Medical Mystery
September 4, 2015
Each year in MHSAA member schools there are approximately 200,000 student-athletes who complete a pre-participation physical examination for which an MD, DO, Nurse Practitioner or Physician’s Assistant will sign a form certifying the fitness of the student for one or more interscholastic sports.
That massive number of physical exams will produce a minimal number of complaints – mostly from medical personnel – regarding the “burden” of MHSAA procedures. But if there is one group for whom I have little sympathy, it’s for these medical offices.
During the past half-year I have had personal appointments at a half-dozen different medical offices. On each occasion of a first visit, I was required to complete a half-dozen or more forms, including information regarding my medical history. I became increasingly unimpressed with the antiquated operations of our health care system. This is a mystery to me.
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Why is it that I must answer the same questions at every medical office to which I’m referred? Why, for example, don’t the orthopedic specialist and the physical therapist receive electronically my medical history from my primary physician?
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Why is it that my primary physician does not receive a complete record of my immunizations from the county health department or any one of several pharmacies that has given me shots?
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Why is it necessary to rely on the memory of the patient? Why isn’t there a medical database for me, accessible with my permission to every health care provider I see?
I expect that within three years, the MHSAA will follow a handful of other state high school associations to promote (and some state associations may require) electronic pre-participation medical history/physical exam forms which will not require parents to complete entirely new medical histories each and every year their child participates in school sports.
While we may follow a few states by a year or two, it appears we will precede the medical establishment by many years in modernizing procedures. This will tend to assure that student-athlete medical histories are more complete and accurate; it will be a greater convenience to both parents and medical providers; and it will promote greater participant health and safety.
Girls, Boys and Concussions
September 13, 2016
On Monday the Michigan High School Athletic Association announced the major findings from the first year that member high schools were required to report all suspected concussions in the practices and competitions conducted in the 28 sports served by the MHSAA.
It surprises no one that 11-player and 8-player football ranked first and third, with 49 and 34 head injuries per thousand participants, respectively.
And while I’m told it’s not surprising to the experts that girls report more head injuries than boys, it is stunning to me how very many more head injuries are reported for girls than boys.
In sports with identical playing rules, girls reported head injuries with approximately twice the frequency that boys did.
In soccer, girls reported 30 head injuries per 1,000 participants, compared to 18 per 1,000 for boys.
In basketball, girls reported 29 head injuries per 1,000 participants, compared to only 11 per 1,000 for boys.
Girls reported concussions at the rate of 11 per 1,000 participants in softball, while boys reported just 4 per 1,000 in baseball.
Only a small percentage of either girls or boys were cleared by licensed medical personnel to return to activity in less than six days, and more than half were withheld between six and 15 days in soccer and basketball. The data suggests that clearance for girls to be returned to activity was slightly more gradual than it was for boys.
Researchers and reporters may find dozens of other observations and curiosities from the summary of 4,452 confirmed head injury reports submitted by the MHSAA’s 755 member high schools for MHSAA-supported sports in 2015-16; but what has the MHSAA’s attention is this giant gender difference.
Is this gender difference accurate, and if so, what are the physiological factors involved that make it so?
Is there a tendency for over-reporting by females, or under-reporting by males, and if so, what are the social and/or psychological factors that may cause this?
Regardless, what does this mean for how coaches work with boys and girls; and what does that mean for how we prepare coaches through the MHSAA Coaches Advancement Program?
The MHSAA will take to an even deeper level its nearly 30-year partnership with the Institute for the Study of Youth Sports at Michigan State University to explore the issues related to coaches education that have emerged as a result of the first year of mandated concussion reporting for Michigan high schools.
The 2015-16 school year was only a start; it identified some initial themes. The more important value will be realized after the 2016-17 school year, and subsequent school years, when year-over-year comparisons will be made and trends will become apparent that will demand action to further promote the welfare of participants in school-sponsored sports.