Survey: Medical Staff Pressured on Student-Athlete Health

In a new survey conducted by the National Athletic Trainers’ Association (NATA), collegiate-level athletic trainers reported that just over half of college athletics programs are currently following NCAA guidelines for independent medical care. 

Put another way, there is still outside influence weighing on athletics health care providers such as team doctors and athletic trainers when it comes to making decisions regarding student-athletes’ participation. 

The survey results, which were presented Tuesday at NATA’s 70th Clinical Symposia in Las Vegas, indicated that non-medical personnel sometimes pressure athletic trainers regarding care plans for student-athletes. Some relevant survey numbers include:

• 29.98 percent of respondents reporting that medical autonomy is affected by sport assignment.
• 18.73 percent of respondents reporting a coach playing an athlete who had been deemed medically ineligible. 
• 36.32 percent of respondents reporting that a coach can influence the hiring or firing of sports medicine staff.
• 49.41 percent of respondents reporting that no formal document describes the medical model adopted by the school.
• 57.81 percent of respondents reporting receiving pressure from a coach or administrator to make a decision that wasn’t in the best interest of student-athlete health — with 2.56 percent of that group reporting being pressured by non-medical personnel on a daily basis.

“It is appropriate and expected for coaches as well as other relevant athletic personnel to ask questions,” said NATA president Tory Lindley in a release describing the survey results. “What is not acceptable is when the inquiry is laced with an expectation to influence, dictate, coerce or challenge the athletic trainer’s autonomous authority to make medical decisions in the sole interest of student-athlete health and wellbeing.”

The NCAA recommends that member institutions establish a structure for student-athlete health that “provides independent medical care and affirms the unchallengeable autonomous authority of primary athletics health care providers (team physicians and athletic trainers) to determine medical management and return-to-play decisions related to student-athletes.”

“While we believe that the pendulum is shifting in a positive direction, there is certainly more work to be done,” Lindley added. “NATA’s goal is to continue to advocate for and support NCAA delivery of care legislation. Student-athletes and their parents should feel confident that decisions about health and safety are based solely on medical information and judgment and are not influenced by personnel who are not trained and experienced in that area.”

The University of Kansas in May announced a high-profile arrangement whereby the athletic department’s sports medicine staff — team doctors, athletic trainers, nutritionists, wellness coordinators and strength and conditioning coaches — all report to medical professionals instead of to a doctor within the athletic department. The model, a collaboration between the athletic department, the University of Kansas Health System and LMH Health, was dubbed Kansas Team Health. The new reporting structure will help to minimize the potential conflicts of interest the athletic trainers in the NATA survey indicated. 

“At KU, our student-athletes have received outstanding care and we have not had issues related to supervision and adherence to best practices,” KU chancellor Douglas Girod said when the move was announced. “That said, we knew we had a special opportunity to be innovative and get ahead of the curve. As a result, I believe we can tell all current and future student-athletes that they’re getting the best care and training in the country at the University of Kansas.”