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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.

The Imperative of Institutional Control

March 13, 2018

Of the various criticisms about the MHSAA’s handling of transfers, these three have the ring of some validity:

  • The Transfer Rule is too complicated.

  • The Transfer Rule is poorly understood at the local level, and thus unevenly administered.

  • The MHSAA office is ill-equipped to police the transfer scene.

The language of the Transfer Rule has expanded from a few sentences to many pages over its 90-year lifetime. This is the result of changes in schools, sports and society, as well as people operating at the edges of the rule, which has led to a rule that has attempted to cover more circumstances with more specificity year after year.

This increasingly nuanced rule takes both training and time. The MHSAA does an excellent job of providing training online and in person, but local administrators are not putting in the time – they can’t! They are usually less experienced but given more non-sports duties than athletic directors of 10, 15 and 20 years ago; and they are leaving the profession after shorter careers. They often lack the training and time to do the complicated and potentially contentious tasks, including Transfer Rule administration.

Overwhelmed local athletic directors are not shy about contacting the MHSAA office for assistance in interpreting and applying the Transfer Rule. These incoming questions dominate the time of MHSAA staff who have many other duties, including the administration of MHSAA tournaments in 14 sports for each gender.

Lacking sufficient staff time and subpoena power, the MHSAA must depend on local school administrators to police their own programs, communicate with their neighbors, and report what they believe might be violations within their own and nearby programs.

While we keep working on the language of the Transfer Rule, we harbor no illusions that it will become simpler to understand and enforce. That’s just not how the modern world works ... everything becomes more complicated. Which may only make it more unlikely that schools will dedicate the time and talent necessary to assure that the principle of “institutional control” is practiced by MHSAA member schools.

However, if we give up on that principle, no amount of oversight by the MHSAA office will ever be enough to police school sports in Michigan ... not just to monitor transfers, but also to attend to the dozens of other elements that distinguish educational athletics.