Weekend Sport Injury Evaluation

Hannah Blaske, Ethan Fink, Derrick Henkenius, Cheyenne Peters

Background and Opportunity:

According to Johns Hopkins Medicine, there are roughly 3.5 million athletic injuries each

year in the United States with one-third of them coming from high school athletes.1 With this

number of injuries and the decreased access to resources, rural high schools across Iowa lack

the ability to treat their athletes efficiently. To try and decrease the risk of injury for their athletes,

many of these schools will share athletic trainers for their sporting events, which ultimately

increases the demand for more care post-injury. This creates an opportunity for physical

therapists to get involved in high school athletics to provide care for numerous high schools in

the area by providing evaluations of sports related injuries. This would increase the opportunity

for athletes to obtain care and treatment sooner at a decreased cost, while also increasing

caseload and referrals to physical therapy. Along with increasing patient caseload, providing

more access to care for high school athletes would build rapport with the community as well as

the school systems and potentially increase physician referrals. The vision for Optimum

Performance Physical Therapy and this program is “to become the premier sports physical

therapy clinic in northeast Iowa.” The program’s mission is to provide weekly injury evaluations

to local high school athletes, post-competition, to reduce time to care while establishing

relationships with local high schools and their athletes.

Proof of the Opportunity:

Injuries in high school athletics are very prevalent, with 90% of athletes reporting some

kind of injury, according to the National Athletic Trainer Association, while 54% of student

athletes have reported playing through an injury.² The high schools surrounding the area where

our clinic is located have minimal athletic training coverage, therefore decreased access to

immediate care. Most athletic trainers are only there 2-3 afternoons per week to assess injuries

and provide rehabilitation services to athletes. They attend some practices, but not all, and

home sporting events only. There are also many situations where athletic trainers have to split

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their attention between 2 different sporting events if they are going on at the same time. This

leaves plenty of room for athletes to get injured when there is not an athletic trainer there to

provide care, especially if they are injured on a Friday night at an away game. After injury, the

athlete, their parents, and their coaches will likely want to have the injury evaluated prior to them

returning to play.

When an athlete is injured, say on a Friday night, often the first option is to go to the

emergency department that night or the next day. A study comparing costs and wait times

between ED and an urgent care orthopedic center found a difference in cost of care to be

$7,689 ($8,150 at the ED, $461 at the clinic).3 Many of the injuries seen in the ED were able to

be seen in the orthopedic clinic, however, patients were not aware of that option. In addition to

the massive difference in cost for care, patients also saw an increase in wait time to see a

provider both from time of injury and from the time they got into the waiting room. On average,

patients waited 3.4 days to see a physician in the ED versus just 1.2 days in an orthopedic

clinic, more than a 50% reduction in time to care.3 High school athletes competing in sports

towards the end of the week are at a disadvantage when they are unable to reach a provider

due to weekend availability, further increasing that time to care. Further, time to point of care is

an issue in healthcare that is detrimental to athletes with acute injuries. The same study found

that patients spent just 17 minutes in an orthopedic waiting room compared to 45 minutes in the

ED waiting room with total visit time being 43 minutes in the clinic versus 156 minutes in the

ED.3 Our program is not an orthopedic urgent care site, however, the structure is semi-parallel

to such a site.

Our program identifies this opportunity to serve rural athletes when they are injured

during sport activities. By providing services outside of the normal business week, we reduce

the amount of time that they have to wait to receive care. Additionally, by having licensed

physical therapists perform these evaluations, we are saving the patient and their families

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money by using less expensive means to evaluate the situation and provide recommendations

or further referral if necessary. Below is our SWOT analysis.

