Interview with Tiffany McGuffin

Interview

Tiffany – While speaking with Laura Kunkel about degrees related to athletic training, master’s degrees and what the job market looks like for graduates, she told me about some of the new types of opportunities we’re starting to see for athletic trainers in corporate settings, police and fire departments and police departments based on how healthcare is delivered and how some of those organizations have started shifting to having athletic trainers on staff. I think it’s a really interesting, emerging field, something that could be a good choice for the right type of person out there. You were recommended as someone who might be able to talk about this aspect of the field. My first question, tell me about your journey and how you ended up where you are today in athletic training.

I knew I wanted to do something medical and I got paired with my high school athletic trainer while I was an injured athlete and that is when I discovered athletic training. It seemed like the perfect marriage between what I was currently loving and what I thought I wanted to do with the rest of my life. When I started my career, we were pretty limited on education programs. In Texas, we had one state school and one private school, so as a normal middle-class kid, state school was the best option for me. I applied to that school and that’s where my pathway took off. From there, I did work in traditional athletics both at the collegiate setting and the high school setting. About eight years into my career, I started to realize it was more the medicine part I was enjoying than the sports part. I think I just fell out of love with the intensity that comes with some of the aspects for sports.

I moved from there to a sports medicine orthopedic position office where I did some first assist, helping him in the operating room doing ACL and shoulder surgeries as well as total joint replacement surgeries, and in his clinic.  I really enjoyed that but was looking to grow a little bit more professionally. I then moved to concussion research and clinical management. This was right on the brink when everything in concussion care was changing.

At that point, it was another five or six years before I was ready for a new adventure. That’s how I ended up picking the job where I am now. I currently work as an occupational/industrial AT for a major food manufacturer [where] I am contracted to work by a national health care company, Pivot Onsite Innovations. This setting wasn’t necessarily something I had my sights on but as you said earlier, that is where the growth is and a lot of job opportunities are for ATs. Every single job application and interview process I was a part of in that transition was in an industrial/occupational setting. I am involved in COPA (the Council on Practice Advancement) within NATA. It’s a special committee in the NATA that identifies the need and gaps in those emerging settings, and then gets resources and opportunities built to advocate for more jobs and advocate for higher standards of care in these new emerging settings. I was already keyed into some of these settings through this work, so it all just kind of fell into place.

I just want to unpack a little about your journey. So when you went working as a ‘normal’ athletic trainer working in an athletics-type setting to the orthopedic setting, and then to concussion research, how were those steps made? Were you able to navigate those different roles strictly with your athletic training degree or were you doing continuing education along the way that opened those doors?

Yes and yes. I don’t have any other credentials outside of athletic training, so there wasn’t any other education or degree plans that I had to pursue for those [opportunities]. All essential skills were all the things that I learned in my athletic training education and early profession. We are required, like all other health care professionals to have continuing education units, so, for me, it’s all about intention. What’s your intent with your continuing education? Are you just checking a box or are you seeking out [the training that is] going to help you in those areas?

In your role with the NATA, you focus on athletic trainers in emerging settings. For some of our readers out there who are not really familiar with the new and exciting training opportunities that are growing in these settings, can you talk a little about the overview and types of growth you are seeing?

COPA itself is a council of volunteers in NATA. We have several committees within that council. We have performing arts, industrial/occupational, military, public safety, physician practice, community outreach, health care administrators and entrepreneurs. Those areas are what we focus on and that’s where we believe the growth is. Each setting has their own niche just like each sport we deal with. We don’t treat a baseball and football player in the same way. We prevent and rehab differently for both sports. So each one of these subsets has the same results, but you change your approach to the patient, but not what you know. Your basics are always there, but how you go about doing them is where you see the nuances.

I know it’s hard to compare when we’ve got so many different committees and areas that we are talking about, but since these are typically all non-athletic or court/field-side positions, how do these compare with the more traditional athletic trainer positions? Compared to the traditional athletic trainer role, what is similar in these new areas, and what is different?

I’ll start by coming from my standpoint, and then come at it more globally if we need to. As I said, my knowledge and skills are the same. I’m still going to treat an overuse injury physiologically the same way regardless if it’s a traditional overhead athlete versus an employee who works overhead the twelve-hour shift, five days a week. Between the two groups, the diagnosis might be the same, but the biggest difference is going to be the management and treatment timetable. Athletes always have [a sense of] urgency while [in] the occupational/industrial [setting] – although it has its own kind of urgency – the motivation is a little different. We have to get this person back to work so they can provide for their families and lead a healthy life and not set themselves up for some chronic, lasting illness. I think they are a little bit better at [seeing the] big picture [perspective], and that lends them to be better at compliance. They are a little bit more amiable sometimes than some athletes at getting back, because again, it’s livelihood not hobby. We encounter that need with some of our professional athletes, but so few of us work with professional athletes that we don’t get to experience that as much.

