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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.

Program Priorities

January 10, 2014

Many school districts face more requests from their constituents for sports programs than they have the resources to accommodate, so they are forced to make very difficult decisions. For three decades, when I’ve been consulted, I have offered and stood by this advice.

First, I advance the premise that if the activity is educational, there is just as much potential for the education to occur at the junior high/middle school and subvarsity levels as at the varsity level. Just as we would not discriminate against one race or gender, we should not disadvantage one age or ability level. In fact, with a little less pressure to win, it is likely to see more education at subvarsity levels and more reason to sponsor them.

Second, I advocate the position that schools should avoid sponsorship of any activity for which a qualified head coach cannot be secured. Qualified personnel are, in order of priority:

  1.  a teacher within the building who has current CPR certification and completed CAP.
  2.  a teacher within the district who has current CPR certification and completed CAP.
  3.  a teacher in another district who has current CPR certification and completed CAP.
  4.  a certified teacher from the community who has current CPR certification and completed CAP.
  5.  a non-certified person who has current CPR certification and completed CAP.

I urge schools not to descend lower than this for program leadership. Coaches are the delivery system of the education in educational athletics; they are the critical link in the educational process. More problems occur than are worth the effort if the program is in the hands of an unqualified coach.

Next, I urge that schools rank sports on the basis of cost per participant, and give higher priority to sports that spread funds over the greatest number of participants.

Next, I urge that schools place lowest in priority the sports that cannot be operated on school facilities and create transportation, supervision and liability issues, and give higher priority to those conducted at or very near the school.

Next, I urge that schools place lowest in priority the sports which are most readily available in the community, without school involvement. If resources are precious, then duplicating school programs should be a low priority; doing what the community can’t do or doesn’t do should be given a much higher priority.

While I’m a fan of school sports, I recognize that an athletic program has as much potential to do harm as to do good. Programs without qualified coaches that are conducted for small numbers of students at remote venues and without comprehensive school oversight and support may create more problems for schools than the good they do for students.

Bare bones budgeting will require brutally honest assessments based on priorities like these.