TMA Testimony by Kim Monday, MD
Sunset Advisory Commission
TMA’s Preliminary Comments on University Interscholastic League Sunset Review
July 25, 2014
Good morning, my name is Dr. Kim Monday and I am a practicing neurologist from Houston. I am here today representing more than 47,000 physicians and medical students who are members of the Texas Medical Association. Many of TMA’s members are engaged with student athletes in communities across Texas. We give more sports pre-participation exams to more than 750,000 young athletes participating in the University Interscholastic League (UIL). We also serve on concussion oversight teams and volunteer as team physicians and at our local school events.
TMA is grateful for the opportunity to comment on sunset staff recommendations related to UIL. Only one recommendation relates to student athlete health, Item No. 4 on steroid testing.
We concur with sunset staff recommendations regarding steroid testing. TMA supports science and evidence-based testing and recommends a full review of current testing programs, such as the steroid testing initiative. The review should assess cost-benefit and scientific value as well as the depth of illegal steroid use in Texas athletes.
TMA applauds UIL for making student health and safety a priority. The organization has been proactive in addressing important health and safety concerns including head injuries, heat-related illness, and cardiac screening based on science. It places a priority on health and safety training for coaches. The organization has produced and distributed educational materials for athletes, their parents, and school personnel. The UIL website also provides important health and safety resources.
The emphasis on health and safety is due to the important role of the UIL Medical Advisory Committee. The committee’s review of the science and evidence in health topics is a key ingredient of sound policies to protect student athlete health and safety. We urge that makeup of the committee include physicians practicing medical specialties related to student athlete care, such as pediatrics, sports medicine, orthopedics, cardiology, and neurology. Each of these specialties brings valuable scientific and medical expertise to the committee’s recommendations.
Preparticipation Exam for Student Athletes. TMA is concerned the sunset staff chose to ignore a significant issue UIL has attempted to deal with relating to student preparticipation exams. UIL has been a leader in recognizing the emerging health and safety issues facing student athletes and has responded with relevant educational materials on cardiovascular disorders, concussion management, and other topics. We believe one of the foundational ways to address these health and safety concerns is through the required preparticipation exam for athletes. We support using the standard form reviewed by the UIL Medical Advisory Committee. These exams include thorough medical and family histories, physical exams, and opportunities for educating families and patients. The preparticipation exam provides a unique opportunity to deal with health concerns beyond providing medical clearance for sports participation. Physicians have the training and expertise to lead the exam, which may be the athlete’s only encounter with the health care system. That is why medicine remains concerned about allowing students to seek partial exams from chiropractors, who have little training to provide a comprehensive physical exam that includes cardiovascular and neurologic systems. We urge this committee to take steps to ensure each student has a full medical preparticipation exam.
Injury Surveillance. Finally, we also believe UIL is in a unique position to expand its role in protecting young athletes by placing greater emphasis on injury surveillance. We recommend dedicating additional resources to collecting aggregate data on injuries. We believe this information can better inform the UIL Medical Advisory Committee, the medical community, and policymakers. UIL could work with the Department of State Health Services and the Texas Education Agency on potential reporting avenues that could be expanded to include this data collection.
Madame chair and members, I thank you for your time and the opportunity to address the matter of student athlete health issues and the UIL. TMA stands ready to assist commission members in your deliberations on this and other agencies under your review. I would be happy to answer any questions at this time.
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