Intended Consequences Lead to Unintended Issues: NCAA Settlement

Sure the lede looks backwards, but the overwhelming point, in my opinion, of the NCAA recent settlement on concussions has to deal with my profession of athletic training.  The issue is athletic trainers; the need for more of them and what happens if you cannot find them or afford them?

Don’t get me wrong, the fact that attention is being paid to the need for athletic trainers — although the wording does not explicitly name our profession, rather “medical professional” — is tremendous and often overlooked.  Sure, you can have a doctor on the sidelines, but what is their cost?  Perhaps there are some semantics that would allow other medical professionals to be in attendance, but what would be their experience, education and knowledge about concussions?  And how cost/time effective would it be to have another “medical professional” that didn’t have the ability to assess, treat, manage, and rehab other injuries that occur on a sporting field?

In other words, this is an awesome advertisement and endorsement for athletic training.

But there is an issue, as stated in the Chronicle of Higher Education;

Colleges have their own concerns about the settlement, including a requirement that they have a medical professional on the sidelines for every practice and game in the highest-contact sports: basketball, field hockey, football, ice hockey, lacrosse, soccer, and wrestling.

While many big athletics programs already provide such coverage, lower-level NCAA institutions will be hard-pressed to afford it, several athletics officials said.

The requirement could lead colleges to use graduate assistants or others with little medical training, or to cut sports altogether over fears of liability.

“I’m worried about the financial fallout from this, and how it will impact Division II and Division III, and how it’s enforced,” said Tim Kelly, head athletic trainer at the U.S. Military Academy and a former member of the NCAA’s Football Rules Committee. “I’ve always wondered, Do too many schools provide too many sports at a level that’s not effective?”

If you have spent time in the “lower levels” of NCAA sports or even the NAIA you would note the very understaffed sports medicine team compared to the “big boys”.  This is no fault of the fine institutions, rather an economic issue.  From personal experience I can tell you that being a head athletic trainer at a DII school pays less than being in the private sector, say an athletic trainer for a hospital/provider that outsources you to schools.  Often, if they are State funded schools there is a cap on salary, even for the best/highly qualified athletic trainer there is no bump in starting salary.

In my region we are starting to see Universities and Colleges outsourcing their athletic training duties to such providers.  The institutions can create a contract to offset the cost of the staffing with advertisements and exposure for the providers.  Leaving the salary and benefits up to the provider.  This may be the model we are heading toward.

In all honesty, it may be the best for the times.  If an athletic trainer is being paid by someone other than the institution there would be less control by a coach.  Unless, there is pressure of losing a contract if a sports med staffer didn’t cave to a very powerful coach.  However, the chances of this happening in small towns, with limited provider partnerships would allow for more autonomy for the athletic trainer and staff.

Regardless of the pending approval this is a good time to recognize the absolute need for athletic trainers at all levels.  Not just DI or DII or even DIII; all the way down to the youth level.  But there will be a price to pay for the need and support.  It may be uncomfortable for the wallet but it will be much more comfortable when injury does occur, with someone highly trained there to take care of it.

Schools will now have to make such difficult decisions in regards to medical coverage (although I have not seen a mechanism for enforcement yet).  Its time to think outside the box and find a way to get more athletic trainers out on the field, where we belong!

4 thoughts on “Intended Consequences Lead to Unintended Issues: NCAA Settlement

  1. Paul Cuetara August 2, 2014 / 21:48

    As one of the “group” with many concussions ice skating, hockey, HS football and two in one day that ended my college football career.
    As an active adult I continued my participation in sports as an official.
    Over the last more than 40 years I have observed, and received various related injuries. Through the conversation regarding concussions we are leaving out an a whole “group”.
    I am referring to amateur officials. It is my experience that during an average season a high school of college umpire will take as many as 6 hits on the mask. These are often enough to put you on your knees.
    Equipment has improved and manages to provide a margin of safety. But many hits that are a concussion. the only device I have found that offers real protection is the recently developed helmet. My Wilson is designed with no flat surfaces that dissipate the impact.
    Rules makers at both the high school and college levels need to make this a priority.
    We need to make this part of the process so that rules makers and equipment companies will protect this “neglected” segment of our games.
    Paul Cuetara, North Hampton, NH