Looking at a couple of these different roles – for example, an athletic trainer in a corporate setting and those working at a police or fire department. You mentioned compliance and worker’s compensation – do athletic trainers usually get involved prior to worker’s compensation or are they a part of the recovery program with worker’s compensation?

It can be both ways. A lot of it is contingent on your state’s practice act. Athletic training is governed state-by-state through a licensing board of some sort. It’s a little bit different in every state, and each one has their own licensing. California is the only state that doesn’t have any of that protection for the public in regards to who gets to claim being an athletic trainer. There could be people calling themselves athletic trainers without any degree or credential that ensures they are a medical professional, and that’s completely acceptable because they haven’t been able to secure licensure. So what an AT in this setting provides varies from state-to-state and their practice acts. It also depends on who your actual employer is and what the goal of the safety team is. A lot of ATs in this setting are contracted into these work sites by larger health care companies.  The majority of what athletic trainers bring into the work site every day is the prevention aspect to mitigate risks with the intent that worker’s compensation claims don’t happen at all. This prevention is a large component of what I do at my site. We always tell our team members, ideally you would never see me for an injury because we are doing everything correctly so that it doesn’t happen.

What does that look like? Say you’re contracted on a factory site, it seems like you’d be working in conjunction with a risk management plan, walking around auditing the different actions that workers are doing?

Absolutely.

Interesting, so it’s kind of like problem solving before the problem has happened.

Absolutely. Even some companies hire “injury prevention specialists” not “athletic trainers,” but when looking at the qualifications for the posting, athletic training certification/licensure is a requirement. We work hand in hand with the company’s safety teams, the person responsible for all the environmental and safety components for the work force. We help them reach their goals. My goal is to prevent work-related incidences. Conversely, I have some friends associated with a fire department and they don’t do any worker’s compensation at all, but they are available for the fire department’s non work-related injuries and still yield gigantic outcomes when it comes to work related performance. It can be set up both ways.

The injury prevention specialists for example at Amazon, is that a full-time position paid by Amazon?

It is.

Because it’s such a big company, I would guess that you get pretty good benefits working for a company like them in a role like that. Can you comment on that?

I’ve heard you do get good benefits. I don’t have any intimate knowledge of that specific organization, but yes, sometimes you do get tied into their benefits. I would think that would be contingent on who your actual employer is vs. the client you serve. I think that’s one of the things that is a little different coming from the athletic world to the corporate world that I did have to learn. It’s a different language, and how you navigate care and who you report to and how you communicate that care. You get a little bit more of a corporate structure, which typically as a whole does yield higher paychecks and benefits than some of our collegiate settings.

I know that for some athletic trainers who work for teams, travel can be a perk for individuals who are looking to get out and see some parts of the country or even travel internationally. Conversely, you’ve got the corporate setting where you might have the benefits of working for a large company, but I imagine that the work might be a little bit more rigid given the environment.

Yes, it is a little bit more rigid but maybe ‘rigid’ might not be the right word. It might be more ‘structured’. I think that’s one of the things when you hear athletic trainers talking about the prospect of being in a non-traditional setting: it’s the structured hours that attract athletic trainers into this setting. You’re not at the whim of athletic teams, coaches, weather and all the things that come with athletics. It’s more nine to five. At least that’s the appearance to others. With that being said, I do have a set schedule that I work every day and I know what clinic I am serving that day. That certainly is desirable to me.

I see. You mentioned that it ‘appears to be nine to five’ but in reality, there is more to it. Can you elaborate more on that?

Sure. For example, when you’re talking about public safety and you’re working with a police department, police departments are not nine to five. You may have some clinic hours that fall in that “office hours” realm, but your patients are going to be working twenty-four/seven. Similarly, we always hear people wanting to move into physician practice to have set clinical hours. But if you’ve ever worked with an orthopedic surgeon, you know they don’t work nine to five either. It’s kind of just that appearance of having a set schedule; it gets romanticized just a bit. I feel like I am happier with my work-life balance in this situation than if I was working in the traditional setting, however it’s not always as simple as people want to reduce it down to. Going back to the Amazon example, they run twenty-four hours a day, so you have to consider, are you going to be working third shift or weekends? I work at a 24-hour facility and my hours reflect those three shifts (4am to 2pm) with on-call and triage happen at all hours. Those are things that come into play.

