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Annual Sports Physicals Should Be Handled by Child’s Primary Care Provider

Ongoing comprehensive medical care is vital to every student athlete’s success

DAYTON, Ohio (July 21, 2014) – Over the years, mass sports physical events conducted at schools were created to help students complete pre-participation physical examinations in an efficient manner. However, reports of sports-related illnesses and unexpected deaths have brought the effectiveness of this approach into question.

At least six medical societies – including the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP) and the American College of Sports Medicine (ACSM) – now believe mass school physicals deny students the comprehensive care necessary to determine if they are healthy enough to participate in competitive sports. Children involved in sports athletic programs are required by the state to receive a sports-specific exam that screens for potential health problems and provide quick identification of any immediate health danger.

In recent years, the deaths of student athletes have become highly visible events. Research published in the Journal of Athletic Training found that sudden cardiac arrest is the number one killer of young athletes, claiming the life of a young American athlete every three days. Other common causes of non-cardiac sudden death in athletes may include sickle cell crises, heat stroke and asthma, according to the ACSM.

Sean Convery, MD, with Premier Sports Medicine in Centerville, said the best preventive measure remains an annual physical that includes a detailed and accurate family history, which most medical societies agree is best-accomplished with an individualized examination at a physician’s office.

Sports physicals conducted at schools often require students to rotate among stations where physicians take vital signs, listen for signs of deeper problems such as heart murmurs, and look for pre-existing conditions like hernias. The physician’s student recommendation is based upon these vital signs and information provided on a family history form completed by a parent or guardian, who may or may not be in attendance.

“In the last couple of years, it has become apparent to our physicians involved in these mass exams that we can’t meet the recommendations set out by these medical bodies by seeing kids in a public environment, especially when they are examined by a physician they have never seen before,” said Dr. Convery, a Premier Health Specialists physician who also serves as a team physician for the University of Dayton Flyers.

Patients who are seen by their primary care physician have the benefit of a well-established relationship. In many cases it’s this trusted relationship that enables a physician to catch issues an adolescent may have simply forgotten or thought was not important, said Dr. Convery, who has seen this scenario played out firsthand.

“I’ll give you an example,” Dr. Convery said. “I had a high school student come in for his sports physical, and because I had an established relationship with his family I knew about a surgery he had at a young age for a congenital malformation on his neck. When I asked him if there was anything he thought would restrict him from sports he looked at me like I was crazy. Kids often don’t always remember their history and what effect it can have on their current activities.”

Block HSStill, sports physicals aren’t just about preventing health problems that might take place in the sports arena. According to the AAP, school-related physicals are often the only visit most children and teenagers have with their physician each year. When students have their sports physicals completed by a team of doctors at school, they are denied an annual checkup that is often more in-depth, said Dale Block, MD, a primary care physician with Premier Family Care of Mason.

“Evidence has proven the importance of moving away from physical exams that take place in a large group setting,” said Dr. Block, who serves as team physician for Mason High School. “It’s a one-time relationship and not one built over time. More importantly, it doesn’t provide the opportunity to address issues related to physical growth as well as interpersonal problems at school.”

Continuity of regular physical exams is invaluable for students – no matter what age. Dr. Block, a Premier HealthNet physician, said it is important for children to have an annual well visit. Most of the time, however, well visits, which should begin in earnest at infancy to ensure needed immunizations, tend to take a backseat as children grow. Parents need to be mindful that some of the most important conversations and lessons relating to a child’s health will happen during the adolescent years, he said.

“When youngsters reach 12 years of age, they are no longer children. They are adolescents. We begin screening for depression and other mood disorders,” he said. “We begin talking about illicit drugs, alcohol and sexual activity. The visit is not only about physical health, but encompasses an adolescent’s entire well-being.”

To find out more about pre-participation physical exams or to find a physician who can help complete one, visit www.premierhealthnet.com/doctor.

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