Strengths Weaknesses Opportunities Threats

● Only clinic ● Reliance on ● Increased ● PT burnout

providing athletes referrals ● Are all
services coming in ● Referrals from therapists
● Bring in ● Can have too physicians qualified?
revenue for little or too ● Make a ● Another PT
the clinic many athletes difference in clinic moves
● Free showing up overall health into town
evaluations for young
for athletes athletes
● Decreased
costs for
athletes with
potential
injuries

Solution:

Marketing

Our plan is to provide a one-time free evaluation of sports related injuries to the local

high school athletes outside of normal business hours. This will take place in our clinic located

at 200 Sunset Street, Urbana, IA 52345. We are planning on opening our clinic from 8am-12pm

every Saturday morning to provide these evaluations. Initially, we plan to see 12 patients per

week, based on injury trends, for 20 minute evaluations with referral or recommendation at the

end of the session. Patients will have access to a generalized subjective form that they can

download from our website and fill out prior to arrival at our clinic to speed up the evaluation

process. If an injury is identified upon evaluation and the patient is appropriate for physical

therapy, we would provide recommendation for them to return back to the clinic to begin

rehabilitation. Based on experience with sports injuries, we estimate patients would return to

the clinic twice a week for approximately three weeks.

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 We currently have 4 physical therapists and 1 part time physical therapy assistant

employed in our clinic. We are planning on having a rotation where each PT will work one

Saturday every 4 weeks. The PTA will take over on Friday afternoons, covering the patients for

the PT who will be working that Saturday, in order to make up for that extra 4 hours on

Saturdays. Additionally, the PTA will serve as an extra set of hands and a receptionist on

Saturday mornings as well. Having someone there to field phone calls will also assist our

program in reducing the number of people that show up and cannot be seen due to a large

number of evaluations. Depending on the demand for our services, we may need to add

additional physical therapists to work on Saturday mornings and/or expand our hours if we are

unable to see all of the athletes who present to our clinic in this time period.

We plan on promoting this program by reaching out to the athletic directors and coaches

at local high schools, including Vinton-Shellsburg, Center Point-Urbana, Jesup, Independence,

Alburnet, East Buchanan, North Linn, and Central City. We will provide them with information

regarding our program and flyers to hang up in their facility for advertising. We will also reach

out to parents, coaches, and athletes to provide them with more information about our program.

Once we have reached out to these high schools, we plan on creating different platforms of

social media such as Twitter, Instagram, and Facebook to advertise our services, as well as

putting information on our clinic website.

Below is a layout of our expected revenue and expenses during the first year of this

program:

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Revenue

(Table 1) Revenue for First Year

Direct No direct income from $0.00

program

Indirect Return from evaluation $36,000

(Estimated cost of EOC $600
x 5 new patients/month)

Referrals from weekend Variable

evaluations, teammates, etc

Total $36,000

Expenses

(Table 2) Expenses in First Year

Start-up Marketing Costs Flyers - $0.34 x 100 flyers =

$34.00

Addition of subjective form to $150

website

Operating Fixed Absorbed by clinic $0.00

Operating Variable PTs ($40/hr x 16hrs of $7,680

coverage/month)

PTA (to work reception $2,304

$12/hr x 16hrs of
coverage/month)

Total $9,984

Program Assessment Plan:

Our weekend program will be defined as successful based upon the percentage of

athletes that return for treatment and the total number of evaluations we perform each week. To

help determine the success that we are looking for in our program, we plan on looking into

patient outcomes measured via patient satisfaction surveys and documentation of the gross

number of athletes that are evaluated on Saturdays and then return for treatment the following

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week. We plan on evaluating these outcomes every three months after implementing the

program. This will give us the chance to see our trajectories throughout the fiscal year.

When examining the typical Iowa high school schedule, we expect to see the most

athletes in the fall and winter seasons as sports such as football and basketball produce the

highest amount of high school injuries per year. In 2019, it was reported that football related

injuries amassed 292,000 while basketball led the way with 404,000 reports in the United

States.4 With these numbers and the three-month assessments of our program, we can prepare

and adjust the program as time persists.

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 References

1. Sports Injury Statistics. Johns Hopkins Medicine.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/sports-injuries/sports-
injury-statistics. Accessed April 19, 2021.

2. At Your Own Risk: Information for Student Athletes. atyourownrisk.org.

https://www.atyourownrisk.org/studentathletes/. Accessed April 21, 2021.

3. Anderson TJ, Althausen PL. The Role of Dedicated Musculoskeletal Urgent Care
Centers in Reducing Cost and Improving Access to Orthopaedic Care. Journal of
Orthopaedic Trauma. 2016;30(5). doi:10.1097/bot.0000000000000712

4. Facts + Statistics: Sports injuries. III. https://www.iii.org/fact-statistic/facts-statistics-

sports-injuries. Accessed April 21, 2021.