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More Evidence in Support of the Medical Model

On Tuesday’s edition of HBO’s Real Sports, Karl Kapchinski, who spent 31 years as Texas A&M’s athletic trainer, said he sometimes returned players to the field before they were fully recovered because of pressure from head coaches.

Kapchinski’s kicker: “There’s been a lot of great quality athletic trainers that have subsequently lost their jobs because they stood up for the players or were doing the right thing.”

Probably worth noting here that A&M’s former athletic director, Eric Hyman, relieved Kapchinski of duty in the fall of 2013. Since his dismissal, Kapchinski has sued A&M, citing age discrimination. At 56, no less.

Anyway, given the circumstances, a skeptic could argue that Kapchinski was simply grinding his ax on a national stage.

Except his story isn’t exactly an aberration.

As one long-time athletic trainer put it to me, “It’s a dirty little secret.”

Multiple national surveys, including one last fall, indicate that more than half of athletic trainers, or ATs, have felt the pressure Kapchinski cited. As you might imagine, the percentage is greater in cases where ATs report directly to someone in the athletic department, which, unfortunately, is the overwhelming majority.

According to a 2015 survey by Sports Medicine Research, of ATs responding from 530 institutions across all three NCAA divisions, only 63 report to a doctor instead of a coach or athletic director. Which is an important distinction when it comes to who’s supervising these ATs, because in all my years wandering around coaches’ offices, I never saw any decorated with medical certificates.

Basically, what we don’t need is 1.) coaches playing doctor or 2.) coaches evaluating medical personnel.

If we’ve learned anything about coaches and leagues and owners in general, it’s that most haven’t always had the best interests of the athletes at heart. It’s not so much that they didn’t care; it’s what they didn’t know. Or didn’t want to know.

The majority got religious about safety issues with athletes only at the point of a lawsuit. Only when the NFL reluctantly took the lead on concussion protocols, in particular, did colleges and high schools follow.

All this time, the best friend you or your hero or son or daughter ever had on a playing field was an AT.

The good news is that just last month, the “power five” conferences passed a rule giving athletic trainers full autonomy in deciding when an athlete returns to play. The Big 12 pushed for its passage, in fact.

For a little perspective, the NCAA’s chief medical officer called it “the most important piece of legislation in the history of the NCAA.” Let’s hope it lives up to the billing, removing coaches from the evaluation process and prompting a trickle-down effect all the way to your local junior high.

Surely you can see how a coach could have a vested interest in returning a good athlete to play as soon as possible. The greater the stakes, according to the Sports Medicine Research survey, the better the probability that a coach intercedes where he shouldn’t.

Consider a 2013 report from The Chronicle of Higher Education about the Pirate, Mike Leach. Maybe you remember that his termination at Texas Tech was precipitated by a little dust-up over the treatment of a player, Adam James, who’d been diagnosed with a concussion. Seems that at his new job at Washington State in 2011, Leach clashed with Bill Drake, the AT, over how fast he was clearing concussions. Before the 2012 season, they’d averaged a dozen a year. When the number jumped to 21 in ’12, the coaching staff grew concerned, you might say.

Drake attributed the bump to increased awareness among both players and coaches. But sources told the Chronicle that Leach’s staff thought ATs were simply too soft on players.

Bottom line: Washington State and the Pac-12 cleared Leach of any wrongdoing, and Drake moved over into administration.

If you haven’t heard many stories like Drake’s or Kapchinski’s, it’s probably because you don’t know any ATs. Loose lips, and all that. They kinda like their jobs, and they’d like to keep them.

But we would be wise to remember the words of Scott Sailor, president of the National Athletic Trainers Association, in crediting the power five for acting on their recommendation.

“It really is all about the athletes,” he said.

And for the record: Don’t take any of this to mean that all coaches are bums or that I don’t like them. Some of my best friends are coaches. My daughter even dates one. If that’s not objectivity, I don’t know what is.

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Power 5 Conferences Clarify Return to Play Decisions

The NCAA’s major conferences approved a rule Friday requiring that school medical professionals have autonomous and final authority in deciding when an athlete may return to play after a concussion or other injury, a move lauded as a significant health and safety protection.

Although schools are already required to have concussion protocols, the move defines who are the primary medical providers in key decision-making roles and sets a strong wall between medical professionals and coaches, officials said. Schools will be required to ensure that no coach have hiring, retention or dismissal authority over the team doctors or trainers.

“I believe it’s the most important piece of legislation in the history of the NCAA,” said Brian Hainline, the NCAA’s chief medical officer and a neurologist. “It really defines who the primary athletics health care providers are.”

Power Five puts doctors in charge of when players can return to action photo

Stew Milne

The rule, approved at the NCAA’s annual convention in San Antonio, was proposed by the Big 12. University of Texas women’s athletic director Chris Plonsky said UT physicians and trainers already control return-to-play issues, and she believes most schools do the same. But she said it was necessary to make it a rule.

“Our students are other people’s children,” Plonsky said. “If I was a parent, I’d want to know who makes that decision. It should be someone with medical authority.”

The rule also means that even if an athlete seeks an outside second opinion, the school’s medical officers still have the final say, Hainline said.

“I think there has been concern expressed there are sometimes influences on the athletic trainer and physician to get them to return to play sooner than they are ready to,” Hainline said. “No one can challenge their authority.”

Southeastern Conference Commissioner Greg Sankey said the conference endorsed medical autonomy in 2014.

“We didn’t need a rule to get there, but it’s healthy to make that clear,” Sankey said.

The rule specifically applies to the NCAA’s autonomy group, comprising the Power Five major football conferences, but other NCAA schools are encouraged to adopt similar guidelines.

In other votes Friday, the autonomy group delayed action on several proposals limiting time demands on athletes, including mandated time off after a season and weekly off days. The group voted to bring those issues back at the 2017 NCAA convention.

“I think we all agree there needs to be a retooling of not only how we count the hours, but also what the expectations on a student-athlete are,” Big 12 Commissioner Bob Bowlsby said. “The life of a Division I student-athlete is not for the faint of heart. They know that when they sign up.”

The group adopted a resolution pledging to come back next year with a proposal that will consider a two-week postseason break, weekly time off and a mandatory eight-hour overnight break from sports requirements.

The delay upset a few student-athlete members of the autonomy group who lobbied for immediate action.

“If we come back a year from now with a comprehensive action plan, that’s ideal. That’s what student-athletes need,” said Ty Darlington, the center on Oklahoma’s football team. “I feel like this should have been done already. … We keep pushing it back. It’s very frustrating for us it wasn’t ready for this convention.”

The autonomy group passed a rule allowing high school baseball players to hire agents when negotiating with professional teams before they enroll in college.

Texas Tech baseball player Anthony Lyons called it an important step for players and their families when deciding whether to turn pro or go to college when “life-changing money” is being offered.

“Right now, there’s a lot of things going under the table you might not know about,” Lyons said.

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