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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.

Researching Reclassification

January 25, 2013

The MHSAA was the first state high school association in the U.S. to divide its member schools into enrollment groups for season-ending tournament play. Over the years, in one form or another, all other statewide associations have done the same; and in more recent years, some have tweaked their systems to facilitate practical considerations of tournament administration or to address demographic or political shifts among their memberships.

Two forces have combined to bring increased attention to the participation of public and nonpublic schools in the same tournaments: 

  • First, as state associations expanded the number of classifications to provide more opportunities for their schools to experience tournament success, the percentage of nonpublic schools winning those championships has increased.  Nonpublic schools rarely won any championships at all before the expansion to multiple classifications and especially to the additional expansion in football classifications.  Public schools are not winning fewer championships today than years ago; they are merely winning a lower percentage of the championships now provided.
  • Second, as state governments have reduced funding to public schools, those schools have been forced to reduce support for their sports programs and more often make them pay-as-you-go, much like nonpublic schools have operated for years.  As pay-for-play and fundraising have been popularized in public schools, their “marketing advantage” over nonpublic schools has been diminished.

Often overlooked by those who call for separate tournaments for public and nonpublic schools is the fact that the majority of nonpublic schools rarely have had any success in statewide tournaments, and some have never had any success at all.  An occasional District championship and a rare Regional trophy is the reality of most MHSAA member schools, both public and nonpublic. This, and the fact that "multipliers" have addressed only nonpublic schools and not also select-enrollment public schools (magnet, charter, choice), explains why MHSAA study groups have rejected the use of an automatic enrollment multiplier for nonpublic schools which is now in use in about 10 states.

Acknowledging the flaws of a multiplier that is applied only to nonpublic schools, a few states have been working with a formula, applied to all schools, that reduces the enrollment figures used for tournament play based on factors that may tend to reduce the percentage of a school’s enrollment likely to participate in sports.  For example, there is limited evidence that students who are on free and reduced lunch participate at a rate that is 10 to 14 percent lower than other students; so this is a factor reducing schools’ tournament enrollments in two states.  A third state association looked at this and decided that the data didn’t justify the effort.

Two other states have recently implemented a system that places schools in a classification for larger schools after they achieve a certain level of tournament success in the classification in which they would normally be placed.  Of course, critics of this type of system that address the “chronically successful” are quick to point out that this does nothing for the school which is successful in the largest classification and tends to “penalize” next year’s students for the success of the previous years’ teams.  Would it be right to force Ithaca High School into a higher classification in football in 2013 because it captured MHSAA titles in 2010, 2011 and 2012?  And what would be done with Detroit Cass Technical after back-to-back titles in Division 1 of the Football Playoffs?

About these topics nationwide, there is much talk, some action, and no consensus.