In those corporate setting positions, is there a considerable amount of work that you have to take home, or do you find you are able to leave your work at work?

For the most part, I’d say that you leave it at work, unlike some of my peers. I think the big difference is when for me is when you are at work, your hours are filled. That was a big difference for me coming from the athletic setting where you are at the whims of a lot of other outside factors. Is the coach going to change practice and have a film session instead? What are you going to do for that hour and a half they are sitting in a meeting room? If they move a film study session from Monday night to Tuesday night – but nobody sends you a text and you just show up – what do you do? [This type of thing] happens all the time in athletics. I know that when I go to work now, I know that people are going to be there and my hours are going to be filled and valuable with my tasks at hand. That consistency part is nice for me. But some people like the unpredictable nature of sports and athletics and that’s why they choose it. Some people thrive on that, but for me having intentional time is huge.

I can certainly understand the appeal of a structured schedule. Zooming out a little bit and looking at things generally – just like yourself, there are quite a few people out there pursuing a career in sports medicine, whether it be as athletic training or not. What type of person do you think makes a good athletic trainer?

A communicator. No matter what setting you are in, you need to have strong communication skills both verbally and written. You need to be able to document accordingly to protect yourself and your patients. Then you need to be able to communicate your treatment plan with all of your stakeholders whether it’s [one] coach or five coaches. Whether you’re talking to the offensive coordinator, the head coach, or athletic director you’ve got to be able to talk to all those people. [It is] the same thing with the jobs I work now. I’ve got to talk to supervisors, medical coordinators, safety coordinators. Being able to manage that communication effectively I think is the biggest need for anybody in this profession.

Whether you’re talking to the offensive coordinator, the head coach, or athletic director you’ve got to be able to talk to all those people. [It is] the same thing with the jobs I work now. I’ve got to talk to supervisors, medical coordinators, safety coordinators. Being able to manage that communication effectively I think is the biggest need for anybody in this profession.

Why do you feel athletic training is a good choice for young people to pursue at this moment?

Just all the things we mentioned today. There is just so much variety and so many growth opportunities, and you are not going to be pigeonholed into one setting for the rest of your life. As we already talked about, I didn’t have to acquire any new credentials to have such a dramatic change in my profession. I’m not sure you could find that in other professions where you would be able to do something so radically different than what you started, without getting any other degrees or certifications, while still applying your original skills. There are lots of opportunities, diversity, and growth.

Looking at your colleagues. Do you feel that the people around you are happy with their professions and are leading lives with a good work life balance?

I don’t know that we could say that universally. It is something we are constantly working towards as a profession. The model of athletic training is changing so some colleagues are really accepting that and embracing it while some don’t necessarily feel that’s the direction they would like to go. What I mean by that is there is a big shift in college athletics moving the athletic training department to health care department or the student health center, versus being housed in the athletic department. So trying to get a real separation of church and state. You don’t want the football coach being your boss when you are in charge of making medical decisions for the athlete. There is a shift in that foundational piece of our profession, but by aligning with other departments that operate with clinical hours, an AT can seek the structure we talked about and still practice in traditional sports. We aren’t available twenty-four seven because doctors or physical therapists aren’t available twenty-four seven either. That is a seismic shift in profession. Some are not as welcoming of it as others. It’s new and it’s going to take a lot of sacrifice to get there. Saying no to jobs you want to say yes to or saying no to tasks you want to say no to in order to maintain the integrity of your credential and degree while preventing burnout. It’s a big change in our profession and hopefully it will yield some good results when it comes to that work-life balance.

In terms of demand, would you say for recent graduates of athletic training that there is a good solid level of demand for them in the workforce?

I believe so. There is a big push from the NATA to have athletic trainers available in all secondary schools. In Texas, we do a really good job of doing that, often having multiple athletic trainers in the secondary level. If we even employed one athletic trainer in every secondary school across the country, we could employ thousands of people. So continuing to advocate for that, along with all these new and emerging fields, there are so many opportunities.

That’s great to hear. My last question for you, what advice do you have to share for the next generation following in your footsteps and how do you stay ahead of the curve?

I think being flexible is really important when you head [into this field]. Being open to all these different types of opportunities requires a little bit of flexibility. If you would have asked me when I was a grad student, if this where I would have ended up, I would have told you that you were bananas. Allowing those opportunities for growth [to happen] and being open to those opportunities is huge. The more involved and engaged you are in the professional setting, the more connections you are going to make. I would have never known that industrial occupational athletic training was an option if I wasn’t involved in my profession. Really, networking and knowing people and getting involved will really open a lot of doors.