  2. vliberi August 4, 2014 / 16:00

    I am not a fan of privatization. Also, the thought of having two bosses and many debates over who is responsible for what has created conflict from my 20+ years of observation and experience. Being an employee in the environment you work also has intangible benefits. I also believe just about all institution of higher learning DO have the funds to provide adequate comprehensive healthcare. I am adamantly in favor of the medical, not athletic model of athletic healthcare and there are examples of this currently in NCAA athletics. However, Paul makes a very good and valid argument. With quality cooperation among the stakeholders in the outreach environment, this medical model is perhaps effective at minimum, at least on paper. Good job Paul.

  3. Tom August 4, 2014 / 16:32

    I think this is going to be very problematic for athletic trainers and/or lead to cuts in sports – particularly men’s sports. My personal example from working in DIII – the large public university had 18 sports, but >50% were low risk (e.g., fencing, tennis, and similar); however, we did have wrestling. The problem with this scenario is that I would have had 4 “high-risk” concussion sports which required practice going on at 4 different locations during the Fall/Winter overlap (MSoc, MBB, WBB, Wr). There is zero chance this institution would ever been in a financial position to hire 4 FT ATCs as there were no FT coach-only positions – so yes, this is the very small time DIII. What options does the AD have;
    1. Hire 4 FT ATCs (great, but not going to happen in the real world)
    2. Hire hourly/contract ATCs (best possible solution?)
    3. Cut sports. This will most likely be men’s sports since most institutions would be very hard pressed to cut women’s sports under Title IX. This isn’t going to be MBB or FB, since those are the “profile” sports even at small schools. This could/would be the final blow to wrestling as an NCAA sports.
    4. Blatantly violate NCAA rules and just not do it? Serious liability issue, but we’ve probably all seen senior administrators make myopic decisions.
    4.Extend the day (most likely solution?). Considering my previous scenario, the easiest and cheapest solution (from an AD’s perspective) is to simply tell the BB’s they have to practice at opposite times – thus, rather than 2 teams practicing in 2 gym’s from 4-6, now it will be 4-6 and 6-8pm. Now the workday just got 2 hours longer. Not enough gym space, fine – practice in the morning (6-8am) before classes.

    [start rant] Of course I support more ATC’s and more AT coverage for all sports, but we need to live in the real world where that simply isn’t going to happen. Ask college faculty about what’s happened to their class sizes and salaries in the last half decade, they’ve gone in opposite directions in many/most cases. Sure, somehow (despite state required hiring/salary freezes) senior administrators seem to manage to continue to get raises and add administrative staff, but there is little to no evidence this is going to trickle down to the lowly athletic trainer. This doesn’t even begin to address the annual tuition increases and increased reliance on contingent faculty…. Sure, maybe there is money at the institution for the President to take a 2 week trip to China or a Dean to refurnish their office, but that doesn’t mean ATs are going to see any of it (if you want a good example of Presidential abuse, look up the recently “retired” President of Westfield State University). [end rant]

    There are, of course, many other aspects to this discussion (Availability of ATs to fill these roles, NATA Vision Quest 2020, CAATE move to ELM, NCAA “shall” vs “should”,), but I actually see this as very problematic for many AT’s if this settlement is approved and enacted.

  4. Scott L. Bruce August 5, 2014 / 11:47

    Schools can cry that they lack the money to have a certified athletic trainer on the sidelines for their high risk sports, but the bottom line is that should they face litigation, the courts are not going to accept financial constraints as a viable reason for not having the appropriate coverage. The fact is that if a school or organization cannot “afford” to have the appropriate medical coverage for their sport then they should really think twice (or three, or four, or five or . . . times) about sponsoring that sport or activity. They provide other amenities to surrounding the sport to aid in recruiting, etc., but yet they will not have a certified athletic trainer assigned to the sport. Doesn’t make sense to me, but then again as a certified athletic trainer I have a tainted or slanted view toward the topic.

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