PRE-PARTICIPATION EXAMINATION

Most Pre-Participation Examinations are finalized when the Doctor checks the statement ☑☒ “Cleared to Play”. A Lesser number of Examinations end with ☑☒ Full & Unlimited Participation.

In either case the clearing an Athlete to Play or Participate must be qualified from this day forward.

☑☒ “Cleared to Play only during–Standard Care+Protection+Supervision.” should be the qualification. This provision should be printed (or stamped) above the Doctor’s signature on the Pre-Participation Examination Forms thereby qualifying approval to Participate in Sports after the Pre-Participation Examination only when Safety Standards are to be obeyed by the Coach and supervisor.

“On June 16, 2011 U.S. Surgeon General Regina Benjamin and members of the National Prevention Council released the first ever National Prevention Strategy at a news conference in Washington, D.C.”

“On June 10, 2010 President Obama signed an Executive Order creating the National Prevention, Health Promotion, and Public Health Council. The National Prevention Council, chaired by Surgeon General Regina Benjamin, is charged with providing coordination and leadership at the federal level and among all executive departments and agencies with respect to prevention, wellness and health promotion practices.”

“With input from the public and interested stakeholders, the National Prevention Council is charged with developing a National Prevention and Health Promotion Strategy (National Prevention Strategy).[HealthCare.gov]

After Private Sector Publilc Health Advocacy and input such as this post, U.S. Amateur Athlete Pre-Participation Examination Provisions can be recommended and enacted by congress as part of National Prevention Law by

• The Surgeon General, who directs the Office of the Surgeon General which is part of the Office of the Assistant Secretary for Health in the Office of the Secretary, The Office is in the U.S. Department of Health and Human Services.
• And The National Prevention Council.

The Surgeon General serves as America’s Doctor by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury. Dr. Regina M. Benjamin is the current Surgeon General. [U.S. Dept of Health and Human Services]

Doctors, including the Surgeon General, are in the center of the Comprehensive Model of Athlete Safety, Health, Care, Protection, Supervision and Human Rights and Treatment Compliance. Without Doctors, Sports would not continue to operate.

Until such time of legal enactment of this suggested change in policy, however, every Doctor who does Pre-Participation Examinations should have a self-inking rubber stamp made-up and used for Pre-Participation Examinations stateing ☑☒ “Cleared to Play only during–Standard Care+Protection+Supervision.”

DOCTORS CAN AND SHOULD TAKE CONTROL OF THE SPORTS PRE-PARTICIPATION EXAMINATION AUTHORIZATION WHEN ATHLETES ARE “CLEARED” TO PARTICIPATE

Doctors should only approve clearance for Athlete Sports Participation and Play with the Above stipulations and provisions.

Every Doctor who does examinations should have a self-inking rubber stamp made-up for Pre-Participation Examinations that says the above to be stamped above the Doctor signature,

Following Pre-Sports-Participation Physical Examinations currently, Doctors are routinely checking the box entitled “Cleared to Play” if the Athlete passes the examination. Doctors do not detail their clearance and approval to play.

The Doctor does not perform a Pre-Particpation Examination on the Coach for his/her Coaching Conduct and Methods. Coaching Dynamics might be dangerous and unknown by the Doctor, yet the Coach’s behavior is destined for the Athletes’ encounter.

Unbeknown Doctors clear athletes to participate in Sports potentially with both proper and unsafe playing and sports participation conditions. Unprotected, exposed, vulnerable Athlete Clearance and Approval to play by Doctors with routine form completion habits about Athletes participation in potentially harmful circumstances must cease.

What’s a school to do? Lauran Neergaard of the Associated Press provided one suggestion that University of Georgia Director of Sports Medicine Ron Courson called “the most important thing”:

“The American Heart Association recommends a thorough physical exam and detailed family and personal medical history for every athlete, but not an automatic EKG. The idea is to look for red flags—like fainting episodes, a heart murmur or whether a relative died young of a heart problem—that would prompt the doctor to order further cardiac testing.”

“There’s no doubt that a detailed medical history for all student-athletes should be schools’ logical, low-cost first step……after all, ensuring student-athlete safety should be schools’ highest priority in athletics.” [Trainers: States Dragging Feet on Student-Athlete Safety Laws, By Bryan Toporek April 6, 2011, Education Week]

Why would any meticulous Doctor do such a detailed examination and then toss the Athlete into Maltreatment and Harms Way? That wouldn’t make sense.

Child and Youth Sports Pre-Participation Examinations are analogous to the Doctor taking his or herChild or Youth’s car in for a Tune-Up.

The Doctor’s Child’s automobile is taken to the service department for Safety 1st and foremost, Child Care, Protection and Supervision before the car is driven any further.

The oil is changed, tires rotated, brakes checked and engine is tuned-up for the prevention of an engine blow-up, tire blow-out, brake loss, a wreck, serious damage, injury and/or death to the Child.

The Doctor doesn’t service his Child’s car with the intention of the Child entering a Demolition Derby, a damaging sport participation that has no rules, where cars are required to crash into another vehicle every 2 minutes, have required head-to-head hits at the close of the event and the last car running wins the sporting event. That is not the Doctor’s intention for the Child’s car check-up.

The automobile check-up, before the Child drives, is for safe driving and the prevention of Preventable, Not-Accidental Injuries and/or Deaths, where all authorities have implemented Standard Driving Protection, Supervision and Duty of Care on the road.

