The atypical work schedule of an athletic trainer (AT) at the secondary school or collegiate level can present many opportunities that traditional 9-to-5ers don't have. But that flexibility is part of what makes maintaining a healthy work/life balance more challenging for ATs than those in other professions.

We asked Tory Lindley, Northwestern's Senior Associate Athletic Director, Head Athletic Trainer and President-elect of the National Association of Athletic Trainers (NATA), to share his insights on the obstacles ATs faces—and how they can be overcome.

Explain the unique challenges faced by athletic trainers that other health professionals don't have to deal with.

The AT lifestyle is a complex issue for a couple of reasons. ATs practice in a number of different settings, and those settings present different challenges. Some of the traditional roles of athletic trainers, either at the secondary school setting or the collegiate setting, are far different from other allied health professionals and clinicians, such as physical therapists.

First of all, our work weeks, work days and workflow are different. We lack the kind of structure where we're meeting with a patient from 8:00 to 8:35 in the morning, and then expect the next patient at 8:35, and so on. With a patient population of athletes, our workflow is typically team based, so when a team practices at a given time—say, 4 in the afternoon—the entire team is going to follow a schedule that typically allows them to receive their medical treatment from the AT.

This means that prior to the practice, as well as after, there could be 20 individuals seeking the services of one person. That kind type of schedule variability is what makes ATs stand out among other health professions.

But I also believe that variability provides some flexibility that ATs can use to achieve some work/life balance.

How does the athletic trainer's reporting structure affect that life balance?

We're a profession that's getting better at the idea of work/life balance because we're more cognizant of the need to build in boundaries and to take advantage of some of the flexibility. Where we're still not very good, however, is a lot of times, an AT's work/life balance is connected to the supervisor, or to the reporting structure of the organization. When the manager is an athletics administrator—rather than a health care administrator or health care provider—there's a greater challenge.

The migration toward a medical model is one of the more prominent ways that work/life balance in our profession can change. The idea that instead of reporting to an athletics administrator who also oversees a coach—who might be working with the same kind of scheduling model—the AT should instead be reporting to another health care provider/administrator at some level, such as a fellow AT in an administrative role or a team physician.

These health care professionals understand the best ways health care is delivered, and this means you have the sports medicine people deciding when, or for how long, health care should be delivered rather than when an administrator believes it should be delivered, which is often tied to the coach's schedule—and an AT has little to say about that.

I'm not suggesting that the medical model change the time when practice is going to occur. Rather, the migration to a medical model allows for the delivery of the health care services to happen around that particular practice—when the health care providers think it should be. In turn, boundaries can be set and some of the age-old ridiculousness of a clinic or facility being open just for the simple fact that someone might need something. And I'm not talking about a time when practice is going on, I'm talking about just any time during the day when it might be convenient for an athlete to get treatment.

Set times, set days and hours, and set expectations of when availability is going to exist are all what a medical model can provide.

Is it harder to find a work/life balance at the secondary school setting than the collegiate setting, or vice versa?

Challenges are likely greater at a secondary school setting, because the AT there is usually the sole health care provider after 3pm. That does not offer a lot of flexibility, including the opportunity for the AT to be responsive to family life or personal life. ATs in this setting don't often have a backup. As such, better integration of work and personal life is key.

A collegiate setting may be more conducive for a work/life balance. If a parent needs to get their sick child from school, s/he can find coverage from other ATs within the organizational structure. S/he's able to take advantage of the flexibility our profession provides.

What are some strategies you suggest to improve the work/life balance of an AT?

Having a medical model rather than an athletic administrative model is ideal, simply because health care providers better understand other health care providers and their challenges.

However, regardless of model, the support of leadership is paramount toward changing some of the old paradigms, especially the idea that ATs are always on call. We need to help leadership and administration understand that respecting appropriate boundaries and appropriate accessibility will still result in great care for their athletes, even if it's delivered differently than they've been used to.

And that's key. Because, obviously, some after-hours accessibility is necessary for ATs in some of our settings, but by the same token there needs to be individual expectations and boundaries set by the AT. The patient population needs to understand that ATs offer emergency access to care but not every need is an emergency and can be treated during an AT's regular hours.

You have some ATs who complain about—while still wearing as a badge of honor—the fact that they work 12-hour days or 60-hour plus weeks. But with better support, those can be avoided. If you choose to put in a 60-hour week, you're not working hard enough in preventing that from happening.

That kind of attitude has been really troubling for our profession, which is why we need great mentoring and engaged clinical supervisors to teaching the things we've been talking about and what the NATA is trying to do, to change a culture that led to overworked ATs.

Although the NATA isn't a union in the traditional sense where we address individual grievances, on a broader level we offer support, tools, and services—along with a spirit of community—to empower ATs to advocate for themselves, through mentoring, research, and publications on a wide range of issues, including best practices in work/life balance.

How is work/life balance affected by non-treatment responsibilities that come with the job?

An AT isn't always on the field, and those "other duties assigned" are also vital. With mentoring and education, ATs need to recognize, before it's too late, the importance of being organized and taking advantage of all the available tools to help manage time and work.

These are tools that are used in any profession. You should definitely use a program like Outlook to create your schedule—not necessarily to be strictly bound to it, but to set up blocks of your day and to decide what you want to achieve in those particular blocks, and try very hard to protect it.

You shouldn't be "open" whenever someone wants to roll in. Make it clear to your patients when you're going to be available for injury treatment. You might see patients from 7 to 9am, then you've blocked out parts of your day for tasks like updating electronic medical records, patient education, physician and coach communication, and pre-practice setup.

Managing our schedules is something a lot of us aren't good at. If you take the day as it comes, the day will take control of you. The things that have to get done won't get done: emails aren't answered, calls aren't made, and records aren't updated, and that's typically why an AT will have to stay late or take work home.

And the best ATs, in addition to managing their schedules, know how to manage the many different individuals they come in contact with, including the coaching staff, administration, staff, athletes, and even the athletes' parents. Being an AT is a very complex job, which is why the work/life balance can be hard to manage.

Are there additional challenges for an AT in a management role?

ATs in management face additional obstacles when leadership doesn't understand the role delineation or provide the support so that patient care can be maintained, while affording the AT manager the time and resources to manage others ATs and fulfill other managerial tasks. The solution is easy: you can't expect someone to do multiple fulltime jobs.

What advice would you give to a new AT considering a role at a secondary school or collegiate setting?

Understand what comes with those settings. Some ATs might be envious of the health care professional with that 9-to-5 schedule in a clinical or industrial environment that usually means weekends off. Maybe that's a better situation for them.

It comes down to predictability vs. flexibility. Our (collegiate) environment is very conducive for flexibility—and offers opportunities that you don't get during a traditional job schedule. You might not have control of your weekend because that's when the games are played, but you often have time during the week to do things that people with a 9-to-5 job can't do, such as get in a workout in the middle of the day, pick up your kids, or walk your dog in the afternoon.

Achieving that work/life balance is so important, because it will not only make your life feel more satisfying, it will make you a better AT overall!