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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.

More Than X’s & O’s

April 17, 2015

It’s nearly the fourth quarter. We are just completing year six of eight years in which we have been addressing four important health and safety issues that, for ease of conversation, we call the “Four H’s.” These are much more important than the X’s and O’s of sports.

During the 2009-10 and 2010-11 school years, the first quarter, our focus was on Health Histories. During this time we made enhancements in the pre-participation physical examination form, stressing the student’s health history, which we believe was and is the essential first step to participant health and safety.

During the 2011-12 and 2012-13 school years, the second quarter, our focus was on Heads. We were an early adopter – before state law mandates – of removal-from-play and return-to-play protocols, and our preseason rules/risk management meetings for coaches included information on concussion prevention, recognition and aftercare.

Without leaving that behind, during the 2013-14 and 2014-15 school years, the third quarter, our focus was on Heat – acclimatization. We adopted a policy to manage heat and humidity – it is recommended for regular season and it’s a requirement for MHSAA tournaments. The rules/risk management meetings for coaches during these years focused on heat and humidity management. At the mid-point of this two-year period, the MHSAA adopted policies to enhance acclimatization at early season football practices and to reduce head contact at practices all season long.

Without leaving any of the three previous health and safety “H’s” behind, during the 2015-16 and 2016-17 school years, the fourth quarter, our focus will be on Hearts – sudden cardiac arrest and sudden cardiac death. Coinciding with this emphasis is the requirement that all high school level, varsity level head coaches be CPR certified starting this fall. Our emphasis will be on AEDs and emergency action plans – having them and rehearsing them; and this summer we are expecting to deliver to every high school free of charge the “Anyone Can Save a Life” program developed in Minnesota and being distributed nationwide with the assistance of the National Federation of State High School Associations.