"Million-dollar arms," Bancells said just before Julio walked into the Orioles' Camden Yards training room this week for his daily therapy session. "Eighty percent of my work is taking care of shoulders and elbows that have millions of dollars on them."
But take Bancells out of the training room or off the field, and Maryland doesn't recognize him as qualified to perform the same rehabilitation exercises in a clinic. The distinction: Athletic trainers aren't licensed health care providers in the state, forcing many of those who practice in clinics to work as lower-paid physical therapists' assistants, athletic trainers say.
Today, Bancells will be among those testifying for a bill to change the status of athletic trainers by licensing them to treat physically active patients under the direction of a physician, regardless of the setting.
The bill, set for a 1 p.m. hearing before the House Health and Government Operations Committee, is the latest salvo in a decades-long push by the state's athletic trainers. Although they say that licensing would protect the public by ensuring athletic trainers are properly educated and regulated, the main impetus for the bill is a desire for a level playing field with physical therapists, who generally oppose allowing athletic trainers to practice more broadly.
"We're trying to protect our practice area," said Richard T. Peret, president of the American Physical Therapy Association of Maryland.
Peret supports licensing athletic trainers but opposes expanding their practice, saying the trainers could end up doing work for which they're unqualified. Another fear among physical therapists is that licensing could lead insurers to reimburse clinics for care provided by athletic trainers, cutting into therapists' business.
There are about 400 certified athletic trainers in Maryland and about 27,000 nationwide, according to the National Athletic Trainers' Association. Athletic trainers must have at least a bachelor's degree from an accredited athletic training curriculum and pass an exam to be certified. The association requires that certified trainers practice under a physician.
Twenty-eight states require athletic trainers to be licensed, and 14 more regulate them in some fashion. Gary Horsmon, head athletic trainer at the Johns Hopkins University, and former Baltimore Colts team trainer John Lopez support the bill. Despite his experience, Lopez said, he had to work under the supervision of a physical therapist in a Towson sports medicine clinic he co-founded.
"You should be able to practice your profession whether you work in a high school or clinic or doctor's office," Lopez said.