Accidents are guaranteed in a Demolition Derby. They are Not-Accidental. If the Doctor believed his Child would enter a Demolition Derby, after the automobile safety check-up, the Doctor would take-away the Keys.

The same attitude should be for Doctors, after a Pre-Participation Examination. The Doctor should take control, take-away the Cleared to Participate Key and NOT allow the Child or Youth Athlete to participate in Harmful Sports, if there is any indication that Athlete Safety Rules will not be strictly enforced by the Coach and/or other safe-keepers during Sports Participation.

What’s a Doctor to do? Well, let me tell you, “think outside the little box you check with your pen that says “Cleared to Play”.

☑☒ “Cleared to Play” Doesn’t mean the Child and Youth Athletes are worthiness, unprotected Gladiators, who after Doctor approval will be forced to perform in Dangerous Heat, Air Pollution, with Faulty Equipment, Over Exercise, Over Training, after Concussion, beyond Exhaustion and so forth with total Inhumanity and Cruelty.

After a thoroughly complete Pre-Participation Physical Examination, every Doctor should do their Duty and add to their physical examinations a clearance and approval provision, for their own and the Athletes protection, a proviso ink-stamped over the Doctor’s signature for clearance, until our Government mandates changes on the examinatin form:

☑☒ Cleared to Play only “during–Standard Care+Protection+Supervision.” applied with the self-inking pen.

Doctors should forbid the heretofore clearance of Limitless, Unrestricted Athlete Sports Participation where Coaches cross the line and Athletes are at Risks of being Pushed and Punished beyond their Physical and Emotional Limits and/or Sexually Abused, after the Doctor naively checked the box provided on the Pre-Participation form provided by the school, athletic association or other non-medical group.

Doctors must take Control of the Clearance and Approval of Child and Youth Athletes to Participate-in and Play Sports, just like they would protect, care-for and supervise their own child driving the car after a tune-up.

Control of the Clearance and Approval of Child and Youth Athletes to Participate-in and Play Sports is a Public Health Innovation by Doctors, as called for in 2005 by the Surgeon General to make Child Abuse a Priority in all venues and settings including the Sports.

So you ask, “Where is the Doctor’s Authority to make such a change in Sports’ Pre-Participation Examination policy by his ownmeans, method, device or instrumentality?”

Enactments of Law: Kentucky Revised Statutes, KRS 311.550 Definitions for KRS 311.530 to 311.620 and KRS 311.990(4) to (6). As used in KRS 311.530 to 311.620 and KRS 311.990(4) to (6):

The “practice of medicine or osteopathy” means the diagnosis, treatment, or correction of any and all human conditions, ailments, diseases, injuries, or infirmities BY ANY AND ALL MEANS, METHODS, DEVICES, OR INSTRUMENTALITIES.

• The Doctor has 2 primary Duties to Child and Youth Athletes in regard to the Pre-Participation Examination:

1. Implementation of the aforementioned proviso ink-stamped over the Doctor’s signature for clearance, until our Government mandates changes on the examinatin form:

☑☒ Cleared to Play only “during–Standard Care+Protection+Supervision.” applied with the self-inking pen.

• If the Doctor has any knowledge after a Forensic History during follow-up Examination about Dangerous, Harmful, Substandard Protection and Failed Athlete Safety during Sports Participation of an Athlete whom he has performed Pre-Participation examination and stipulated the participation conditions, the Doctor:

2. Report the suspected Maltreatments and Endangerments to the County Attorney and Child Protective Services (CPS) as Mandated by Child and Youth Protection Federal and State Laws
3. Assist the Forensic Investigation
4. Close-down the Sport until the investigation has been completed and Dangers entirely removed

• In accordance with State Law “The Practice of Medicine” for the “Correction of any and all human conditions, ailments, diseases, injuries, or infirmities BY ANY AND ALL MEANS, METHODS, DEVICES, OR INSTRUMENTALITIES.”

• In accordance with the Doctor’s duty to Public Health: “As well as seeking to improve population health through the implementation of specific population-level interventions, Public Health contributes to medical care by identifying and assessing population needs for health care services, including:
1. Assessing current services and evaluating whether they are meeting the objectives of the health care system
2. Ascertaining requirements as expressed by health professionals, the public and other stakeholders
3. Identifying the most appropriate interventions
4. Considering the effect on resources for proposed interventions and assessing their cost-effectiveness

Doctor, think Athlete Safety 1st! Do your Duty, If Danger lurks, Take the Keys!

References:
^ WHO Definition of Health Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, 1946
^ The Solid Facts: Social Determinants of Health edited by Richard Wilkinson and Michael Marmot, WHO, 2003
^ Brandt, A. M., and M. Gardner. 2000. Antagonism and Accommodation: Interpreting the Relationship Between Public Health and Medicine in the United States During the Twentieth Century. American Journal of Public Health 90:707 – 715

^ Gillam Stephen; Yates, Jan; Badrinath, Padmanabhan. Essential Public Health. Cambridge University Press 2007.
^ Pencheon, David; Guest, Charles; Melzer, David; Gray, JA Muir. Oxford Handbook of Public Health Practice. Oxford University Press 2001.
^ Smith, Sarah; Sinclair, Don; Raine, Rosalind; Reeves, Barnarby. Health Care Evaluation (Understanding Public Health). Open University Press 2006.
^ Sanderson, Colin; Gruen, Reinhold. Analytical Models for Decision Making (Understanding Public Health). Open University Press 2006.

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