Sports Medicine Coverage for College Club Athletics Justin Mullner, MD 5.30.2018

Introduction Georgetown University Marymount University

Introduction

Marymount University 3,633 students Division III 2,373 undergraduate Capital Athletic Conference see a few patients and stay out of catie’s way

Georgetown University 17,849 students 7,636 undergraduate 750 varsity athletes (11m, 12w) 4 physicians 12 athletic trainers

Club Sports 1,050 total participants 18 men’s teams 16 women’s teams 1 physician 1 athletic trainer

Logistics Concussion Protocol Club Sports Manual Emergency Action Plan impact sway Club Sports Manual Emergency Action Plan Athletic Trainer CPR training Pre-participation Physical Exams Hoyalink SportsWare reign in some of the teams Hoyalink for waivers and forms, impact and now sway for concussion

Athletic Trainer Certified Athletic Trainer (ATC) 4 years undergraduate degree 2 years full-time master’s degree post-professional graduate assistant around 1000 hours of supervised clinical hours pre-requisites anatomy kinesiology exercise physiology nutrition

Club Sports Advisory Council 6 undergraduate students supervise the administration of club sports Program Coordinator Athletic Trainer DEMOC department of emergency management and operational continuity lawyer and one other shared staff member

Funding 1st two years, paid for through club sports general fund fund from club athlete dues + funding from school trial period As of summer 2016, ATC salary picked up by Center for Student Engagement

Services Provided injury prevention concussion awareness safety captains website / blog strength training access to student health health education services health education services

Club Sports Tier System developed after the first year tiers 1, 2, 3 Teams may apply for access to the athletic trainer at the beginning of the spring semester move between tier 2 and 3 after the first year, due to sheer numbers, a tier system was introduced

Tier System Tier 1: 145 total athletes ATC at home games Men’s Rugby (65) Women’s Rugby (30) Ice Hockey (25) Boxing (25) 145 total athletes ATC at home games ATC around for practices ATC available for rehab and treatments

Tier System Tier 2: 180 total athletes M Soccer W Soccer M Ultimate W Ultimate W Basketball Triathlon 180 total athletes These teams could request the Athletic Trainer at home games and would have access to treatment and referrals to the Sports Medicine physician, as well as other physicians. However, the Athletic Trainer would not attend practices. They can attend educational seminars. Teams would need to “opt-in” to the second tier by filling out a “responsibilities agreement” and providing practice/injury data.  

Tier System Tier 3: Badminton M Squash Fencing W Squash Swimming Golf Running Tennis Polo Equestrian Water Polo Rock Climbing Badminton Fencing Swimming M Basketball M Volleyball W Volleyball Baseball Softball W Lacrosse Field Hockey Figure Skating

Injury Prevention FIFA 11+ Women’s sports 50% reduction in injury drop vertical jump ACL Injury-Prevention Programs – JBJS 2013 ACL Injury-Prevention Training in Female Athletes – AJSM 2012 Impellizzeri FM, Bizzini M, Dvorak J, et al. Physiological and performance responses to the FIFA 11+ (part 2): a randomised controlled trial on the training effects. J Sports Sci 2013;31:1491–502. Physiological and performance responses to the FIFA 11+ (part 2)... J Sports Sci 2013;31:1491–502.

Concussion Preseason Talk Computerized Neurocognitive Testing Sway vs Impact vs Other centralized database athletes can run from their phones (apple or android) SCAT5 + BESS adding VOMS testing cost per athlete rather than per test

Athletic Trainer Increased productivity in sports medicine clinic 3-4 additional patients per 8 hour clinic day $200 – 1200 per day increase in collections 15-30% decrease in productivity when ATC removed ATC - $44,000 – 52,000 MA - $30,000 – 36,000 RN - $60,000 – 76,000 LPN - $40,000 – 50,000 conservative estimate ~ 36 weeks per year where student health clinic is busy – if you increase collections by $200 per day, you would make $36,000 extra. AJSM 2013 - Comparison of the Effect of Medical Assistants Versus Certified Athletic Trainers on Patient Volumes and Revenue Generation in a Sports Medicine Practice

Athletic Trainer Certified Athletic Trainer (ATC) 4 years undergraduate degree 2 years full-time master’s degree post-professional graduate assistant around 1000 hours of supervised clinical hours pre-requisites anatomy kinesiology exercise physiology nutrition

Challenges Bureaucracy Staff / Athlete ratio Budget Georgetown University and MedStar Health - both very large and very separate organizations Staff / Athlete ratio Budget Balance of competitiveness vs fun Buy-in (enforcement of policies) no authoritative coaches impressed with what Katharine has put together and what we have accomplished with this in a relatively short period of time. the hard work was done early on and it has been about smoothing out the wrinkles since then

Challenges

Goals development of the lecture series improved training room – in the works more robust injury prevention program FIFA 11+ research concussion injury prevention

Questions?? jam506@georgetown.edu