Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”

“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”

“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”

“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”

“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”

“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”

The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”

Carry On

April 27, 2018

For many years my vocation has been that of executive director of the Michigan High School Athletic Association.  My vocation -- not my occupation, which has the connotation of a pastime that merely consumed my days and years, or a space that only my physical presence has been taking up.

No, this has been my vocation, in the sense of the root word “vocari,” which means "to be called.” The MHSAA has not been my job; it’s been my purpose.

Anyone who knows my background would understand.

I grew up at the home of the executive director of the Wisconsin Interscholastic Athletic Association who was my role model as spouse, father and man. I was a twenty-something staff member of the National Federation of State High School Associations under the mentoring of Clifford Fagan, one of the deepest thinkers in the history of educational athletics. It was he who encouraged me to write about our work.

Anyone who has worked with me, listened to me or read what I've written would understand.

Everything has pivoted on protecting and promoting the core values of school-sponsored, student-centered athletics: policies, procedures and programs that put academics before athletics and attempt to develop the whole child.

For example, I see sportsmanship not as some corny promotion, but as a critical issue of educational athletics. I view good sportsmanship as a precursor to good citizenship. This is not the mindset of a man on the job, but of a man with a mission.

Going forward, those who love and lead school sports in Michigan must avoid doing those easy things that increase the scope and stakes of competition. Instead they must address every day those difficult policies, procedures and programs that enhance the physical, mental and emotional values of interscholastic athletics to students and the value of educational athletics to schools and society.

It's not more competition that is needed in high school sports, but more character. Not more sport specialization that's needed in junior high/middle school sports, but more sport sampling. Less attention to celebrating hype in sports events for youth, but more attention to cultivating life long-habits and good health for adults.

In leaving the MHSAA after 32 years this summer, I will have some regrets ... sad to be leaving the company of great staff and some extraordinary colleagues in our member schools ... sorry that even though we worked so hard and accomplished so much, there is still so much to do to keep school sports safe, sane and sportsmanlike. 

There’s lots to do. Carry on.