Minnesota Family Physicians Highlight the Real Reasons for a High School Sports Physical

Wednesday, July 17, 2002

‘This is stupid, there’s nothing wrong with me.’ Any physician who does pre-participation athletic exams has heard this greeting from one of their teenage patients. It’s often followed by the parent saying something like, ‘It has to be done to make sure you’re safe.’ Minnesota family physicians say both teen and parent are right… and they’re both wrong.

Common knowledge has been that the sports physical is done to make sure an athlete will not be at excess risk for injury and will not be one of those rare people who dies while participating in their sport. Until recent years, however, nobody had studied whether this was indeed true. To some doctors’ surprise, when sports physicals were finally researched, it was discovered that pre-participation physicals are not necessarily capable of uncovering many of the things that put athletes at risk for death or injury during competition.

“These findings actually caused some physicians to call for the abolishment of the sports physical,” said Glenn Nemec, M.D., a Monticello family physician and member of the Minnesota Academy of Family Physicians (MAFP). “They were in effect agreeing with their young patients that the physical was worthless so why waste everyone’s time.”

But Minnesota family doctors stress that’s only half the story. They believe there’s a reason sports physicals have not gone away. They believe a pre-participation exam can do much more than anyone ever thought it could.

Dr. Nemec says the first thing he does when a patient comes in for a physical is make a list of the things likely to kill or seriously damage the person. He says teenagers rarely have physical problems on the list, but they do have a list, and most of the things on it are preventable. “A doctor telling a teen to wear their seatbelt, to avoid the substance-using crowd, and to postpone sexual activity can be a powerful thing. Without the sports physical, I would never get a chance to help these kids prevent fatal and life-changing events.” Dr. Nemec said.

Preventive medicine and “sport-worthiness” are not the only components of the athletic physical. A section of the sports physical form asks several questions designed to alert the physician to those who may be at a higher risk for injuries, but the questions also screen for a number of common teen problems, including anorexia, bulimia, asthma, allergies, head injury and mononucleosis.

“I often make a diagnosis, of asthma, for example, by reviewing these questions. I am able to significantly affect that athlete’s performance and life by getting their condition under control,” Dr. Nemec added. “One of my partners even persuaded two young women to get treatment for anorexia as a result of reviewing those questions with them and their parents.”

The MAFP feels this underscores the importance of having a sports physical done by a physician or a trained practitioner who works with a physician. There are many other types of providers who advertise their ability to sign a form for an athlete, but family doctors say only physicians and those working with them have the medical training to deal with other problems that can be found.

“Just because an athlete thinks they are healthy, doesn’t mean something won’t be found. Non-medical providers are simply not trained to find and treat these other diagnoses,” Dr. Nemec said.

The bottom line – getting a sports physical does not guarantee an athlete will stay safe during competition, but having a sports physical performed by a family physician is the best way to guarantee comprehensive health evaluations for student athletes.

“The physical is needed to help keep students safe, not just from sports, but from life,” Dr. Nemec said. “That is not a useless thing.”

The Minnesota Academy of Family Physicians is a professional association of approximately 2,700 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, the largest medical specialty organization in the United States with more than 93,000 members.