The Long-term Impact of Athlete-Centered Care

 

How do you want to be remembered? I worked with a football coach that often repeated this to his team, and find it an interesting question for athletic trainers and anyone involved in helping provide healthcare to consider. At Relation, we care about helping our clients lead safer and healthier lives—that’s at the core of how we operate, and it’s one of the things we want people to remember about us.

That service mindset really resonates with me because I spent my entire athletic training career caring for and supporting student athletes, and striving to keep athletes at the center of every decision. My mentor consistently modeled this for me as he cared for the players and managed the conflicting interests, especially with coaches who tried to influence medical decisions.

Today, athletic trainers are still confronted with outside pressures that might not have the best interests of the athletes at heart. But, over the years, the field has seen an increased awareness of, and emphasis on, athlete-centered care in sports medicine, which has significantly influenced the decision-making process for both healthcare providers and athletes.

Practicing Athlete-Centered Care

It is now understood that one of the primary obligations as an ATC is to provide athletes (patients)—or, if applicable, their families or healthcare surrogate—with the information they need to make an autonomous decision about their healthcare. The healthcare provider should educate the patient about their specific illness/injury, the best practice available for their condition, and options for care based on the evidence, coupled with the short and long-term risk/benefits of each option. Additionally, the healthcare provider should determine the athlete’s values and goals that may influence the recommended course of treatment. (“Managing the Health of the Elite Athlete,” published in the British Journal of Sports Medicine, has some interesting thoughts on this subject.)

As an example of how athletic-centered care can look in practice, one orthopedist I worked with always followed the same multi-step method of educating patients: first, the doctor laid out the current research and evidence, then discussed their personal experience dealing with the condition, and then would offer three to four options for care and potential outcomes. The options could range from doing nothing to surgery, and it was up to the patient to take all of that information and decide their course of treatment.

The Importance of Transparency and Trust

After receiving all the information, the athlete and/or their parent usually asked me for my thoughts. They trusted me to be an unbiased voice of reason, especially pertaining to treatment and return-to-play decisions, and how that decision could impact the athlete later in life.

Giving a recommendation requires weighing the evidence, the physician preference, and the athletes’ goals in a delicate and deliberate way that gives attention to all parties and avoids conflict of interest. Keeping the patient at the center of the decision also requires an athletic trainer to strive to find a balance between evidence and preference. “Evidence, Preferences, Recommendations — Finding the Right Balance in Patient Care” by Timothy E. Quill, M.D. and Robert G. Holloway, M.D is a useful read about reconciling this tension.

When I offered advice, I was very mindful that my ultimate responsibility is always to the patient and their welfare, both immediate and long term. Many times I reminded the athlete to not only consider the present, but also think down the road—how will this decision affect them in 20 years? I asked about their life goals and listened closely to contextualize how their present-day healthcare choices could impact those goals: “You say that you want kids, and here is how this choice could impact your ability to run and play with them.” In these moments, I found transparency and trust to be essential, and the human connection that was required to discuss honestly often had the added benefit of forging life-long relationships.

Athlete-Centered Care’s Long-term Impact

Following these patient-centered principles does not always ensure a good outcome, but it does ensure that the patient had the information to make the best decision at the time. The athlete is the one who will have to deal with the impact of the decision for the rest of their life, so it is important to empower and support them in the decision-making process.

An athlete-centered approach also has the side benefit of having people remember you as someone who was honest and truly cared. Two years ago, an athlete I treated in 1985 called me looking for a surgeon recommendation because they trusted me and knew, even all these years later, that I would help them. And, earlier this year, a former football athlete reached out to my wife on Facebook with an affirming message to pass on to me:

As I get ready to go to bed and turn 40 tomorrow, please tell Andy that he was right. As I sat in the fieldhouse with the doctor getting ready to inject me so I could play and not lose my starting position, Andy looked at me and said, “You’re going to regret this when you’re 40,” and I said “I may not make it to 40.” Well I made it and Andy was right…but I am pretty sure I wouldn’t trade it for anything. Just let Andy know how much I appreciated him. I knew he was on our side and cared for us and I am, and always will be, grateful.

Keep the athlete at the center of all you do, and it will positively impact them—and you—for longer than you may know!

 

Andy Massey is an Athletics Risk Consultant for Relation Insurance. His career in intercollegiate athletics spans three decades, including Director of Athletic Training at Tulane University (LA); head athletic trainer at Appalachian State University (NC), where he also taught in the Department of Health, Leisure, and Exercise Science; and head athletic trainer at Wofford College (SC). Andy now consults with intercollegiate athletic departments across the U.S. and also serves as an ATC Spotter for the NFL. Andy can be reached via email at [email protected] or on LinkedIn.

