and another in the spring as injuries from soccer and other sports tend to rise. Just a couple of months into the high school football season in 2009, at least two of the athletic trainers had already covered their costs based on the number of surgeries they had generated.
Strictly from an orthopedics perspective, the cost-benefit of athletic trainers' salaries may not be worthwhile. But the hospital has to consider downstream revenue, Geier says.
"The trainers are going to make money for all different parts of the institution. Using our preliminary database we figured out the hospital was making four to eight times the cost of the trainer's salary plus benefits in hospital charges for things like physical therapy, radiology, surgery, ER visits, etc.," he says.
Success Key No. 2: Build community partnerships
Not all hospitals are convinced that the salaries of athletic trainers pay off, however. Washington University School of Medicine used to employ five athletic trainers who worked in St. Louis-area high schools, but recently decided to stop the program for economic reasons.
With an established service line, Washington University's sports medicine program already has decent brand recognition and doesn't have to rely as heavily on athletic trainers to make an initial impression. However, the hospital recognizes that reaching out to the local community is still crucial, Matava says. It just has to find other ways to do it.
One coveted approach that select sports medicine programs are able to pull off is an official affiliation with professional sports teams, which can be an effective strategy for building name recognition for both individual physicians and the sports medicine program as a whole. Washington University currently provides sports medicine services for St. Louis' professional football and hockey teams, the Rams and the Blues, and for the women's professional soccer team, the St. Louis Athletica.
"There's a lot of time and effort that goes into taking care of a professional sports team, and you hope that one thing you get in return is the marketing benefit of having patients know that you're taking care of a professional athlete," he says. The teams generally have links on their Web site to the Washington University sports medicine page, and many patients, when they are new to an area, will find a physician by looking up the group affiliated with the local sports team. "The idea being that, 'If they're good enough to take care of an elite athlete such as Steven Jackson or Marc Bulger, they're good enough to take care of my son.'"