Skip to main content

The Sport Physical: Insanity and Magic



A father stands anxiously at the window to our reception desk, shifting his weight from side to side, clutching at a piece of paper.  “ My son can’t play football unless this form is signed, and practice starts this afternoon.  Can’t you help me?”  
“Unfortunately,” explains my receptionist, “We are booking out 6 to 8 weeks for a well check up.  Our same day appointments are set aside for patients with serious, acute illnesses, and besides, sport physicals are not covered by insurances.”  
“What am I supposed to do?”  asks the distraught parent.  The receptionist gives him a sympathetic look and hurries to answer the persistently ringing phone.  Some desperate families actually go to the emergency room to get their sport physical forms filled out.  Thus the insanity of the sport physical season plays out.
Typically, the required paperwork is handed out to families in late July, and the school system expects physician offices to to see all student athletes in a two week time period during the first half of August.  Sorry, but that is  logistically impossible. We do actually have sick people to take care of. The school system’s insurance won’t allow the coaches to allow the athletes to play unless the sports physical form is signed.  
I’ve spent years wondering why this was required, and I think I have finally figured it out:  The sports physical form is magic.  With this miraculous piece of paper, no student athlete will ever get sick. Nor will they suffer any type of cardiac arrhythmia during play, nor will they be harmed in any way by their chosen sport, and if by some chance they are hurt in course of play, they will never, ever sue the school.  Amazing.
A teenage boy was undergoing his well child check up with me, and I asked if it would be okay if I did a hernia exam.  He told me that he already had that done last month.  I checked the chart and saw no record of a visit in our office, so I asked if he was sure, and he said the school had done it at the gymnasium.  Some “old lady” he didn’t know “poked around down there and said I was okay”.  Wow.  And this type of activity is supposed to decrease a school’s liability?  I’m not a lawyer, but it seems to me that allowing an athlete to run around on a football field while he awaits an appointment for his annual physical would incur less liability than allowing a volunteer to undress boys in a school gymnasium and examine their genitalia.  But what do I know?  I’m just a doctor.
At Eureka Pediatrics our medical records are confidential, but even so, for personal topics we have a “counseling section” where we can further restrict access to the information.  Conversely, the most commonly used school sport physical form blatantly violates the student’s confidentiality.  The form has about 6 questions at the top asking students to check “yes” or “no” boxes indicating ...whether they are depressed, suicidal, abusing drugs and alcohol and if they have emotional problems.  The form is in triplicate, and is clearly designed to have copies go to various departments within the school.  What part of “MEDICAL INFORMATION IS CONFIDENTIAL”  do the school lawyers fail to comprehend?  The form blatantly violates HIPPA laws.  This is supposed to reduce liability?  I just don’t get it.  Can you imagine having your patients fill out a personal, medical questionnaire in triplicate and then distributing it in an indiscriminate fashion?  Your malpractice carrier would be on the phone with you so fast it would make your head spin.  

Schools put out pleas for doctors to volunteer to line up a bunch of athletes in a gym and pass a stethoscope across their chests and pronounce them “fit to play”.  I am all for volunteerism, but I think if a physician donates his or her free time it ought to be for the purpose of helping poor, sick people, not relieving the school system of an unreasonable obligation that it has placed upon itself.  It is unfortunate that the school’s liability insurance requires this, but the sport physical does not make sense medically.  Children should have an annual well child exam (in any month of the calendar year--not just August) in their medical home with primary care provider, and that should suffice to clear them for sports.

Comments

Popular posts from this blog

Waiting is Hard

  WAITING IS HARD To all you video game addicts, you cocktail party haters, you isolationists, you antisocial homebodies and hermits: 2020 was your year! Need an excuse to say home and avoid the crowds? Covid was the perfect cover. Need a reason to avoid travel? Blame Covid! However, now that the vaccine is here we all need to prepare to socialize again..at some point. The vaccine roll out is upon us, and proceeding steadily. As a pediatrician I am very familiar with the ups and downs of giving vaccinations and the national plan for the COVID vaccine roll out raised some concerns for me. The plan, as I understand it, is that federally purchased vaccines get allocated to each state on a weekly basis, and from there get distributed to various hospitals (listed first), clinics and pharmacies in each county. While hospitals are wonderful organizations, their focus is to run emergency rooms and care for in-patients. Historically they have not vaccinated large numbers of the general public,
Response to the North Coast Journal article on health care reform I am a local pediatrician and I really enjoyed reading Alan Sanborn's salient and entertaining article in favor of health reform. I, too, am an advocate of a single payer system because I can see no other way to improve care and contain costs. There is fat in the system, but it belongs to: INSURANCE COMPANIES (most of these companies keep about 20% of the premiums thay take in for themselves in the form of administartive costs and profit), MALPRACTICE LAWYERS and PHARMACUETICAL COMPANIES. Without fundamental reform, including tort reform, much of the money put into the system will not go towards health care essentials. To rebut Ron Ross, the comparison between running health care and running a company is not a comparison that works, because there are fundamental differences between some one with cancer who needs treatment, and some one who would like to mail a package (i.e. the Fed Ex example). Health

Cash for Clunkers and EMR's

Our household has had the dubious honor of being deeply and directly affected by some of the major initiatives contained in the economic stimulus package. My husband, who is a sales manager at Mid City Motor world has been working long, busy days trying to accommodate the rush of car buyers flooding in to take advantage of the “Cash for Clunkers” program, while our pediatric office, with the promise of future reimbursement for “meaningful use” of an EMR, has begun the process of converting to electronic medical records. The cash for clunkers program is meant to reduce carbon emissions by encouraging people to turn in gas guzzlers and purchase more fuel efficient vehicles, but questions remain as to the overall benefit. Cash for Clunkers does not reduce, recycle or reuse in the least. The clunkers must be destroyed and sent to landfills,—so no used vehicles come out of the transactions to sell again, and no parts can be gleaned for resale. Jobs involved with used car sales and p