Are Athletic Trainers Losing the PRN Market They Helped Build?

Athletic trainers spent decades establishing themselves as healthcare professionals. Are we now going to hand over the PRN and event coverage market to other professions?

EMS companies, physical therapists, nurses, and other healthcare providers are increasingly competing for sports medicine coverage contracts.

And here's what concerns me: We're not necessarily comparing professionals with equivalent educational preparation, clinical competencies, or scopes of practice.

Certified athletic trainers historically entered the profession through accredited bachelor's degree programs. Today, entry-level certification requires a master's degree.

Yet event organizers can hire EMTs who typically complete certificate-level education with substantially fewer educational hours and less specialized preparation in musculoskeletal evaluation, rehabilitation, injury prevention, and return-to-play decision-making.

That's not a criticism of EMTs. They provide an important service.

But emergency medical response and comprehensive athletic healthcare are not interchangeable services.

So why are we allowing the market to treat them that way?

The Business Problem

Look at how competing medical coverage companies market themselves.

They're not necessarily selling their educational credentials.

They're selling reliability, professionalism, rapid response, communication, and peace of mind.

They're speaking directly to what athletic directors and event organizers believe they need.

Meanwhile, athletic trainers continue fighting for recognition of their education, credentials, and value.

We may have spent so much time trying to prove we're healthcare professionals that we've forgotten we also need to compete as businesses.

Event organizers don't always understand the difference between an AT, EMT, nurse, or PT.

They understand cost, availability, liability, and whether someone will respond when an athlete gets hurt.

If athletic trainers cannot communicate the additional clinical value they provide, why would an organizer pay more?

The Workforce Shortage Question

We're constantly hearing about the athletic trainer shortage.

But are we experiencing a shortage of qualified professionals, or a shortage of professionals willing to accept the compensation being offered?

If an organization cannot find an AT for $25 an hour but can find one for $60, is that really a workforce shortage?

Or is it a compensation problem?

And when athletic training contracting companies cannot fill their assignments, what happens next?

Do they increase compensation to attract qualified ATs, or do they start contracting with EMS companies and other healthcare professionals to maintain their contracts?

There's a significant difference between supplementing athletic training coverage with EMS services and substituting one profession for another.

One expands healthcare capabilities.

The other may reduce the availability of the specialized services athletes previously received.

Who Controls the Market?

This is where things become particularly interesting.

What happens when larger staffing organizations begin controlling event contracts, customer relationships, pricing, and staffing decisions?

Athletic trainers could transition from being independent healthcare contractors to subcontractors working under organizations that previously competed against them.

And once another company controls the contract, who determines what an athletic trainer is worth?

This also raises questions about unions, collective bargaining, and market consolidation.

Unions can strengthen workers' negotiating power, while concentrated control of contracts by staffing organizations can reduce individual contractors' leverage. These aren't the same thing, but both deserve attention as the PRN market evolves.

So What's the Long Game?

Do athletic trainers:

1. Protect the PRN market by advocating for appropriate clinical coverage standards and demonstrating why specialized athletic training services matter?

2. Collaborate with competitors by developing multidisciplinary coverage models with EMS organizations, nurses, and other healthcare professionals?

3. Build stronger contracting companies capable of competing for larger contracts, improving compensation, and maintaining control over staffing and clinical expectations?

4. Walk away from low-paying PRN opportunities and allow the market to determine whether cheaper alternatives can adequately meet its needs?

I don't believe athletic trainers should automatically be entitled to every sports medicine coverage contract.

But I also don't believe we should willingly surrender a market we spent decades developing simply because another organization can provide a different service at a lower price.

We raised our educational standards. We expanded our clinical competencies. We fought for recognition as healthcare professionals.

Yet we're still competing for contracts where the decision may come down to who can put the least expensive medical professional on the sideline.

At what point do we stop asking why people don't recognize our value and start questioning whether our own business practices are contributing to the problem?

Are athletic trainers being pushed out of the PRN market, or are we failing to compete for it?

And perhaps the most uncomfortable question:

Are athletic training contracting companies protecting the profession's market share, or are they willing to replace ATs with other healthcare professionals to protect their own contracts?

scd 10/10/26