NATA Issues New Guidelines

The NATA issues long-researched guidelines on appropriate medical coverage.

By Staff

Athletic Management, 12.5, August/September 2000,

Intercollegiate sports has seen a boom in participation levels during recent years, but the level of sports medicine coverage hasn’t kept pace with the increase. That’s the word from the National Athletic Trainers’ Association (NATA), which has been studying this trend.
“In the last 10 years, college sports have flourished, with athletes required to train and compete year-round rather than seasonally,” said Denny Miller, Head Athletic Trainer at Purdue University, in an NATA press release. “More women are participating, more sports are being offered, and more colleges are getting into the game. At the same time, athletes are getting bigger, stronger and more physical—which leads to a greater risk of injury.”
To help remedy that situation, the NATA has issued a set of new guidelines to help colleges and universities determine the amount of medical care needed to keep players safe. “The guidelines we’ve developed simply offer colleges a way to see that their healthcare keeps pace with their athletics program,” said Miller, who chaired the task force that developed the guidelines. “The recommendations are designed to make sure student-athletes get appropriate care.”
The guidelines use a point system, with each point dubbed a healthcare unit (HCU). Each sport is initially examined for its injury rate, catastrophic injury rate, and treatments per injury rate, and assigned a base healthcare unit ranging from one to four.
The system then looks at five other factors: the team’s out of season or nontraditional practice time, squad size, amount of time athletic trainers travel with the team, amount of administrative work athletic trainers are also completing, and other factors (such as the distance from the campus to the hospital). These five factors then adjust the base HCU. For example, a football team with 100 players and spring practice, would usually have a very high adjusted HCU, but a tennis team competing only in the spring would have a low adjusted HCU.
HCUs for all sports are then added together to determine the minimum number of qualified personnel needed for adequate medical coverage of all intercollegiate sports at the specific college or university. The guidelines recommend that one athletic trainer should not be responsible for more than 12 HCUs.
“We hope the NCAA, NAIA, and NJCAA will embrace this formula and the recommendations because only these organizations or an individual conference can mandate this,” Miller said.
The guidelines also protect institutions in today’s litigious climate, said Dale Rudd, Head Athletic Trainer at Stanford University, who devised the formula. “By using this tool to evaluate their situation, universities will have a better sense of their athletic healthcare needs,” Rudd said. “This, in turn, will help them avoid the repercussions of poor healthcare such as athletes going unrehabilitated or slipping through the cracks—or worse yet, an injury occurring when no qualified person is available to provide care.”
Thus far, the guidelines have received mixed responses from various quarters. “From people who are in the business—that is, athletic trainers—we’re getting overwhelming support,” Miller says. “The physicians’ community understands what we’re trying to get at—that the healthcare needs of the intercollegiate athlete are not being met—so they’re interested in seeing how this is going to affect that area in the future.
“From administrators, we’re getting a real cautious, ‘explain it to me’ reaction, with some obvious concerns,” Miller continues. “We’ve had one conference look at it and say they disagree with it, and we’ve had another conference that forwarded it to their individual schools to evaluate themselves and report back in a year.
“There’s a concern that this might be viewed as a mandatory thing. But our [legal] counsel suggests to us that a university would be wise if they looked at it and used it as something to gauge their healthcare. It is a very flexible document that can be tailored to each school’s situation. If a college, according to our legal advice, were to look at the guidelines and say, ‘This is where we are, what our budget allows us to do, and we’ve acknowledged that here are some guidelines,’ then they’d be far better off in a courtroom situation than if they didn’t pay attention at all.
“Of course, they’re worried about the possible legal implications of it. But in reality, the liable situation is already there—people don’t initiate litigation unless an injury occurs. So once it occurs, the possibility of litigation is there anyway. This really should be used by schools as a defense.”
Miller is optimistic that the guidelines will ultimately have a positive effect on for the healthcare of intercollegiate athletes. “The bottom line is that, as an association, we feel this is the only thing out there that is based on as much scientific data currently available and the professional consensus of the people providing the health care as to what such general guidelines should be,” he says. “We’re hoping that universities and colleges will look at it, and say, ‘Here’s how we measure up. Let’s start to implement a plan over the next few years based on what we can afford and what sort of sports program we want to have.’ We hope they look at it from a proactive viewpoint.”
A complete version of the “Recommendations and Guidelines for Appropriate Medical Coverage of Intercollegiate Athletics,” is available at .