Jan 29, 2015
Coming Together

Sometimes, the best way to improve sports medicine services is to bring physicians’ offices and treatment facilities right onto campus. Three innovative programs discuss the partnerships they’ve formed to do just that, and more.

By Abigail Funk

Abigail Funk is an Assistant Editor at Training & Conditioning. She can be reached at: [email protected]

Twenty minutes into a high school soccer game, one of your players rolls his ankle and falls to the ground in obvious pain. After you and an assistant coach help him off the field, you see that his ankle is extremely swollen and he can’t put any weight on it. You’re afraid he may have a broken bone.

Here’s where the story takes an unexpected turn. Instead of helping the athlete into the nearby ambulance for a trip to the emergency room, you help him onto a golf cart and drive two minutes to a nearby campus building, where you meet the team physician for further evaluation and an x-ray. The EMS crew remains at the game in case of another injury, the ambulance doesn’t have to be deployed, and the athlete’s parents don’t have to make a trip to the hospital.

While it may seem far-fetched to have almost instant access to an x-ray machine, a radiologist, and a physician right on campus, David Baker, Superintendent of the Springboro (Ohio) Community School District, fully expects a scenario like this one to play out at Springboro High School next school year. The district is working hard to finish a new campus building in which nearby Premier Health Partners’ Miami Valley Hospital has agreed to lease two floors for the next 22 years. In essence, Springboro will be bringing sports medicine services right to its student-athletes.

At the University of Northern Iowa, a similar partnership with several nearby medical groups put a state-of-the-art facility on campus and is benefiting Panther athletes immensely. And at Boise State University, the Idaho Sports Medicine Institute, located next door to the football field, has been helping the campus athletic training staff rehab student-athletes for the past 25 years. Through innovative sports medicine partnerships, these three schools are helping their athletes receive convenient access to the best possible care.

GOLDEN OPPORTUNITY

Springboro, like many high schools facing the tough economic climate, was having trouble securing money for its athletic program. Its football field was in desperate need of renovation, there were no coaches’ offices or a weightroom to speak of, and while community members were proud of the growing district’s academic prowess, they were frustrated with the sports teams’ lack of success.

Nearby Miami Valley Hospital (MVH), which already provided Springboro with athletic training coverage for a minimal fee, knew the area was rapidly growing–the district welcomes over 200 new students each year–and wanted a stronger presence in the Springboro community. So a deal was struck.

In exchange for naming rights, MVH paid for a brand new synthetic turf field and other stadium improvements. Then, as part of Springboro’s plan to construct a 40,000 square-foot building on campus with new locker rooms and a weightroom on the first floor, MVH signed a 22-year lease for the top two floors. The hospital will bring in its sports medicine physicians and the latest treatment and rehab equipment, and plans to sublease some of the space to a local family medicine practice and other specialists, like an orthodontist or dermatologist.

All of Springboro’s students, faculty, staff, and community members will have access to services in the new campus building, which should be completed by the start of school this fall. And the athletic trainers who provide coverage at Springboro will be able to work closely with other healthcare professionals in the building.

“Here’s a way that we can provide medical services to the athletes, students, and the rest of the community right at the school,” says Tom Daskalakis, Vice President for Business Development at MVH. “They won’t have to drive to the hospital for our services thanks to this partnership. It truly is a win-win relationship.”

The lease is structured so that after 22 years, MVH will have paid for the cost of construction, and whatever lease money Springboro brings in after that is essentially profit. “For Miami Valley Hospital, there are no development costs, just the lease payment,” Baker says. “The hospital writes us a check and we use that money to pay back the building loan. In the end, it costs the school district nothing.”

For MVH, there was no better way to become ingrained in the Springboro community. “The physicians who occupy the new building will be forever linked to the school, and we expect positive relationships to form over time,” Daskalakis says. “We’re building trust and goodwill with the school and community. Not only are we developing partnerships that benefit us as healthcare providers, but we are also promoting health education and creating an interest in healthcare careers among students.”

Baker hopes that a family practice will sublease space from MVH soon. “With a general practice in the building, instead of parents having to pull their kids out of school for a doctor’s appointment downtown, the kids can just walk across the street to the medical building and not lose as much time from class,” he says.