Click here to learn more about Relation’s insurance solutions and services for Intercollegiate Athletics.

 

When I was a kid, I would work on assembling scale model kits for cars, airplanes, tanks and naval ships. My friends shared the same hobby, and while their models all looked similar but with individual variations, my completed models never looked as good. Why was that—how could that be? The model kit was manufactured at an assembly plant, the plastic parts we glued together were all uniform, and our kits had the exact same numbers of pieces in the box, along with the same instructions. Well, it turns out that I usually put my planes and cars together with significantly less time and attention to detail than my friends. I just wanted a working toy, and didn’t realize until I was older that design details are crucial to success.

Finding the Right Model of Care

In the world of sports medicine and athletic training, we are trying to build the “right” model to deliver healthcare for colleges and universities. (See this NATA Member Statement on collegiate medical models.) Everyone has access to the same research, position papers, and effective practices, and yet each program’s model of care can look different.  There is a great deal of emphasis on the medical model being the gold standard. However, the reality might be that all models—while they look somewhat different from each other—can work, so long as the model is built intentionally and carefully, and care is appropriately delivered and ongoing.

If you would like to read more on models of care and how this can impact patient care and mitigate risk, go to www.relationinsurance.com/athletic-model-of-care for an article download. 

I remember one friend’s model car of Richard Petty’s 1970 Plymouth “Superbird” that looked beautiful. The car even rolled!  One day my friend was not paying attention and crashed it into a brick wall. It wasn’t any good after that. It doesn’t matter how well something is designed and built if you don’t provide continued care.

 

Andy Massey is an Athletics Risk Consultant for Relation Insurance. His career in intercollegiate athletics spans three decades, including Director of Athletic Training at Tulane University (LA); head athletic trainer at Appalachian State University (NC), where he also taught in the Department of Health, Leisure, and Exercise Science; and head athletic trainer at Wofford College (SC). Andy now consults with intercollegiate athletic departments across the U.S. and also serves as an ATC Spotter for the NFL. Andy can be reached via email at [email protected] or on LinkedIn.

Click here to learn more about Relation’s insurance solutions and services for Intercollegiate Athletics.

 

We’re now officially in autumn, fall sports seasons are in full swing, and Halloween décor is already in stores. It’s also duck season, which I only know because my former college roommate is an avid duck hunter. He lives in Louisiana now and is excited that duck season opened there recently.

I don’t hunt, but I do spend a lot of time throughout the year tracking down best practices in athletic accident insurance. As such, I want to remind you that it’s that time again for open enrollment. Many company enrollments begin in October and healthcare.gov open enrollment begins November 1. Since athletes’ families may use this time to adjust their insurance plans, you should prepare for open enrollment’s impact on your athletic department’s excess insurance plan by monitoring changes in your athletes’ primary coverage.

The Importance of Primary Insurance Verification

Relation Insurance and its partners offer primary insurance verification services. Utilizing this service is an effective best practice to maximize the benefits of primary insurance and limit claims exposure to your excess insurance plan. If you do not currently verify primary insurance or are looking to implement a more robust system, contact your broker or insurance carrier to discuss implementation options

You likely already verified coverage and limits in the initial on-boarding process. However, it is important to plan to re-verify coverage at least two additional times each year. The first re-verification should occur sometime between the close of the open enrollment period on December 15 and the start of the spring semester. This process can help you understand open enrollment’s impact on your athletic program and catch changes that are not self-reported by your athletes and their families. Additionally, having a third verification in March/April gives you a robust process for the entire year and can help identify any changes in primary insurance that occurred during the spring, likely due to a qualifying event. Start your planning now to verify coverage after the marketplace open enrollment period ends on December 15, 2019.

 

Andy Massey is an Athletics Risk Consultant for Relation Insurance. His career in intercollegiate athletics spans three decades, including Director of Athletic Training at Tulane University (LA); head athletic trainer at Appalachian State University (NC), where he also taught in the Department of Health, Leisure, and Exercise Science; and head athletic trainer at Wofford College (SC). Andy now consults with intercollegiate athletic departments across the U.S. and also serves as an ATC Spotter for the NFL. Andy can be reached via email at [email protected] or on LinkedIn.

Click here to learn more about Relation’s insurance solutions and services for Intercollegiate Athletics.