With almost eight million secondary school student-athletes across the country, it’s important that schools have a comprehensive health-care team in order to ensure the proper management of athletic injuries for their student-athletes.
An Athletic Health Care Team should be comprised of the chief medical inspector (CMI), athletic trainer, school nurse, athletic director and coach (of the team). Most often, the CMI is a medical physician. While some schools have the CMI serve as the team physician, other schools may outsource this service. Either way, it’s important to understand the process in selecting and keeping your team physician.
In its policy statement, the American Academy of Pediatrics outlines the role of physicians in the school setting. A CMI must “focus on the needs of individual children as well as the public health of the school community.” The CMI oversees the areas of acute illness, chronic illness, emergency response, environmental health and safety, sports medicine and employee physicals for the school district.
Due to the multiple duties and responsibilities of a school CMI, selecting a team physician outside the school community may be the next best viable option. However, above all, the outsourced team physician and CMI must have a good working relationship as both will need to have the same philosophy with regard to the school’s Athletics Emergency Action Plan. The number of consulting physicians is limitless. It would be wise to develop a professional relationship with specialists from various medical disciplines such as orthopaedics, general medicine, neurology, dermatology and dentistry – to name a few.
Consulting Physician’s Agreement
Most team physicians outside the school community are considered consulting physicians and provide their services gratis. They are not considered an employee of the school district. For this reason, it would be prudent for the school district to require a background check and a copy of the physician’s malpractice insurance.
Upon submission of those items, a Consulting Physician’s Agreement should be created to delineate the physician’s role. The agreement should make mention of the Freedom of Information Act (FOIA). This act states that the consulting physician serves as an independent contractor and shall provide the school with any records pertaining to the injury.
Upon request, the school district would also be bound to provide a student-athlete’s health history information to that physician, if it directly affects the appropriate management of an injury. The agreement must guarantee the school has no obligation to make athlete referrals, otherwise, the public may view the relationship as a conflict of interest. Finally, the agreement should include the return-to-play process.
Cultivating the Professional Relationship
As previously stated, most consulting physicians offer their services gratis and usually inform their front desk staff to accommodate injured athletes in their office schedule. This friendly offering decreases stress levels among parents, injured athletes, athletic trainers and coaches by decreasing the wait time for athletes to be seen for a formal office evaluation.
In order to cultivate a professional relationship and keep that physician on board, it’s important to provide creative ways of expressing a “thank you” in return. Here are some simple examples.
Benefits of a Good Relationship
The benefits of a good relationship with your consulting team physician can be a two-way street. From the school’s perspective, the athletic trainer can get physician sideline assistance. Sometimes, arrangements can be made for the physician to visit the school and, through coordination with the athletic trainer, offer a weekly “Injury Clinic” to evaluate injured athletes. From the physician’s angle, his or her practice gets recognition at sports banquets. Also, it’s not uncommon for physicians to donate a medical tent, sideline cart or transport (golf) cart emblazoned with the logo of their practice.
In the age of tight school budgets, it is reassuring to know that school districts can still provide appropriate medical care for their student-athletes with a little ingenuity.
David Csillan, MS, LAT, ATC, is the manager of physical therapy for Princeton Orthopaedic Associates, Princeton, New Jersey. Prior to that, he served as a secondary school athletic trainer in New Jersey for more than 30 years.