Hiring an Athletic Trainer: Finding the Right Fit for Your School

Minimizing risk of injury for high school athletes is a top priority for high school athletic administrators nationwide. With more than 7.8 million students participating in sports during the 2022-23 school year, it’s crucial to ensure proper care for injuries and illnesses that athletes incur.

Athletic directors and school administrators are the individuals responsible for coordinating the major aspects of a secondary school’s athletic program. These same administrators are often assigned the task of determining the best way to minimize risk of injury for their school district’s athletes when they participate in athletic activities.

Athletic trainers are health-care professionals who are specifically trained to care for injuries and illnesses suffered by athletes and physically active individuals. Athletic trainers not only provide emergency care for injured athletes such as CPR, but they are also trained to evaluate, treat and rehabilitate injuries suffered during participation in athletic activity. They can develop venue-specific emergency action plans (EAP).

Athletic trainers are also trained in the management of concussions, as well as life-threatening conditions such as exertional heat stroke (EHS) and hyponatremia. Understanding who the athletic trainer is and the skill set that individual brings to a school is important when considering adding this position to the athletic staff. Now, the big question for schools is: What employment model works best for bringing an athletic trainer on board?

With all the different ways to hire an athletic trainer, figuring out the best fit for your school can be a puzzle. There are three common approaches to athletic trainer employment in a school system: outreach contracts, direct employment by the school system and independent athletic trainer contractors. Following is a breakdown of those approaches:

Outreach Contracts
One common approach is reaching out to external agencies like hospitals, physicians or universities through outreach contracts. According to the ATLAS Survey, 57 percent of high schools opt for this model.

Pros:

• With this model there is a wider pool of available athletic trainers. If the athletic trainer is sick or on vacation, a per diem or one-day replacement should be easier to find.

• When the athletic trainer is employed on this type of contract, the individual can easily collaborate with doctors and other specialists from their contracted medical facility or system.

• This model could be more cost-effective as the school or district doesn’t pay all the benefits and overhead costs like it would with a direct employee (social security, insurance benefits and retirement costs).

Cons:

• This model could possibly result in less patient-centered care. The athletic trainer might not know the athletes as well as someone who is always at school, especially if the school athletic trainer is not always the same person but rather whoever is “on duty” for that day.

• The athletic trainer might feel like an outsider and have less sense of belonging.

Direct Employment
When the school system directly employs an athletic trainer, this comes with its own set of advantages but also has some things that the district needs to be aware of when utilizing this model.

Pros:

• There should be stronger bonds developed with everyone. This includes student-athletes, coaches/teachers and administrators. When the athletic trainer builds stronger relationships with athletes and staff, this leads to better care.

• Better patient-centered care should result from this model of employment. When the athletic trainer gets to know each athlete’s needs and preferences, a better level of trust should develop, and this leads to improved outcomes.

• When the athletic trainer is employed by the school or school district, he or she should not be called away from school duties because of a conflicting event. This can happen occasionally with outreach contracts.

Cons:

• This model will be more costly for the school district. The district will be required to pay full benefits and other employee expenses (social security, insurance benefits and retirement costs).

• The district must find the right fit. Hiring the best individual athletic trainer for the district can take time and effort. Oftentimes, there are good athletic trainers and good school districts, and they aren’t a good match for each other for various reasons.

Independent Contractors
In effect, this is hiring a freelance athletic trainer. When the district hires an independent contractor, it offers a balance between the outreach and direct employment models.

Pros:

• There is more flexibility in this model. This person can fill short-term needs such as an absence of the staff athletic trainer or help to add additional staffing for busier times when multiple events are occurring simultaneously.

• This will be more cost-effective. Like outreach contracts, the district will only pay for the service directly. The district avoids the costs typically associated with direct employment such as benefits.

Cons:

• It may be hard to find someone quickly for long absences as there may not be available people willing to step in and work.

• The location of the school district can be a concern. In rural areas, finding qualified independent athletic trainers might be difficult.

The Bottom Line
There’s not a one-size-fits-all answer. The best model for a school district depends on the budget, needs and community. When the district is deciding on a course of action, it should consider several factors.

• Is budget a larger concern? Can the district afford a fulltime employee or is the district on a tighter budget where an outreach or independent contractor is a better option?

• How important is patient-centered care? Does the district value the athletic trainer getting to know the athletes personally?

• Are there athletic trainers living in the area? Does the district have access to medical facilities or a pool of independent athletic trainers?

• The school size and sports offered are an important factor. The bigger schools with more athletes might need a different model (i.e., more than one athletic trainer) than smaller schools.

When making this decision, administrators should talk to coaches, members of the local medical community, and other important groups to get their input. The school district should do its research and compare the different models and make the decision that is best for the district. When hiring the right athletic trainer, it will make a huge difference with a focus on health and safety of student-athletes.

The district should also consider several factors when hiring an athletic trainer regardless of which model it chooses. First, “soft skills” are important. Ideally the athletic trainer will communicate well with all stakeholders (school staff, medical community, parents/ guardians), build relationships, and understand the needs of teenagers.

The district should get references from trusted individuals such as other schools, athletic professionals and members of a medical community. When hiring, it is important to set clear expectations. The specific duties and responsibilities of the athletic trainer in the job description or contract should be outlined. The district should also invest in training, such as providing the athletic trainer with ongoing professional development opportunities within the school system and making allowance for its own continuing professional education.

By taking the time to find the right fit, the district can create a safe and healthy environment for the athletic trainer and student- athletes to thrive. Ultimately, the employment model choice for an athletic trainer will be made by school administrators where they must weigh all the factors of each employment model. The final decision will depend on the unique needs, resources and priorities of each school system.