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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.

  • 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?

  • 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?

  • 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.

Best Practices

June 28, 2016

Two-thirds of concussions reported in Michigan high school football last fall occurred in games. Even though there are at least five times more hours of exposure during practices than games, there are half as many concussions during practice, according to the mandated concussion reporting requirement of the Michigan High School Athletic Association that is unmatched in the country in terms of its depth and breadth for a statewide requirement.

Michigan was among the handful of states to restrict contact in practice, in 2014, a full season prior to recommendations from the National Federation of State High School Associations and later action by most other statewide associations.

Some of those statewide organizations continue to operate without limitation on contact in football practices, while their counterpart organizations in other states have gone so far as to limit contact to a certain number of minutes in a day and/or week.

Entering mostly uncharted waters for high school football in early 2014, an MHSAA task force recommended that the number of practices be limited where collisions between players could occur – no more than one per day during preseason, no more than two per week after the first game.

This change was embraced by this state’s football coaches association and adopted by the MHSAA Representative Council. All parties liked the ease of administration of this policy, and all distrusted the idea of limiting the number of minutes of contact during practices.

If there is a 30-minute limit on contact in a day or a 90-minute limit on contact in a week, is it the same 30-minute or 90-minute period for all players, even if many are not involved in one or more of the contact drills? Or does the limit apply to each player individually; and if so, how is that tracked, and by whom?

These and other questions made coaches and administrators question how effective a limit on minutes might really be. Nevertheless, a 90-minute per week limit during regular season has been made an MHSAA recommendation for the 2016 season. This will provide an opportunity to address and possibly answer some of the questions that have been raised.

The MHSAA will survey schools this fall about their practice plans and the actual time spent in contact drills by players, assessing how that differs according to offense, defense, player position and grade in school, and determining best practices for how to track player contact minutes.

When Michigan acted in 2014 to limit contact in practice, it was one of the first states to do so. As Michigan takes additional steps to limit contact in practice, it will be one of the first states to do so after researching the best ways to actually do it.