As Springboro gets ready to open the doors of the new building, Baker is fielding a lot of calls from other school districts interested in learning more about the partnership. “We presented this concept at our state school boards convention, and all of a sudden I had people asking, ‘How can we do something like this?'” he says. “A group of superintendents from Marion, Ohio, came to look at the building, and another school district is seriously thinking about doing this exact same thing. I think this is the future for high school athletics and sports medicine.”

COMMON INTEREST

When the University of Northern Iowa’s Human Performance Center opened last May, it wasn’t just the UNI community that was smiling. Several area medical groups, a U.S. Senator, and even a team of federal grant workers in Washington, D.C., all felt a sense of accomplishment. They had come together to build a state-of-the-art sports medicine facility that is benefiting thousands of people, both on and off the UNI campus.

The $7.8 million, 50,000 square-foot building houses the athletic training education program and the Sports and Performance Center on the first floor, and the Davis Center for Healthy Youth Development upstairs. The first floor caters to Panther athletes, other UNI students, faculty, staff, and community members, providing healthcare services like x-ray, MRI, and hydrotherapy, in addition to substantial classroom and research space. The second floor is geared toward youth health and safety, and houses groups like UNI’s Camp Adventure Youth Services.

“We’ve built a pretty unique complex,” says Gil Irey, Chief Executive Officer of Cedar Valley Medical Specialists, which oversees much of the ground floor. “We have UNI’s team physician, who is our own orthopedic surgeon, and a physical therapy department that sees 45 to 50 patients a day. There’s also full-service diagnostic imaging that does 10 to 12 MRIs a day. There really is a little of everything.”

Years ago, discussions about a one-stop healthcare center on UNI’s campus began. Richard “Biff” Williams, PhD, LAT, ATC, then the Athletic Training Program Director, approached Cedar Valley Medical Specialists about constructing a building together. Irey loved the idea, especially since Cedar Valley was just then looking for office space near UNI.

“It was perfect timing,” Irey says. “We had already been working with UNI on a sports acceleration program for their athletes, so it was a natural partnership. We could even design the building together.”

Cedar Valley Medical Specialists brought local Allen Hospital on board, and together, the two entities raised enough capital to outfit the space with new rehab equipment. For the building itself, UNI began fundraising in 2001, with a jumpstart $500,000 donation from a local philanthropist. State Representative Jim Nussle and U.S. Senator Tom Harkin also took special interest, helping secure a federal grant of $1.8 million.

With so many groups sharing one building, collaboration is frequent and student-athletes are reaping the benefits. “It has made life a lot easier for my staff here on campus,” says Don Bishop, MA, LAT, ATC, Head Athletic Trainer and Director of Athletic Training Services at UNI. “Having our team orthopedic surgeon right across the hall is a huge advantage. If an athlete comes into the athletic training room and has a problem we want the orthopedic surgeon to see, they just walk on over for an x-ray, MRI, or whatever else they need.

“The physical therapy clinic is right across the hall, too,” Bishop continues. “Our physical therapist used to be here only in the morning. Now we have access to him full-time, which is especially helpful for long-term and specialty rehabs. The situation has really enhanced our entire sports medicine team.”

The new facility also includes a hydrotherapy rehab area, which had been a dream of UNI’s athletic training staff for years. “Now we have a hydrotherapy pool and hot and cold plunge tanks,” Bishop says. “We have a hydraulic floor with a treadmill, cameras, and jets. It’s as state-of-the-art as you can get, and something we couldn’t have afforded on our own.”

The Human Performance Center isn’t just a plus for the athletes and other patients who use it. UNI athletic training students have seen their clinical horizons expanded dramatically through the partnerships with Cedar Valley Medical Specialists and Allen Hospital.

“Our grad students work as high school athletic trainers through graduate assistantships with our partners,” Bishop says. “Their off-campus locations also serve as clinical sites for our undergrads. Our relationships with the different constituents have really blossomed into many positive opportunities for our campus.”

PRACTICE MAKES PERFECT

For a tried and true example of a successful partnership between a school and an outside medical practice, look no further than Boise State and the Idaho Sports Medicine Institute (ISMI). ISMI employees and the Boise State athletic training and strength and conditioning staffs have been teaming up to provide outstanding sports medicine services to Bronco athletes since 1984.

