Results of a survey presented at the National Athletic Trainers’ Association Clinical Symposia and AT Expo showed a greater need for collegiate institutions to adopt and adhere to an athlete-centered independent medical model of care administered by athletic health care providers.
“The [Intercollegiate Council for Sports Medicine] ICSM believes that independent medical model of care is the cornerstone to ensuring that athletic trainers have the unchallengeable and autonomous authority to do work ... out of the interest of the student athlete,” Murphy Grant, MS, ATC, LAT, first executive chair of the ICSM, said in his presentation.
Adherence to independent model of care
The National Athletic Trainers’ Association (NATA) ICSM distributed a survey to 9,223 collegiate athletic trainers on their institution’s adoption and adherence to an independent medical model of care for collegiate student-athletes. Overall, 1,796 collegiate athletic trainers responded, for a response rate of about 19%, of whom 43% reported working at the division 1 level.
“The results showed that only about half, 52%, of the collegiate level sports medicine programs identified themselves as following the independent medical model of care,” Grant said.
Further, 76% of athletic trainers reported having medical autonomy, defined as the authority to make decisions related to the health and safety of an athlete without the influence of non-medical personnel, vs. 24% who reported not having medical autonomy.
Influence of non-physicians
Grant said that more than one-third of athletic trainers reported that coaches influenced the hiring and firing of sports medicine staff. Of these respondents, 17% also reported “receiving pressure from a coach, administrator or member of the coaching staff to make a decision that was not in the best interest of the student athlete’s health,” Grant said.
He noted that 58% of athletic trainers reported pressure from an administrator, coach or member of the coaching staff, and about 59% reported receiving pressure at least once a month.
“The NATA believes that it is appropriate and expected for coaches, as well as other relevant athletic partner personnel, to ask questions and request updates on student athletes,” Grant said. “However, when acquiring turns into an attempt to influence, dictate, coerce or challenge the athletic trainer’s autonomous authority to make medical decisions, this is problematic.”
Although 82% of athletic trainers reported that a coach has never played an athlete who was deemed medically ineligible, Grant noted that one of five respondents said the coach has played the athlete.
“While collegiate athletics have made monumental strides to advance the safety of sports, the results of the survey suggest a greater need in compliance to independent medical model of care,” Grant said. “It is important that institutions infuse this model into their culture, so it remains even if there are changes in leadership and/or staff.” – by Casey Tingle
Grant M. Collegiate setting: Athlete safety first press briefing. Presented at: National Athletic Trainers’ Association Clinical Symposia and AT Expo; June 24-27, 2019; Las Vegas.
Disclosure: Grant reports no relevant financial disclosures.