Athletic Training, Compact Licensure, and the Future of Healthcare Access
Why Advocacy Matters Now
Each March, National Athletic Trainers’ Month (NATM) recognizes the vital contributions of athletic trainers to the health and safety of physically active populations and the broader healthcare system. Sponsored by the National Athletic Trainers’ Association (NATA), NATM offers an important opportunity to highlight not only the clinical value of athletic trainers but also the policy frameworks that enable them to practice effectively within interdisciplinary care teams.
As orthopaedic care delivery increasingly relies on coordinated, team‑based approaches to musculoskeletal health, licensure policy has emerged as a critical advocacy issue. The Athletic Trainer Licensure Compact (AT Compact) represents a timely and consequential reform, aimed at reducing interstate practice barriers while preserving state regulatory authority and patient protections 1. In recognition of National Athletic Trainers Month, this blog features the AT Compact. While still in its preadoption phase, the AT Compact is a key policy initiative with direct implications for orthopaedic practice efficiency, workforce mobility, and patient access to musculoskeletal care.
By examining the AT Compact through an orthopaedic advocacy lens, this discussion underscores how modern licensure frameworks can strengthen collaborative care models and support the evolving demands of healthcare delivery.
Understanding the Athletic Trainer Licensure Compact
The Athletic Trainer Compact represents a legislatively enacted agreement among participating states that allows licensed athletic trainers to obtain privileges to practice in other compact member states without securing separate full licenses in each authority. Like other healthcare compacts, it is based on mutual recognition, meaning an AT maintains a primary license in a home state while practicing in remote states under compact privilege.
The compact is not a federal mandate; rather, it requires individual state adoption of uniform model legislation. A threshold of states, usually seven to nine, must enact the legislation before the compact becomes operational. Regulatory authority remains with each member state, ensuring continued oversight, disciplinary enforcement, and protection of the public 2.
Why AT Compact Licensure Matters in Healthcare
Workforce Mobility and Shortage Mitigation
Healthcare workforce shortages, particularly in rural and underserved areas, have intensified calls for licensure reform.
AT Compact licensure is increasingly important to orthopaedic physicians as practices face growing difficulty recruiting and retaining qualified athletic trainers. ATs are essential members of the care team, supporting clinic efficiency, continuity of care, and patient access. The AT Compact expands the hiring pool by allowing practices to recruit across state lines without lengthy licensure delays, reducing time‑to‑hire and streamlining onboarding. For multi‑site and regional practices, compact licensure also enables faster redeployment of experienced ATs as service lines grow. Physician advocacy for compact adoption aligns licensure policy with modern workforce needs while maintaining patient safety and regulatory oversight.
Athletic trainers are projected to experience 11% employment growth from 2024–2034, much faster than average, underscoring the need for flexible deployment of this workforce 3. Although the athletic training profession continues to expand, the diversity of settings in which athletic trainers are now employed is growing just as rapidly. As a result, finding the right AT for a specific role is still a significant challenge.
Advocacy: The Critical Link Between Policy and Practice
The Role of Professional Advocacy
The success of the Athletic Trainer Compact depends heavily on state-level advocacy. Professional organizations such as the National Athletic Trainers’ Association (NATA), the Board of Certification (BOC), and state associations play a central role in educating legislators, regulators, and the public about the value of athletic training within the healthcare system 4.
Advocacy efforts emphasize that:
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Athletic trainers are licensed or otherwise regulated in all 50 states and the District of Columbia
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The profession is evidence-based and patient-centered
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Compact licensure supports workforce readiness and healthcare equity
Why Advocacy Matters Now
Legislative windows are often narrow, and states must adopt model language without substantive changes to maintain compact integrity. Grassroots engagement: emails, testimony, coalition-building, and storytelling can influence whether compact legislation advances or stalls.
For healthcare leaders and educators, advocacy also reinforces the broader recognition of athletic trainers as essential healthcare providers, not ancillary or sports-only professionals.
Implications for the Future of Healthcare
The Athletic Trainer Compact represents more than administrative efficiency. It signals a shift toward:
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Integrated, team-based care
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Responsive healthcare delivery
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Interstate collaboration in regulation
Patient-centered access models
As other professions have demonstrated, compact licensure can improve access, stabilize workforces, and support innovation while maintaining public trust.
The Athletic Trainer Licensure Compact, while in its preadoption phase, represents a strategic opportunity to strengthen the musculoskeletal healthcare workforce, improve continuity of care, and support orthopaedic practice efficiency, without altering scope of practice or compromising patient safety. For orthopaedic societies committed to advocacy, engagement with compact licensure policy is not ancillary; it is integral to advancing access, quality, and sustainability in musculoskeletal care.
As states consider adoption of the AT Compact, orthopaedic voices can play a decisive role in shaping informed, balanced legislation that benefits patients, providers, and healthcare systems alike.