“We all work together here,” says Korene Mayo, LAT, ATC, Athletic Trainer at the ISMI. “Ultimately, it comes down to this: How are we going to get these athletes the best care and get them back onto the field or court as quickly and safely as possible? We have a great concept here on campus, and the athletes definitely benefit from it.”

Though the ISMI–which also sees private non-student patients–has been working with Boise State athletes since its inception, it was located off campus for its first four years of existence. Founder George Wade, MD, a physician at the ISMI, says it took a forward-thinking athletic director and university president to invite his practice onto campus.

“The president was very interested in athletics, so that was a big help,” he says. “And because our setup has been this way for so long, everyone in the different departments–athletic trainers, strength and conditioning coaches, and us at the ISMI–gets along very well. It’s a total team approach.”

The ISMI staff includes five orthopedic surgeons, a sports medicine doctor, a family medicine doctor, an athletic trainer, four physical therapists (two of whom are also athletic trainers), and an exercise physiologist. Having them all work in concert with the Boise State athletic training staff requires clear communication, something the parties involved have learned through experience.

“There are a few things we do to make sure we’re all on the same page,” Mayo says. “Once a week, I meet with Boise State’s head athletic trainer and strength and conditioning coach and we review all the athletes who are doing rehab at the ISMI. When there isn’t great communication among everybody involved in an athlete’s care, their recovery isn’t as smooth and successful as it could be.”

The ISMI is located next to the football field in Bronco Stadium, and the convenience of its location has been one of its greatest advantages. “If the physical therapist, one of Boise State’s athletic trainers, or anyone else has a question about a rehabbing athlete, we all have direct access to the physician,” Mayo says. “There’s an immediate answer to our inquiry.

“This setup has also improved our compliance rate,” Mayo continues. “It’s much easier for the athletes to follow their rehab instructions when they know we’re checking up on them through the athletic trainers and strength coaches.”

Most often, Boise State athletes seen at the ISMI have recently undergone surgery. Once the ISMI professionals feel an athlete is ready for sport-specific exercises and drills, they connect with the school’s athletic trainers and strength and conditioning coaches next door. But the information flows in both directions.

“Our physicians make regular training room visits,” Mayo says. “If a Boise State athletic trainer has an athlete who isn’t progressing after an ankle sprain and the athletic trainer isn’t sure what to do, they can have a physician evaluate the ankle. From there, if something else is wrong–maybe the athlete needs x-rays–we have x-ray capabilities right on site, so that’s immediately taken care of.”

Though athletes don’t have to travel far for an ISMI visit, its location does pose one unique challenge. “We have to close early when there are home contests during the week,” Wade says. “For example, the Humanitarian Bowl was here on a Tuesday, so we couldn’t see our usual patients that day.”

ISMI doctors and rehab specialists care for local community members as well, or “weekend warriors” as Mayo and Wade call them. And of course, Boise State athletes are free to go off campus to another orthopedic surgeon or sports medicine specialist if they choose, though it’s a rare occurrence.

“We have an understanding with the university that we will make sure an athlete gets back to good health, even if insurance stops covering their care,” Mayo says. “We don’t just dump them. But that means we have to work very closely with the athletic trainers next door, so when it’s time to return to play, that athlete has a smooth transition. Communication really is the key to a better recovery.”

While it’s clear to the Boise State athletic training staff and ISMI employees that the ISMI is a private group, Wade says he has always felt a part of Boise State. “I like that I can see the athletes outside the office,” he says. “It’s nice to say hi to people walking around campus, and I think it makes us feel more like family.”

Boise State athletes are not the only students who benefit from the ISMI’s proximity. The school’s biomechanics lab and kinesiology department have also formed partnerships with ISMI doctors interested in research projects. “There are countless learning opportunities,” Wade says. “We have athletic training students and physical therapy students rotate through. Right now, some biomechanics students are using our facility for a study on turf and shoes.”

Mayo says she’s seeing more and more schools interested in partnerships similar to Boise State’s with the ISMI. “It’s not uncommon for outside physicians to come by with athletic trainers to see how we operate,” she says. “I won’t be surprised when facilities like ours start popping up all over the place.


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