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.

Helmet Debate Escalates in Girls Lacrosse

July 2, 2015

Recently the Florida High School Activities Association escalated the girls lacrosse helmet debate to higher levels by mandating the equipment during competition involving its member schools. I’m guessing their hearts are in the right place; but without a recognized performance standard yet established for such protective head gear, there are important practical questions added to the philosophical debate over the efficacy of such a requirement at this time. Here’s what we posted on this topic nearly two years ago.

One of our newest sports – girls lacrosse – is today presenting one of the oldest conundrums in competitive athletics.

On one side of the complex issues are many moms and dads who cite the dangers their daughters confront from contact to the head and face by other players’ sticks or the ball. They want hard helmets with face masks required in girls lacrosse. Many coaches and administrators agree.

On the other side of the issues are the “purists,” including the official position of US Lacrosse, who are concerned that by increasing head and face protection the rule makers would invite the kind of hard and high contact that would fundamentally alter the nature of the game and lead to more serious injuries in girls lacrosse.

This is the classic dilemma that the leadership and playing rules bodies of sports organizations have faced many times over many years for many sports. Justifiably.

When football added helmets, then face masks and then mouth protectors to the list of required equipment, there was a significant reduction in broken noses and chipped teeth, but techniques of blocking and tackling changed. The protected head and face became much more of a target and weapon than it had been before, and the unprotectable neck and spine became more at risk.

Some would argue that ice hockey’s experience is similar to football’s history. The discussion in the soccer community regarding hard helmets for goalkeepers and soft helmets for all other players often revolves around similar questions. Will required protective equipment change the game? And will one of the changes be that the game becomes still rougher and even more injurious, trading “moderate” injuries for more catastrophic?

While the debate continues over additional head protection requirements for girls lacrosse, and other sports, both sides seem to agree that the burden of the rule makers to be out-front in the search for ways to improve the rules is matched by the in-the-trenches responsibility of coaches to teach the game and officials to administer the contests in accordance with existing rules which already place a premium on participant safety.