10 Principles to Guide Administration of Sports Medicine - Athletic Training Services

As part of the Inter-Association Consensus Statement on Best Practices for Sports Medicine Management for Secondary Schools and Colleges, and to guide school superintendents, secondary school athletic directors, college/university athletic department administrators, athletic trainers, and team/school physicians in delivering athlete-centered medicine, the task force has developed the following set of 10 principles to guide institutions and organizations in the assessment of existing administrative policies, procedures, and professional relationships.  Drawn from concepts addressed in standards of professional practice for physicians and athletic trainers and state medical practice guidelines, they provide as follows:

1. The physical and psychosocial welfare of the individual athlete must always be the highest priority of the athletic trainer and the team physician.
2. Any program that delivers athletic training services, including "outreach" services provided to secondary schools orother athletic organizations, must always have a designated medical director.
3. Sports medicine physicians and athletic trainers must always practice in a manner that integrates the best current research evidence within the preferences and values of each athlete.
4. The clinical responsibilities of an athletic trainer must always be performed in a manner that is consistent with the written or verbal instructions of a physician or standing orders and clinical management protocols that have been approved by a program's designated medical director.
5. Decisions that affect the current or future health status of an athlete who has an injury or illness must only be made by a properly credentialed health professional (e.g., a physician or an athletic trainer who has a physician's authorization to make the decision).
6. In every case that a physician has granted an athletic trainer the discretion to make decisions relating to an individual athlete's injury management or sports participation status, all aspects of the care process and changes in the athlete's disposition must be thoroughly documented.
7. To minimize the potential for occurrence of a catastrophic event or development of a disabling condition, coaches must not be allowed to impose demands that are inconsistent with guidelines and recommendations established by sports medicine-athletic training professional organizations.
8. An inherent conflict of interest exists when an athletic trainer's role delineation and employment status are primarily determined by coaches or athletic program administrators, which should be avoided through a formal administrative role for a physician who provides medical direction.
9. An athletic trainer's professional qualifications and performance evaluations must not be primarily judged by administrative personnel who lack healthcare expertise, particularly in the context of hiring, promotion, and termination decisions.
10. Universities, colleges, and secondary schools should adopt an administrative structure for delivery of integrated sports medicine and athletic training services to minimize the potential for any conflict of interests that could adversely affect the health and well-being of athletes.

Unfortunately, as this disturbing video reports, an increasing number of college athletic programs, particularly football, are ignoring this "separation of powers." 

Posted July 19, 2013; updated to include video, September 3, 2013