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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.

Heads and Heat

August 16, 2012

We are engaged in very serious discussions. They’re not only complicated, with unintended negative consequences possible from what are thought to be positive actions; they’re also a matter of life and death.

The topic is football – the high school sport under most scrutiny today and suffering from the most criticism it’s seen since the 1970s when catastrophic neck injuries spiked, liability awards soared, many insurers balked, and most helmet manufacturers abandoned the business altogether.

During recent years we have learned about the devastating long-term effects of repeated blows to the head; and we’re trying to reduce such hits.  We’ve learned that 70 percent of concussions in football result from helmet-to-helmet contact, and we’re trying to have coaches teach blocking and tackling differently and have officials penalize “high hits” consistently and rigorously.

During the past several years we’ve learned that serious heat illness and heat-related deaths are 100 percent preventable, yet nationwide there were 35 heat-related deaths in high school football alone from 1995 to 2010; and we’re promoting practices that acclimatize athletes more gradually than “old school” traditionalists might advocate.

As we simultaneously address issues of heads and heat in football, some coaches may think we’re being overbearing, while many in medical fields say we’re out of date, citing higher standards of the American Academy of Pediatrics, National Athletic Trainers Association and National Federation of State High School Associations, as well as many of our counterpart organizations across the country.

As we consider in-season changes to improve athlete acclimatization and reduce blows to the head, we should be open to making out-of-season changes that work toward rather than in opposition to those objectives.  There can be no sacred cows.  The topic is too serious.

Ultimately, if we err in the outcome of this year’s discussions about heads and heat in football, it must be on the side of safety, on minimizing risks for student participants.  They deserve it and, once again, the sport of football needs it.