Study: 52% of college programs follow medical model of care for student-athletes

June 26, 2019

A new survey of college and university athletic trainers shows that 51.7% of their collegiate-level sports programs follow the NCAA-legislated independent medical model of care. In addition, 76.3% of respondents feel they have medical autonomy — the unchallengeable authority to determine medical management of athletes.

The survey was conducted by the National Athletic Trainers’ Association’s (NATA) Intercollegiate Council for Sports Medicine (ICSM). Results were presented at a press briefing today during NATA’s 70th Clinical Symposia in Las Vegas.

NATA logoThe NCAA legislation for student-athletes is a model that ensures independent medical care by giving primary athletic health care providers — defined as team physicians and athletic trainers (ATs) — the autonomous authority to make decisions related to the health and safety of athletes without the influences of the athletic department, including coaches and other personnel. Autonomous authority is the cornerstone for independent medical care for student-athletes.

The survey also shows that 36.3% reported a coach influences the hiring or firing of sports medicine staff.

A subset of this group (30%), responded to a question subset directly related to receiving pressure from non-medical personnel on medical decisions. Of this subset, which represents 17.4% of the total survey response, almost three out of five collegiate athletic trainers (57.8%) reported receiving pressure from an administrator, coach or member of the coaching staff to make a decision that was not in the best interest of a student athlete’s health.

Of the 57.8% who reported receiving pressure, approximately the same percentage (58.7%) reported receiving pressure at least once a month; almost one in 10 reported receiving pressure at least once a week; more than one-quarter (28.9%) reported receiving pressure at least twice a month; and 2.6% reported receiving pressure daily.

“It is absolutely appropriate and expected for coaches as well as other relevant athletic personnel to ask questions. What is not acceptable is when the inquiry is laced with an expectation to influence, dictate, coerce or challenge the athletic trainer’s autonomous authority to make medical decisions in the sole interest of student athlete health and wellbeing,” said NATA President Tory Lindley, MA, ATC.

“While we believe that the pendulum is shifting in a positive direction, there is certainly more work to be done. NATA’s goal is to continue to advocate for and support NCAA delivery of care legislation. Student athletes and their parents should feel confident that decisions about health and safety are based solely on medical information and judgment and are not influenced by personnel who are not trained and experienced in that area,” Lindley added.

The results suggest that institutions evaluate their administrative structure to ensure the institutional line of medical authority is established according to NCAA’s Independent Medical Care for College Student-Athletes inter-association consensus statement and without influence.

“The survey indicates that there is also a need for programs to structurally and functionally infuse the independent medical model of care into their culture so that it remains, even if there are changes in leadership and/or staff,” said ICSM Chair Murphy Grant, MS, ATC, PES.

Additional Survey Findings

  • 30% reported that medical autonomy is affected by sport assignment, meaning some sports may allow more independent medical decision-making than others.
  • 18.7% reported a coach playing an athlete who had been deemed medically ineligible for participation.
  • 49.4% reported having no formal document that describes the model adopted by the school.

The survey was distributed via email to 9,223 athletic trainers who identify as working in the collegiate setting. A total of 1,796 responded, of which 1,419 completed all questions. The response rate (based on overall total response 1,796) was 19.5%. Forty-three percent of the respondents identified as working in Division I sports. The non-scientific survey was administered to evaluate the adoption and execution of the independent medical model of care.

To support the adoption and infusion of the NCAA’s independent medical model of care, NATA have conducted several regional lecture series and published member resources to help evaluate adherence and support transition to the independent medical model of care.

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